NAMS MENOPAUSE CERTIFICATION
EXAM MOCK TEST 2026/2027
QUESTIONS AND ANSWERS
1. According to the STRAW+10 criteria, what characterizes the ‘Late Menopausal Transition’
(Stage -1)?
A. Variable cycle length with a difference of 7 or more days between cycles
B. Permanent cessation of menses for 12 months
C. Fluctuating FSH levels with no change in cycle regularity
D. Occurrence of amenorrhea for 60 days or more
Answer: D
Conceptual Explanation: Stage -1 (Late Menopausal Transition) is characterized by the
occurrence of amenorrhea lasting 60 days or more, whereas Stage -2 (Early Transition) is
defined by variable cycle lengths differing by 7+ days.
2. Which mechanism best explains the action of Fezolinetant (Veozah) in treating vasomotor
symptoms?
A. Agonism of the serotonin 2A receptor
B. Modulation of the GABA-A receptor complex
,C. Antagonism of the neurokinin 3 (NK3) receptor
D. Inhibition of norepinephrine reuptake
Answer: C
Conceptual Explanation: Fezolinetant is a selective neurokinin 3 (NK3) receptor
antagonist that blocks the binding of neurokinin B on KNDy neurons, which regulate the
thermoregulatory center in the hypothalamus.
3. In the Women’s Health Initiative (WHI), what was the observed effect of Estrogen-only
therapy on breast cancer risk in women with a prior hysterectomy after a long-term follow-
up?
A. A significant increase in invasive breast cancer risk
B. No significant change in breast cancer risk
C. A significant decrease in invasive breast cancer risk
D. Increased risk only when combined with obesity
Answer: C
Conceptual Explanation: Long-term follow-up of the WHI Estrogen-alone trial (CEE only)
showed a statistically significant reduction in the risk of developing invasive breast cancer
and a reduction in breast cancer mortality.
, 4. Which progestogen is associated with the lowest risk of venous thromboembolism (VTE)
and breast cancer when combined with estrogen?
A. Medroxyprogesterone acetate (MPA)
B. Norethindrone acetate
C. Levonorgestrel
D. Micronized progesterone
Answer: D
Conceptual Explanation: Observational studies, such as the E3N study, suggest that
micronized progesterone has a more favorable safety profile regarding VTE and breast
cancer risk compared to synthetic progestins like MPA.
5. A 52-year-old woman with an intact uterus presents with severe hot flashes and a history
of deep vein thrombosis (DVT). Which is the most appropriate next step?
A. Low-dose oral conjugated equine estrogens
B. Fezolinetant or a non-hormonal SSRI/SNRI
C. Transdermal estradiol patch
D. Oral estradiol combined with micronized progesterone
Answer: B
EXAM MOCK TEST 2026/2027
QUESTIONS AND ANSWERS
1. According to the STRAW+10 criteria, what characterizes the ‘Late Menopausal Transition’
(Stage -1)?
A. Variable cycle length with a difference of 7 or more days between cycles
B. Permanent cessation of menses for 12 months
C. Fluctuating FSH levels with no change in cycle regularity
D. Occurrence of amenorrhea for 60 days or more
Answer: D
Conceptual Explanation: Stage -1 (Late Menopausal Transition) is characterized by the
occurrence of amenorrhea lasting 60 days or more, whereas Stage -2 (Early Transition) is
defined by variable cycle lengths differing by 7+ days.
2. Which mechanism best explains the action of Fezolinetant (Veozah) in treating vasomotor
symptoms?
A. Agonism of the serotonin 2A receptor
B. Modulation of the GABA-A receptor complex
,C. Antagonism of the neurokinin 3 (NK3) receptor
D. Inhibition of norepinephrine reuptake
Answer: C
Conceptual Explanation: Fezolinetant is a selective neurokinin 3 (NK3) receptor
antagonist that blocks the binding of neurokinin B on KNDy neurons, which regulate the
thermoregulatory center in the hypothalamus.
3. In the Women’s Health Initiative (WHI), what was the observed effect of Estrogen-only
therapy on breast cancer risk in women with a prior hysterectomy after a long-term follow-
up?
A. A significant increase in invasive breast cancer risk
B. No significant change in breast cancer risk
C. A significant decrease in invasive breast cancer risk
D. Increased risk only when combined with obesity
Answer: C
Conceptual Explanation: Long-term follow-up of the WHI Estrogen-alone trial (CEE only)
showed a statistically significant reduction in the risk of developing invasive breast cancer
and a reduction in breast cancer mortality.
, 4. Which progestogen is associated with the lowest risk of venous thromboembolism (VTE)
and breast cancer when combined with estrogen?
A. Medroxyprogesterone acetate (MPA)
B. Norethindrone acetate
C. Levonorgestrel
D. Micronized progesterone
Answer: D
Conceptual Explanation: Observational studies, such as the E3N study, suggest that
micronized progesterone has a more favorable safety profile regarding VTE and breast
cancer risk compared to synthetic progestins like MPA.
5. A 52-year-old woman with an intact uterus presents with severe hot flashes and a history
of deep vein thrombosis (DVT). Which is the most appropriate next step?
A. Low-dose oral conjugated equine estrogens
B. Fezolinetant or a non-hormonal SSRI/SNRI
C. Transdermal estradiol patch
D. Oral estradiol combined with micronized progesterone
Answer: B
