NAMS Certification Exam 2025–2026 | Updated Questions
and Verified Answers | Complete Exam
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
Early menopause transition (stage -2) - answer-Persistent difference of 7 days or more in the length of
consecutive cycles.
Late menopause transition (stage -1) - answer-60 or more consecutive days of amenorrhea
Luteal out of phase event (LOOP) - answer-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.
Obese women and estradiol levels during menopause - answer-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)
Chinese and Japanese women - answer-These ethnic groups have lower estradiol levels then white,
black and hispanic women.
stage +2 - answer-late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased
genitourinary symptoms.
, NAMS Certification Exam 2025–2026 | Updated Questions
and Verified Answers | Complete Exam
Waist circumference ≥35 in (88 cm) in women
Triglycerides >150 mg/dL OR Drug treatment for elevated triglycerides
HDL-C <50 mg/dL in women OR Drug treatment for reduced HDL cholesterol
BP ≥130/85 OR Drug treatment for hypertension
Fasting blood glucose ≥110 mg/dL OR Drug treatment for elevated glucose
When to screen for DM - answer-begin at 45 y/o and q 3 years
OR earlier if risk factors
-BMI > 25
-first degree relative with DM
-high-risk ethnicity (Native American, Black, Hispanic, Asian)
-h/o CVD
-HTN
-HDL < 35
-TG >250
-PCOS
-sedentary lifestyle
First line drugs for DM2 - answer-metformin
Second line drugs for DM with known CVD - answer-liraglutide
, NAMS Certification Exam 2025–2026 | Updated Questions
and Verified Answers | Complete Exam
empagliflozin
canagliflozin
Second line drugs for DM WITHOUT known CVD - answer-sulfonylureas
dipeptidyl peptidase-4 inhibitor
sodium glucose cotransporter 2 inhibitors
GLP-1 receptor agonist drugs
Risk of breast cancer in BRCA 1 or 2 - answer-72% lifetime risk
Chemoprevention for breast cancer - answer-Tamoxifen 20mg/5yrs
Risk: emboli, endometrial cancer, Raloxifene with decreased complications
AIs
VMS treatment for women with h/o breast cancer - answer-gabapentin
sertraline
venlafaxine
What cancer has the highest mortality rate in women? - answer-lung cancer
Stages +1a, +1b, +1c - answer-early post menopause: 2 years after FMP. FSH rises, estradiol decreases.
VMS predominate.
Elevated FSH, LH - answer-Endocrine labs after menopause
, NAMS Certification Exam 2025–2026 | Updated Questions
and Verified Answers | Complete Exam
AMH, inhibin B - answer-These hormones work during reproductive years to not deplete follicle pool too
quickly.
Phases during menopause transition and PMS symptoms - answer-Menstrual cycle variable, persistent
>7 day difference between difference in length of consecutive cycles.
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 hromones 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 which supports acidity of vagina and protects tissue from pathogens.
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
Late reporoductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH, AFC, inhibin? -
answer--3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low.
and Verified Answers | Complete Exam
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
Early menopause transition (stage -2) - answer-Persistent difference of 7 days or more in the length of
consecutive cycles.
Late menopause transition (stage -1) - answer-60 or more consecutive days of amenorrhea
Luteal out of phase event (LOOP) - answer-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.
Obese women and estradiol levels during menopause - answer-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)
Chinese and Japanese women - answer-These ethnic groups have lower estradiol levels then white,
black and hispanic women.
stage +2 - answer-late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased
genitourinary symptoms.
, NAMS Certification Exam 2025–2026 | Updated Questions
and Verified Answers | Complete Exam
Waist circumference ≥35 in (88 cm) in women
Triglycerides >150 mg/dL OR Drug treatment for elevated triglycerides
HDL-C <50 mg/dL in women OR Drug treatment for reduced HDL cholesterol
BP ≥130/85 OR Drug treatment for hypertension
Fasting blood glucose ≥110 mg/dL OR Drug treatment for elevated glucose
When to screen for DM - answer-begin at 45 y/o and q 3 years
OR earlier if risk factors
-BMI > 25
-first degree relative with DM
-high-risk ethnicity (Native American, Black, Hispanic, Asian)
-h/o CVD
-HTN
-HDL < 35
-TG >250
-PCOS
-sedentary lifestyle
First line drugs for DM2 - answer-metformin
Second line drugs for DM with known CVD - answer-liraglutide
, NAMS Certification Exam 2025–2026 | Updated Questions
and Verified Answers | Complete Exam
empagliflozin
canagliflozin
Second line drugs for DM WITHOUT known CVD - answer-sulfonylureas
dipeptidyl peptidase-4 inhibitor
sodium glucose cotransporter 2 inhibitors
GLP-1 receptor agonist drugs
Risk of breast cancer in BRCA 1 or 2 - answer-72% lifetime risk
Chemoprevention for breast cancer - answer-Tamoxifen 20mg/5yrs
Risk: emboli, endometrial cancer, Raloxifene with decreased complications
AIs
VMS treatment for women with h/o breast cancer - answer-gabapentin
sertraline
venlafaxine
What cancer has the highest mortality rate in women? - answer-lung cancer
Stages +1a, +1b, +1c - answer-early post menopause: 2 years after FMP. FSH rises, estradiol decreases.
VMS predominate.
Elevated FSH, LH - answer-Endocrine labs after menopause
, NAMS Certification Exam 2025–2026 | Updated Questions
and Verified Answers | Complete Exam
AMH, inhibin B - answer-These hormones work during reproductive years to not deplete follicle pool too
quickly.
Phases during menopause transition and PMS symptoms - answer-Menstrual cycle variable, persistent
>7 day difference between difference in length of consecutive cycles.
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 hromones 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 which supports acidity of vagina and protects tissue from pathogens.
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
Late reporoductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH, AFC, inhibin? -
answer--3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low.
