"Menopause Certification Exam CHEAT
SHEET | HT, Bone Health, HSDD, DEXA, Non-
Hormonal Therapies | 2024 Review"
Climacteric phase ✔✔answer✔✔The period of endrocrinologic, somatic, and transitory
psychologic changes that occur around the time of menopause.
Early menopause ✔✔answer✔✔LMP before age 45
Late menopause ✔✔answer✔✔LMP after age 54
Primary ovarian insufficiency ✔✔answer✔✔Menopause that occurs before age 40
Transdermal does not increase it, so it has a minimal effect on serum cortisol concentration.
✔✔answer✔✔Cortisol and HRT
No, cortisol levels have NOT been associated with more severe VMS. ✔✔answer✔✔Do cortisol
levels associate with VMS severity?
vaginal pain and dyspareunia ✔✔answer✔✔Local DHEA has been proven to help with what?
,Menstrual disturbance-oligomenorrhea or amenorrhea for at least 4 months.
AND
elevated FSH over 25 on two occasions at least 4 weeks apart. ✔✔answer✔✔How to DX POI?
prolactin
FSH
estradiol
TSH
pregnancy test ✔✔answer✔✔Anyone <40years old who misses 3+ consecutive cycles gets these
labs
100 microgram estradiol patch
1.25 mg CEE
2mg oral estradiol
If intact uterus-progesterone for 12 days of the month.
Physiologic is better than continuous hormonal contractption, but if menorrhagia-IUD plus
estrogen patch, or if really not wanting to risk pregnancy, continuous HRT can be used.
✔✔answer✔✔treatment of POI
FPHL is gradual, telogen effluvium is sudden and usually precipitated by a life stressor, chronic
illness, beta blockers or anticoagulants-usually more patchy hair loss. ✔✔answer✔✔Hair loss.
Difference between FPHL and telogen effluvium?
,thinning at the crown of the head and widening of the hair part ✔✔answer✔✔FPHL pattern
MINOXIDIL
spironolactone
finasteride ✔✔answer✔✔Treating FPHL
Japanese ✔✔answer✔✔What ethnicity has the least likely chance of having bad hot flashes?
black
more frequent, longer duration. ✔✔answer✔✔What ethnicity is the most likely to have bad hot
flashes?
10 years, early menopause transition women have them the longest. ✔✔answer✔✔Median
length of hot flashes
lower ovarian estradiol
thermoregulation zone is narrowed
neurokinins-regulate GnRH secretion. KNDy new meds
serotonin
cortisol and HPI axis dysregulation
endothelial dysfunction. ✔✔answer✔✔Theories about etiology of hot flashes (6)
low grade is not precancerous
high grade is precancerous-GYN ONC
differentiated-wide local excision-high risk of invasive carcinoma. ✔✔answer✔✔VIN
, low grade-what to do
high grade-what to do
differentiated VIN-what to do
squamous cell carcinoma ✔✔answer✔✔most common type of vulvar cancer
paget's disease
will not improve on steroids
screen for co-existing breast, GI or GU cancer. They are present 20-30% of the time.
✔✔answer✔✔Vulvar disorder commonly misdiagnosed as eczema or dermatitis?
<100mL ✔✔answer✔✔Normal PVR
will NOT help with stress incontinence. ✔✔answer✔✔systemic and vaginal estrogen will not
help with this type of urinary incontinence?
the vaginal rings
FEMRING IS THE HIGHEST ✔✔answer✔✔Which topical vaginal estrogen has the highest dose?
BV ✔✔answer✔✔Most common cause of vulvovaginitis?
desquamative inflammatory vaginitis. treat different with clindamycin or hydrocortisone+ET
✔✔answer✔✔post menopause burning and diffuse yellow/brown discharge and dyspareunia
that does not respond to local ET?
SHEET | HT, Bone Health, HSDD, DEXA, Non-
Hormonal Therapies | 2024 Review"
Climacteric phase ✔✔answer✔✔The period of endrocrinologic, somatic, and transitory
psychologic changes that occur around the time of menopause.
Early menopause ✔✔answer✔✔LMP before age 45
Late menopause ✔✔answer✔✔LMP after age 54
Primary ovarian insufficiency ✔✔answer✔✔Menopause that occurs before age 40
Transdermal does not increase it, so it has a minimal effect on serum cortisol concentration.
✔✔answer✔✔Cortisol and HRT
No, cortisol levels have NOT been associated with more severe VMS. ✔✔answer✔✔Do cortisol
levels associate with VMS severity?
vaginal pain and dyspareunia ✔✔answer✔✔Local DHEA has been proven to help with what?
,Menstrual disturbance-oligomenorrhea or amenorrhea for at least 4 months.
AND
elevated FSH over 25 on two occasions at least 4 weeks apart. ✔✔answer✔✔How to DX POI?
prolactin
FSH
estradiol
TSH
pregnancy test ✔✔answer✔✔Anyone <40years old who misses 3+ consecutive cycles gets these
labs
100 microgram estradiol patch
1.25 mg CEE
2mg oral estradiol
If intact uterus-progesterone for 12 days of the month.
Physiologic is better than continuous hormonal contractption, but if menorrhagia-IUD plus
estrogen patch, or if really not wanting to risk pregnancy, continuous HRT can be used.
✔✔answer✔✔treatment of POI
FPHL is gradual, telogen effluvium is sudden and usually precipitated by a life stressor, chronic
illness, beta blockers or anticoagulants-usually more patchy hair loss. ✔✔answer✔✔Hair loss.
Difference between FPHL and telogen effluvium?
,thinning at the crown of the head and widening of the hair part ✔✔answer✔✔FPHL pattern
MINOXIDIL
spironolactone
finasteride ✔✔answer✔✔Treating FPHL
Japanese ✔✔answer✔✔What ethnicity has the least likely chance of having bad hot flashes?
black
more frequent, longer duration. ✔✔answer✔✔What ethnicity is the most likely to have bad hot
flashes?
10 years, early menopause transition women have them the longest. ✔✔answer✔✔Median
length of hot flashes
lower ovarian estradiol
thermoregulation zone is narrowed
neurokinins-regulate GnRH secretion. KNDy new meds
serotonin
cortisol and HPI axis dysregulation
endothelial dysfunction. ✔✔answer✔✔Theories about etiology of hot flashes (6)
low grade is not precancerous
high grade is precancerous-GYN ONC
differentiated-wide local excision-high risk of invasive carcinoma. ✔✔answer✔✔VIN
, low grade-what to do
high grade-what to do
differentiated VIN-what to do
squamous cell carcinoma ✔✔answer✔✔most common type of vulvar cancer
paget's disease
will not improve on steroids
screen for co-existing breast, GI or GU cancer. They are present 20-30% of the time.
✔✔answer✔✔Vulvar disorder commonly misdiagnosed as eczema or dermatitis?
<100mL ✔✔answer✔✔Normal PVR
will NOT help with stress incontinence. ✔✔answer✔✔systemic and vaginal estrogen will not
help with this type of urinary incontinence?
the vaginal rings
FEMRING IS THE HIGHEST ✔✔answer✔✔Which topical vaginal estrogen has the highest dose?
BV ✔✔answer✔✔Most common cause of vulvovaginitis?
desquamative inflammatory vaginitis. treat different with clindamycin or hydrocortisone+ET
✔✔answer✔✔post menopause burning and diffuse yellow/brown discharge and dyspareunia
that does not respond to local ET?
