NAMS MENOPAUSE CERTIFICATION
EXAM QUESTIONS AND ANSWERS
1. According to the STRAW+10 staging system, which stage is characterized by a variable cycle
length with a persistent difference of 7 days or more between consecutive cycles?
A. Stage +1 (Early Postmenopause)
B. Stage -1 (Late Menopausal Transition)
C. Stage -2 (Early Menopausal Transition)
D. Stage -3 (Late Reproductive)
Answer: C
Conceptual Explanation: Stage -2 (Early Menopausal Transition) is defined by increased
variability in cycle length, specifically a difference of 7 or more days between cycles. Stage -
1 involves intervals of amenorrhea of 60 days or more.
2. Premature Ovarian Insufficiency (POI) is clinically defined by the onset of
hypergonadotropic hypogonadism before what age?
A. 35 years
B. 40 years
,C. 45 years
D. 30 years
Answer: B
Conceptual Explanation: POI is defined as the loss of ovarian function before the age of
40, characterized by amenorrhea, low estrogen, and elevated FSH levels.
3. Which of the following findings was reported for the Estrogen-Alone arm (CEE 0.625 mg/d)
of the Women’s Health Initiative (WHI) study?
A. Significant increase in breast cancer risk
B. Significant decrease in stroke risk
C. Significant increase in coronary heart disease risk
D. Significant decrease in breast cancer risk
Answer: D
Conceptual Explanation: In the WHI, the CEE-alone arm showed a statistically significant
reduction in breast cancer incidence and mortality during the long-term follow-up, unlike
the E+P arm.
4. Which treatment is considered first-line therapy for mild symptoms of Genitourinary
Syndrome of Menopause (GSM)?
A. Low-dose vaginal estrogen
B. Vaginal DHEA (Prasterone)
, C. Non-hormonal vaginal moisturizers and lubricants
D. Ospemifene
Answer: C
Conceptual Explanation: For mild GSM symptoms, non-hormonal moisturizers used
regularly and lubricants used during intercourse are recommended as the first-line
approach.
5. What is the mechanism of action for Fezolinetant, a non-hormonal treatment for
vasomotor symptoms?
A. NK3 receptor antagonist inhibiting KNDy neurons
B. SSRI/SNRI modulation of serotonin levels
C. GABA receptor agonist
D. Selective Estrogen Receptor Modulator (SERM)
Answer: A
Conceptual Explanation: Fezolinetant is a neurokinin 3 (NK3) receptor antagonist that
targets the KNDy neurons in the hypothalamus to regulate body temperature and reduce
hot flashes.
6. For a woman with an intact uterus, why is the addition of a progestogen to estrogen
therapy necessary?
A. To prevent venous thromboembolism
EXAM QUESTIONS AND ANSWERS
1. According to the STRAW+10 staging system, which stage is characterized by a variable cycle
length with a persistent difference of 7 days or more between consecutive cycles?
A. Stage +1 (Early Postmenopause)
B. Stage -1 (Late Menopausal Transition)
C. Stage -2 (Early Menopausal Transition)
D. Stage -3 (Late Reproductive)
Answer: C
Conceptual Explanation: Stage -2 (Early Menopausal Transition) is defined by increased
variability in cycle length, specifically a difference of 7 or more days between cycles. Stage -
1 involves intervals of amenorrhea of 60 days or more.
2. Premature Ovarian Insufficiency (POI) is clinically defined by the onset of
hypergonadotropic hypogonadism before what age?
A. 35 years
B. 40 years
,C. 45 years
D. 30 years
Answer: B
Conceptual Explanation: POI is defined as the loss of ovarian function before the age of
40, characterized by amenorrhea, low estrogen, and elevated FSH levels.
3. Which of the following findings was reported for the Estrogen-Alone arm (CEE 0.625 mg/d)
of the Women’s Health Initiative (WHI) study?
A. Significant increase in breast cancer risk
B. Significant decrease in stroke risk
C. Significant increase in coronary heart disease risk
D. Significant decrease in breast cancer risk
Answer: D
Conceptual Explanation: In the WHI, the CEE-alone arm showed a statistically significant
reduction in breast cancer incidence and mortality during the long-term follow-up, unlike
the E+P arm.
4. Which treatment is considered first-line therapy for mild symptoms of Genitourinary
Syndrome of Menopause (GSM)?
A. Low-dose vaginal estrogen
B. Vaginal DHEA (Prasterone)
, C. Non-hormonal vaginal moisturizers and lubricants
D. Ospemifene
Answer: C
Conceptual Explanation: For mild GSM symptoms, non-hormonal moisturizers used
regularly and lubricants used during intercourse are recommended as the first-line
approach.
5. What is the mechanism of action for Fezolinetant, a non-hormonal treatment for
vasomotor symptoms?
A. NK3 receptor antagonist inhibiting KNDy neurons
B. SSRI/SNRI modulation of serotonin levels
C. GABA receptor agonist
D. Selective Estrogen Receptor Modulator (SERM)
Answer: A
Conceptual Explanation: Fezolinetant is a neurokinin 3 (NK3) receptor antagonist that
targets the KNDy neurons in the hypothalamus to regulate body temperature and reduce
hot flashes.
6. For a woman with an intact uterus, why is the addition of a progestogen to estrogen
therapy necessary?
A. To prevent venous thromboembolism
