2025 NAMs Menopause Certification Exam. LATEST
UPDATED EXAM WITH CORRECT MARKING SCHEME
ANSWERS (100% CORRECT) | GUARANTEED
CERTIFICATION EXCELLENCE. A+ GRADED
Describe the difference in lichen sclerosus and lichen planus.
The main difference between the two conditions is that LP has a propensity to involve the mucous
membranes including the mouth and vagina which are rarely affected in LS.
How does lichen sclerosus and lichen planus appear?
As white plaques and papules or as erosive-appearing ulcerations, sometimes with fissuring.
How do you diagnose LS or LP? And what is the treatment recommended?
Diagnosed by biopsy and treatment is with high-potency topical steroids.
Vulvar Masses: Condyloma acuminatum are caused by what? How is it treated?
Condyloma acuminatum is caused by HPV infection.
Treated with topical agents such as trichloroacetic acid, podophyllin, or imiquimod. If extensive,
consider laser or excision with GYN ONC.
What are less common masses of the vulva? (5)
,Hidradenomas, lipomas, fibromas, syringomas, and schwannomas.
What are the changes in the female that cause increased risk of postmenopausal UTI?
Increase in vaginal pH and changes in the microbiome.
What are additional risk factors, external to the postmenopausal changes, that increase a woman's risk
of UTI? (4)
DM, incontinence, prolapse, increased PVR
Why might you consider vaginal estrogen, after antibiotics for UTI in postmenopausal women?
Vaginal estrogen restore pH, increases lactobacilli, and may improve immune response.
The period of endrocrinologic, somatic, and transitory psychologic changes that occur around the time
of menopause.
Climacteric phase
LMP before age 45
Early menopause
LMP after age 54
,Late menopause
Menopause that occurs before age 40
Primary ovarian insufficiency
Persistent difference of 7 days or more in the length of consecutive cycles.
Early menopause transition (stage -2)
60 or more consecutive days of amenorrhea
Late menopause transition (stage -1)
Explains why some perimenopausal women have elevated estrogen level sometimes...In the early
menopause transition, elevated FSH levels are adequate to recruit a second follicle which results in a
follicular phase-like rise in estradiol secretion superimposed on the mid-to-late luteal phase of the
ongoing ovulatory cycle.
Luteal out of phase event (LOOP)
Obese women are more likely to have anovulatory cycles with high estradiol levels. They are also more
likely to have lower premenopause yet higher postmenopause estradiol levels compared with women of
normal weight. (why they are at higher risk of endometrial cancer)
Obese women and estradiol levels during menopause
, These ethnic groups have lower estradiol levels then white, black and hispanic women.
Chinese and Japanese women
late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased genitourinary
symptoms.
stage +2
early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS predominate.
Stages +1a, +1b, +1c
Endocrine labs after menopause
Elevated FSH, LH
These hormones work during reproductive years to not deplete follicle pool too quickly.
AMH, inhibin B
Menstrual cycle variable, persistent >7 day difference between difference in length of consecutive
cycles.
Phases during menopause transition and PMS symptoms
UPDATED EXAM WITH CORRECT MARKING SCHEME
ANSWERS (100% CORRECT) | GUARANTEED
CERTIFICATION EXCELLENCE. A+ GRADED
Describe the difference in lichen sclerosus and lichen planus.
The main difference between the two conditions is that LP has a propensity to involve the mucous
membranes including the mouth and vagina which are rarely affected in LS.
How does lichen sclerosus and lichen planus appear?
As white plaques and papules or as erosive-appearing ulcerations, sometimes with fissuring.
How do you diagnose LS or LP? And what is the treatment recommended?
Diagnosed by biopsy and treatment is with high-potency topical steroids.
Vulvar Masses: Condyloma acuminatum are caused by what? How is it treated?
Condyloma acuminatum is caused by HPV infection.
Treated with topical agents such as trichloroacetic acid, podophyllin, or imiquimod. If extensive,
consider laser or excision with GYN ONC.
What are less common masses of the vulva? (5)
,Hidradenomas, lipomas, fibromas, syringomas, and schwannomas.
What are the changes in the female that cause increased risk of postmenopausal UTI?
Increase in vaginal pH and changes in the microbiome.
What are additional risk factors, external to the postmenopausal changes, that increase a woman's risk
of UTI? (4)
DM, incontinence, prolapse, increased PVR
Why might you consider vaginal estrogen, after antibiotics for UTI in postmenopausal women?
Vaginal estrogen restore pH, increases lactobacilli, and may improve immune response.
The period of endrocrinologic, somatic, and transitory psychologic changes that occur around the time
of menopause.
Climacteric phase
LMP before age 45
Early menopause
LMP after age 54
,Late menopause
Menopause that occurs before age 40
Primary ovarian insufficiency
Persistent difference of 7 days or more in the length of consecutive cycles.
Early menopause transition (stage -2)
60 or more consecutive days of amenorrhea
Late menopause transition (stage -1)
Explains why some perimenopausal women have elevated estrogen level sometimes...In the early
menopause transition, elevated FSH levels are adequate to recruit a second follicle which results in a
follicular phase-like rise in estradiol secretion superimposed on the mid-to-late luteal phase of the
ongoing ovulatory cycle.
Luteal out of phase event (LOOP)
Obese women are more likely to have anovulatory cycles with high estradiol levels. They are also more
likely to have lower premenopause yet higher postmenopause estradiol levels compared with women of
normal weight. (why they are at higher risk of endometrial cancer)
Obese women and estradiol levels during menopause
, These ethnic groups have lower estradiol levels then white, black and hispanic women.
Chinese and Japanese women
late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased genitourinary
symptoms.
stage +2
early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS predominate.
Stages +1a, +1b, +1c
Endocrine labs after menopause
Elevated FSH, LH
These hormones work during reproductive years to not deplete follicle pool too quickly.
AMH, inhibin B
Menstrual cycle variable, persistent >7 day difference between difference in length of consecutive
cycles.
Phases during menopause transition and PMS symptoms
