NAMS MENOPAUSE CERTIFICATION REAL EXAM VERIFIED
QUESTION AND ANSWER | LATEST EXAM UPDATE 2025/2026
The period of endrocrinologic, somatic, and transitory psychologic changes that
occur around the time of menopause. - CORRECT ANSWERClimacteric
phase
LMP before age 45 - CORRECT ANSWEREarly menopause
LMP after age 54 - CORRECT ANSWERLate menopause
Menopause that occurs before age 40 - CORRECT ANSWERPrimary ovarian
insufficiency
Persistent difference of 7 days or more in the length of consecutive cycles. -
CORRECT ANSWEREarly menopause transition (stage -2)
60 or more consecutive days of amenorrhea - CORRECT ANSWERLate
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. - CORRECT ANSWERLuteal 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) - CORRECT ANSWERObese
women and estradiol levels during menopause
These ethnic groups have lower estradiol levels then white, black and hispanic
women. - CORRECT ANSWERChinese and Japanese women
late menopause stage: 5-8 years after FMP. Somatic aging predominates.
Increased genitourinary symptoms. - CORRECT ANSWERstage +2
early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS
predominate. - CORRECT ANSWERStages +1a, +1b, +1c
Endocrine labs after menopause - CORRECT ANSWERElevated FSH, LH
These hormones work during reproductive years to not deplete follicle pool too
quickly. - CORRECT ANSWERAMH, inhibin B
Menstrual cycle variable, persistent >7 day difference between difference in
length of consecutive cycles. - CORRECT ANSWERPhases during
menopause transition and PMS symptoms
many pitfalls, variable depending on the day of the cycle you draw the lab,
normal or low FSH is not helpful. - CORRECT ANSWERHow to respond if a
patient requests FSH lab?
AMH - CORRECT ANSWERThe potentially superior marker of menopause, a
lab.
,Adrenal androgens: precursor hromones produced by the adrenal gland that are
enzymatically converted to active androgens or estrogens in peripheral tissues. -
CORRECT ANSWERDHEA (dehydroepiandrosterone)
Vagina, vulva, urethra, trigone of the bladder - CORRECT ANSWERLocation
of estrogen receptors
maintain blood flow, the collagen, and HA within the epithelial surfaces.
Supports microbiome which supports acidity of vagina and protects tissue from
pathogens. - CORRECT ANSWEREffects of estrogen on tissue
Thinning, loss of elasticity, loss or absence or rugae. - CORRECT
ANSWERVaginal changes with menopause
vagina narrows, urethra moves closer to the introitus. - CORRECT
ANSWERVagina and urethra in menopause
Vaginal estrogen and urinary incontinence: what type does it help with? -
CORRECT ANSWERStress urinary incontinence
Minoxidil, spironolactone, finasteride, estrogen therapy - CORRECT
ANSWERTreatment for FPHL
-3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low. -
CORRECT ANSWERLate reporoductive years -3b and -3a. What happens
with menstrual cycles, FSH, AMH, AFC, inhibin?
, Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH
level. - CORRECT ANSWERWhen it is appropriate to check an FSH during
the cycle if you check it? and why?
produced by granulosa cells
used to test damage to ovarian follicle reserve. If AMH is low, the woman has a
low ovarian reserve.
not recommended as a screening tool to predict fertility.
Peaks at around 25 years old. So before age 25, this test is not helpful.
It is influenced by exogenous hormones. Lower in hormonal contraception
users, but increases after d/cing. - CORRECT ANSWERAMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak?
Antral follicle count
Number of follicles that are detectable with ultrasound.
They are sensitive to FSH and considered to represent the availability pool of
follicles. - CORRECT ANSWERAFC
25 or higher - CORRECT ANSWERLate menopause transition (-1) FSH level
on random draw
QUESTION AND ANSWER | LATEST EXAM UPDATE 2025/2026
The period of endrocrinologic, somatic, and transitory psychologic changes that
occur around the time of menopause. - CORRECT ANSWERClimacteric
phase
LMP before age 45 - CORRECT ANSWEREarly menopause
LMP after age 54 - CORRECT ANSWERLate menopause
Menopause that occurs before age 40 - CORRECT ANSWERPrimary ovarian
insufficiency
Persistent difference of 7 days or more in the length of consecutive cycles. -
CORRECT ANSWEREarly menopause transition (stage -2)
60 or more consecutive days of amenorrhea - CORRECT ANSWERLate
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. - CORRECT ANSWERLuteal 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) - CORRECT ANSWERObese
women and estradiol levels during menopause
These ethnic groups have lower estradiol levels then white, black and hispanic
women. - CORRECT ANSWERChinese and Japanese women
late menopause stage: 5-8 years after FMP. Somatic aging predominates.
Increased genitourinary symptoms. - CORRECT ANSWERstage +2
early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS
predominate. - CORRECT ANSWERStages +1a, +1b, +1c
Endocrine labs after menopause - CORRECT ANSWERElevated FSH, LH
These hormones work during reproductive years to not deplete follicle pool too
quickly. - CORRECT ANSWERAMH, inhibin B
Menstrual cycle variable, persistent >7 day difference between difference in
length of consecutive cycles. - CORRECT ANSWERPhases during
menopause transition and PMS symptoms
many pitfalls, variable depending on the day of the cycle you draw the lab,
normal or low FSH is not helpful. - CORRECT ANSWERHow to respond if a
patient requests FSH lab?
AMH - CORRECT ANSWERThe potentially superior marker of menopause, a
lab.
,Adrenal androgens: precursor hromones produced by the adrenal gland that are
enzymatically converted to active androgens or estrogens in peripheral tissues. -
CORRECT ANSWERDHEA (dehydroepiandrosterone)
Vagina, vulva, urethra, trigone of the bladder - CORRECT ANSWERLocation
of estrogen receptors
maintain blood flow, the collagen, and HA within the epithelial surfaces.
Supports microbiome which supports acidity of vagina and protects tissue from
pathogens. - CORRECT ANSWEREffects of estrogen on tissue
Thinning, loss of elasticity, loss or absence or rugae. - CORRECT
ANSWERVaginal changes with menopause
vagina narrows, urethra moves closer to the introitus. - CORRECT
ANSWERVagina and urethra in menopause
Vaginal estrogen and urinary incontinence: what type does it help with? -
CORRECT ANSWERStress urinary incontinence
Minoxidil, spironolactone, finasteride, estrogen therapy - CORRECT
ANSWERTreatment for FPHL
-3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low. -
CORRECT ANSWERLate reporoductive years -3b and -3a. What happens
with menstrual cycles, FSH, AMH, AFC, inhibin?
, Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH
level. - CORRECT ANSWERWhen it is appropriate to check an FSH during
the cycle if you check it? and why?
produced by granulosa cells
used to test damage to ovarian follicle reserve. If AMH is low, the woman has a
low ovarian reserve.
not recommended as a screening tool to predict fertility.
Peaks at around 25 years old. So before age 25, this test is not helpful.
It is influenced by exogenous hormones. Lower in hormonal contraception
users, but increases after d/cing. - CORRECT ANSWERAMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak?
Antral follicle count
Number of follicles that are detectable with ultrasound.
They are sensitive to FSH and considered to represent the availability pool of
follicles. - CORRECT ANSWERAFC
25 or higher - CORRECT ANSWERLate menopause transition (-1) FSH level
on random draw
