NAMS MENOPAUSE CERTIFICATION
COMPREHENSIVE EXAM PREP
QUESTIONS AND ANSWERS
1. According to the STRAW+10 staging system, which characteristic defines the ‘Late
Menopausal Transition’ (Stage -1)?
A. Variable cycle length with a difference of 7 or more days in consecutive cycles
B. Absence of vasomotor symptoms
C. Follicle-stimulating hormone (FSH) levels consistently below 25 IU/L
D. Interval of amenorrhea lasting 60 days or longer
Answer: D
Conceptual Explanation: The Late Menopausal Transition (Stage -1) is characterized by
an interval of amenorrhea of 60 days or longer, whereas the Early Menopausal Transition
(Stage -2) is defined by variable cycle lengths with a difference of 7 or more days.
,2. Which statement regarding the ‘Timing Hypothesis’ for hormone therapy (HT) and
cardiovascular disease is most accurate?
A. Initiating HT within 10 years of menopause or before age 60 is associated with reduced
CHD risk
B. HT is most beneficial for cardiovascular health when initiated 20 years after menopause
C. HT increases cardiovascular risk regardless of the time since menopause onset
D. Transdermal estrogen is contraindicated in women within 5 years of menopause
Answer: A
Conceptual Explanation: The Timing Hypothesis suggests that HT has a favorable effect
on the cardiovascular system when started close to the onset of menopause (within 10
years or before age 60) but may be neutral or harmful if started later.
3. What is the primary mechanism of action for Fezolinetant in treating vasomotor
symptoms?
A. Agonist at the Serotonin 2A receptor
B. Inhibition of the reuptake of norepinephrine
C. Antagonism of the neurokinin 3 (NK3) receptor
D. Selective modulation of estrogen receptors in the hypothalamus
Answer: C
, Conceptual Explanation: Fezolinetant is a non-hormonal neurokinin 3 (NK3) receptor
antagonist that blocks the binding of neurokinin B on KNDy neurons, which helps regulate
the thermoregulatory center in the hypothalamus.
4. In the Women’s Health Initiative (WHI), the Estrogen-plus-Progestin (EPT) arm was stopped
early due to an increased risk of which condition?
A. Colorectal cancer
B. Breast cancer
C. Hip fractures
D. Endometrial cancer
Answer: B
Conceptual Explanation: The WHI EPT arm (Conjugated Equine Estrogen plus
Medroxyprogesterone Acetate) was stopped in 2002 because the health risks, specifically
an increased risk of invasive breast cancer and cardiovascular events, exceeded the
benefits.
5. Which of the following is an absolute contraindication for systemic hormone therapy?
A. Controlled hypertension
B. History of cigarette smoking
C. Unexplained vaginal bleeding
D. Type 2 Diabetes mellitus
COMPREHENSIVE EXAM PREP
QUESTIONS AND ANSWERS
1. According to the STRAW+10 staging system, which characteristic defines the ‘Late
Menopausal Transition’ (Stage -1)?
A. Variable cycle length with a difference of 7 or more days in consecutive cycles
B. Absence of vasomotor symptoms
C. Follicle-stimulating hormone (FSH) levels consistently below 25 IU/L
D. Interval of amenorrhea lasting 60 days or longer
Answer: D
Conceptual Explanation: The Late Menopausal Transition (Stage -1) is characterized by
an interval of amenorrhea of 60 days or longer, whereas the Early Menopausal Transition
(Stage -2) is defined by variable cycle lengths with a difference of 7 or more days.
,2. Which statement regarding the ‘Timing Hypothesis’ for hormone therapy (HT) and
cardiovascular disease is most accurate?
A. Initiating HT within 10 years of menopause or before age 60 is associated with reduced
CHD risk
B. HT is most beneficial for cardiovascular health when initiated 20 years after menopause
C. HT increases cardiovascular risk regardless of the time since menopause onset
D. Transdermal estrogen is contraindicated in women within 5 years of menopause
Answer: A
Conceptual Explanation: The Timing Hypothesis suggests that HT has a favorable effect
on the cardiovascular system when started close to the onset of menopause (within 10
years or before age 60) but may be neutral or harmful if started later.
3. What is the primary mechanism of action for Fezolinetant in treating vasomotor
symptoms?
A. Agonist at the Serotonin 2A receptor
B. Inhibition of the reuptake of norepinephrine
C. Antagonism of the neurokinin 3 (NK3) receptor
D. Selective modulation of estrogen receptors in the hypothalamus
Answer: C
, Conceptual Explanation: Fezolinetant is a non-hormonal neurokinin 3 (NK3) receptor
antagonist that blocks the binding of neurokinin B on KNDy neurons, which helps regulate
the thermoregulatory center in the hypothalamus.
4. In the Women’s Health Initiative (WHI), the Estrogen-plus-Progestin (EPT) arm was stopped
early due to an increased risk of which condition?
A. Colorectal cancer
B. Breast cancer
C. Hip fractures
D. Endometrial cancer
Answer: B
Conceptual Explanation: The WHI EPT arm (Conjugated Equine Estrogen plus
Medroxyprogesterone Acetate) was stopped in 2002 because the health risks, specifically
an increased risk of invasive breast cancer and cardiovascular events, exceeded the
benefits.
5. Which of the following is an absolute contraindication for systemic hormone therapy?
A. Controlled hypertension
B. History of cigarette smoking
C. Unexplained vaginal bleeding
D. Type 2 Diabetes mellitus
