NAMs MENOPAUSE CERTIFICATION REAL EXAM QUESTIONS AND ANSWERS
2025|WELL STRUCTURED|100% PASS
The period of endrocrinologic, somatic,
Climacteric phase and transitory psychologic changes that
occur around the time of menopause.
Early menopause LMP before age 45
Late menopause LMP after age 54
Primary ovarian insufficiency Menopause that occurs before age 40
Persistent difference of 7 days or more in
Early menopause transition (stage -2)
the length of consecutive cycles.
60 or more consecutive days of amenor-
Late menopause transition (stage -1)
rhea
Explains why some perimenopausal
women have elevated estrogen lev-
el sometimes...In the early menopause
transition, elevated FSH levels are ade-
Luteal out of phase event (LOOP) quate 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.
Obese women are more likely to have
anovulatory cycles with high estradiol
levels. They are also more likely to have
Obese women and estradiol levels dur-
lower premenopause yet higher post-
ing menopause
menopause estradiol levels compared
with women of normal weight. (why they
are at higher risk of endometrial cancer)
These ethnic groups have lower estradi-
Chinese and Japanese women ol levels then white, black and hispanic
women.
late menopause stage: 5-8 years after
stage +2 FMP. Somatic aging predominates. In-
creased genitourinary symptoms.
early post menopause: 2 years after
Stages +1a, +1b, +1c FMP. FSH rises, estradiol decreases.
VMS predominate.
, Elevated FSH, LH Endocrine labs after menopause
These hormones work during reproduc-
AMH, inhibin B tive years to not deplete follicle pool too
quickly.
Menstrual cycle shortenes, follicular
phase compresses, women spend more
Phases during menopause transition
time in luteal phase.. meaning more pre-
and PMS symptoms
menstrual symptoms and more frequent
menstrual periods.
many pitfalls, variable depending on the
How to respond if a patient requests FSH
day of the cycle you draw the lab, normal
lab?
or low FSH is not helpful.
The potentially superior marker of
AMH
menopause, a lab.
Adrenal androgens: precursor hromones
produced by the adrenal gland that are
DHEA (dehydroepiandrosterone)
enzymatically converted to active andro-
gens or estrogens in peripheral tissues.
Vagina, vulva, urethra, trigone of the
Location of estrogen receptors
bladder
maintain blood flow, the collagen, and
HA within the epithelial surfaces. Sup-
Effects of estrogen on tissue
ports microbiome and protects tissue
from pathogens.
Thinning, loss of elasticity, loss or ab-
Vaginal changes with menopause
sence or rugae.
vagina narrows, urethra moves closer to
Vagina and urethra in menopause
the introitus.
Vaginal estrogen and urinary inconti-
Stress urinary incontinence
nence: what type does it help with?
Minoxidil, spironolactone, finasteride, es-
Treatment for FPHL
trogen therapy
-3b: menstrual cycles normal, FSH nor-
mal, AMH low, AFC low, inhibin low.
2025|WELL STRUCTURED|100% PASS
The period of endrocrinologic, somatic,
Climacteric phase and transitory psychologic changes that
occur around the time of menopause.
Early menopause LMP before age 45
Late menopause LMP after age 54
Primary ovarian insufficiency Menopause that occurs before age 40
Persistent difference of 7 days or more in
Early menopause transition (stage -2)
the length of consecutive cycles.
60 or more consecutive days of amenor-
Late menopause transition (stage -1)
rhea
Explains why some perimenopausal
women have elevated estrogen lev-
el sometimes...In the early menopause
transition, elevated FSH levels are ade-
Luteal out of phase event (LOOP) quate 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.
Obese women are more likely to have
anovulatory cycles with high estradiol
levels. They are also more likely to have
Obese women and estradiol levels dur-
lower premenopause yet higher post-
ing menopause
menopause estradiol levels compared
with women of normal weight. (why they
are at higher risk of endometrial cancer)
These ethnic groups have lower estradi-
Chinese and Japanese women ol levels then white, black and hispanic
women.
late menopause stage: 5-8 years after
stage +2 FMP. Somatic aging predominates. In-
creased genitourinary symptoms.
early post menopause: 2 years after
Stages +1a, +1b, +1c FMP. FSH rises, estradiol decreases.
VMS predominate.
, Elevated FSH, LH Endocrine labs after menopause
These hormones work during reproduc-
AMH, inhibin B tive years to not deplete follicle pool too
quickly.
Menstrual cycle shortenes, follicular
phase compresses, women spend more
Phases during menopause transition
time in luteal phase.. meaning more pre-
and PMS symptoms
menstrual symptoms and more frequent
menstrual periods.
many pitfalls, variable depending on the
How to respond if a patient requests FSH
day of the cycle you draw the lab, normal
lab?
or low FSH is not helpful.
The potentially superior marker of
AMH
menopause, a lab.
Adrenal androgens: precursor hromones
produced by the adrenal gland that are
DHEA (dehydroepiandrosterone)
enzymatically converted to active andro-
gens or estrogens in peripheral tissues.
Vagina, vulva, urethra, trigone of the
Location of estrogen receptors
bladder
maintain blood flow, the collagen, and
HA within the epithelial surfaces. Sup-
Effects of estrogen on tissue
ports microbiome and protects tissue
from pathogens.
Thinning, loss of elasticity, loss or ab-
Vaginal changes with menopause
sence or rugae.
vagina narrows, urethra moves closer to
Vagina and urethra in menopause
the introitus.
Vaginal estrogen and urinary inconti-
Stress urinary incontinence
nence: what type does it help with?
Minoxidil, spironolactone, finasteride, es-
Treatment for FPHL
trogen therapy
-3b: menstrual cycles normal, FSH nor-
mal, AMH low, AFC low, inhibin low.
