NAMs Menopause Certification Exam
Climacteric phase - CORRECT ANSWER The period of endrocrinologic, somatic, and transitory
psychologic changes that occur around the time of menopause.
Early menopause - CORRECT ANSWER LMP before age 45
Late menopause - CORRECT ANSWER LMP after age 54
Primary ovarian insufficiency - CORRECT ANSWER Menopause that occurs before age 40
Early menopause transition (stage -2) - CORRECT ANSWER Persistent difference of 7 days or more in
the length of consecutive cycles.
,Late menopause transition (stage -1) - CORRECT ANSWER 60 or more consecutive days of amenorrhea
Luteal out of phase event (LOOP) - CORRECT 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 - CORRECT 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 - CORRECT ANSWER These ethnic groups have lower estradiol levels
then white, black and hispanic women.
stage +2 - CORRECT ANSWER late menopause stage: 5-8 years after FMP. Somatic aging predominates.
Increased genitourinary symptoms.
Stages +1a, +1b, +1c - CORRECT ANSWER early post menopause: 2 years after FMP. FSH rises, estradiol
decreases. VMS predominate.
Elevated FSH, LH - CORRECT ANSWER Endocrine labs after menopause
AMH, inhibin B - CORRECT ANSWER These hormones work during reproductive years to not deplete
follicle pool too quickly.
Phases during menopause transition and PMS symptoms - CORRECT ANSWER Menstrual cycle
shortenes, follicular phase compresses, women spend more time in luteal phase.. meaning more
premenstrual symptoms and more frequent menstrual periods.
, How to respond if a patient requests FSH lab? - CORRECT 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. - CORRECT ANSWER AMH
DHEA (dehydroepiandrosterone) - CORRECT 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 - CORRECT ANSWER Vagina, vulva, urethra, trigone of the bladder
Effects of estrogen on tissue - CORRECT ANSWER maintain blood flow, the collagen, and HA within the
epithelial surfaces. Supports microbiome and protects tissue from pathogens.
Vaginal changes with menopause - CORRECT ANSWER Thinning, loss of elasticity, loss or absence or
rugae.
Vagina and urethra in menopause - CORRECT ANSWER vagina narrows, urethra moves closer to the
introitus.
Stress urinary incontinence - CORRECT ANSWER Vaginal estrogen and urinary incontinence: what type
does it help with?
Treatment for FPHL - CORRECT ANSWER Minoxidil, spironolactone, finasteride, estrogen therapy
Late reporoductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH, AFC, inhibin? -
CORRECT ANSWER -3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
Climacteric phase - CORRECT ANSWER The period of endrocrinologic, somatic, and transitory
psychologic changes that occur around the time of menopause.
Early menopause - CORRECT ANSWER LMP before age 45
Late menopause - CORRECT ANSWER LMP after age 54
Primary ovarian insufficiency - CORRECT ANSWER Menopause that occurs before age 40
Early menopause transition (stage -2) - CORRECT ANSWER Persistent difference of 7 days or more in
the length of consecutive cycles.
,Late menopause transition (stage -1) - CORRECT ANSWER 60 or more consecutive days of amenorrhea
Luteal out of phase event (LOOP) - CORRECT 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 - CORRECT 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 - CORRECT ANSWER These ethnic groups have lower estradiol levels
then white, black and hispanic women.
stage +2 - CORRECT ANSWER late menopause stage: 5-8 years after FMP. Somatic aging predominates.
Increased genitourinary symptoms.
Stages +1a, +1b, +1c - CORRECT ANSWER early post menopause: 2 years after FMP. FSH rises, estradiol
decreases. VMS predominate.
Elevated FSH, LH - CORRECT ANSWER Endocrine labs after menopause
AMH, inhibin B - CORRECT ANSWER These hormones work during reproductive years to not deplete
follicle pool too quickly.
Phases during menopause transition and PMS symptoms - CORRECT ANSWER Menstrual cycle
shortenes, follicular phase compresses, women spend more time in luteal phase.. meaning more
premenstrual symptoms and more frequent menstrual periods.
, How to respond if a patient requests FSH lab? - CORRECT 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. - CORRECT ANSWER AMH
DHEA (dehydroepiandrosterone) - CORRECT 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 - CORRECT ANSWER Vagina, vulva, urethra, trigone of the bladder
Effects of estrogen on tissue - CORRECT ANSWER maintain blood flow, the collagen, and HA within the
epithelial surfaces. Supports microbiome and protects tissue from pathogens.
Vaginal changes with menopause - CORRECT ANSWER Thinning, loss of elasticity, loss or absence or
rugae.
Vagina and urethra in menopause - CORRECT ANSWER vagina narrows, urethra moves closer to the
introitus.
Stress urinary incontinence - CORRECT ANSWER Vaginal estrogen and urinary incontinence: what type
does it help with?
Treatment for FPHL - CORRECT ANSWER Minoxidil, spironolactone, finasteride, estrogen therapy
Late reporoductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH, AFC, inhibin? -
CORRECT ANSWER -3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
