1|Page
NAMS MENOPAUSE CERTIFICATION EXAM 2
NEWEST 2025 COMPLETE EXAM| ACTUAL
EXAM QUESTIONS WITH CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+
How to respond if a patient requests FSH lab? - ANSWER - many
pitfalls, variable depending on the day of the cycle you draw the lab,
normal or low FSH is not helpful.
The potentially superior marker of menopause, a lab. - ANSWER -
AMH
DHEA (dehydroepiandrosterone) - ANSWER - Adrenal androgens:
precursor hormones produced by the adrenal gland that are
enzymatically converted to active androgens or estrogens in peripheral
tissues.
Location of estrogen receptors - ANSWER - Vagina, vulva, urethra,
trigone of the bladder
Effects of estrogen on tissue - ANSWER - maintain blood flow, the
collagen, and HA within the epithelial surfaces. Supports microbiome
and protects tissue from pathogens.
What stage are VMS more likely? - ANSWER - +1b (generally last 2
years)
pg. 1
,2|Page
What hormone is generally higher in obese women? - ANSWER -
Estrone-via aromatization.
The postmenopausal ovary continues to produce what two hormones? -
ANSWER - testosterone and androstenedione
Surgical menopause causes women to have lower levels of what
hormone? - ANSWER - testosterone. 40-50% lower than in women w/
intact ovaries.
Driving piece of menopause is ovarian follicles depleting. What does
this do to the inhibin B and AMH? - ANSWER - inhibin and AMH
decrease
therefore, follicle growth is not restrained, this allows for the growth of
the remaining, diminished follicle pool.
In the menopause transition, women spend more time in what phase? -
ANSWER - Luteal-more PMS symptoms, more frequent menstrual
periods.
HPO axis theory and the menopause transition - ANSWER - It is felt
that the HPO axis may become less sensitive to estrogen, so even with
good follicle growth and estradiol secretion, LH surges can fail which
can lead to more cycle irregularity.
In the first year after the FMP, there is no production of what hormone? -
ANSWER - progesterone
pg. 2
, 3|Page
What region of the adrenal gland secretes the androgens? - ANSWER -
zona reticularis
what are considered the 'adrenal androgens'? - ANSWER - DHEA,
DHEAS, Androstenedione.
Aldosterone secretion from the zona reticularis in the adrenal gland is
regulated by 3 main factors. - ANSWER - Angiotensin II, potassium
concentration, adrenocorticotropic hormone secreted by the anterior
pituitary.
What part of the pituitary gland secretes adrenocorticotropic hormone? -
ANSWER - Anterior pituitary. The posterior only secretes vasopressin
and oxytocin.
Vaginal changes with menopause - ANSWER - Thinning, loss of
elasticity, loss or absence or rugae.
Vagina and urethra in menopause - ANSWER - vagina narrows, urethra
moves closer to the introitus.
Stress urinary incontinence - ANSWER - Vaginal estrogen and urinary
incontinence: what type does it help with?
Treatment for FPHL - ANSWER - Minoxidil, spironolactone,
finasteride, estrogen therapy
pg. 3
NAMS MENOPAUSE CERTIFICATION EXAM 2
NEWEST 2025 COMPLETE EXAM| ACTUAL
EXAM QUESTIONS WITH CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+
How to respond if a patient requests FSH lab? - ANSWER - many
pitfalls, variable depending on the day of the cycle you draw the lab,
normal or low FSH is not helpful.
The potentially superior marker of menopause, a lab. - ANSWER -
AMH
DHEA (dehydroepiandrosterone) - ANSWER - Adrenal androgens:
precursor hormones produced by the adrenal gland that are
enzymatically converted to active androgens or estrogens in peripheral
tissues.
Location of estrogen receptors - ANSWER - Vagina, vulva, urethra,
trigone of the bladder
Effects of estrogen on tissue - ANSWER - maintain blood flow, the
collagen, and HA within the epithelial surfaces. Supports microbiome
and protects tissue from pathogens.
What stage are VMS more likely? - ANSWER - +1b (generally last 2
years)
pg. 1
,2|Page
What hormone is generally higher in obese women? - ANSWER -
Estrone-via aromatization.
The postmenopausal ovary continues to produce what two hormones? -
ANSWER - testosterone and androstenedione
Surgical menopause causes women to have lower levels of what
hormone? - ANSWER - testosterone. 40-50% lower than in women w/
intact ovaries.
Driving piece of menopause is ovarian follicles depleting. What does
this do to the inhibin B and AMH? - ANSWER - inhibin and AMH
decrease
therefore, follicle growth is not restrained, this allows for the growth of
the remaining, diminished follicle pool.
In the menopause transition, women spend more time in what phase? -
ANSWER - Luteal-more PMS symptoms, more frequent menstrual
periods.
HPO axis theory and the menopause transition - ANSWER - It is felt
that the HPO axis may become less sensitive to estrogen, so even with
good follicle growth and estradiol secretion, LH surges can fail which
can lead to more cycle irregularity.
In the first year after the FMP, there is no production of what hormone? -
ANSWER - progesterone
pg. 2
, 3|Page
What region of the adrenal gland secretes the androgens? - ANSWER -
zona reticularis
what are considered the 'adrenal androgens'? - ANSWER - DHEA,
DHEAS, Androstenedione.
Aldosterone secretion from the zona reticularis in the adrenal gland is
regulated by 3 main factors. - ANSWER - Angiotensin II, potassium
concentration, adrenocorticotropic hormone secreted by the anterior
pituitary.
What part of the pituitary gland secretes adrenocorticotropic hormone? -
ANSWER - Anterior pituitary. The posterior only secretes vasopressin
and oxytocin.
Vaginal changes with menopause - ANSWER - Thinning, loss of
elasticity, loss or absence or rugae.
Vagina and urethra in menopause - ANSWER - vagina narrows, urethra
moves closer to the introitus.
Stress urinary incontinence - ANSWER - Vaginal estrogen and urinary
incontinence: what type does it help with?
Treatment for FPHL - ANSWER - Minoxidil, spironolactone,
finasteride, estrogen therapy
pg. 3
