NAMS MENOPAUSE CERTIFICATION Exam
Questions and Answers | Fall 2025/2026
Update | 100% Correct
Dairy free diet amount of calicum. How much do they need to supplement? -
answer>>>dairy free diet-300mg calcium daily.
Needs 800-1200mg
Tibolone and
osteoporosis where is
it approved?
why wasn't it submitted for approval in the US and canada? -
answer>>>approved in mexico
decreased risk of vertebral and nonvertebral
fracture increased risk of stroke
Why was estrogen not approved for osteoporosis? - answer>>>decreased risk
of vertebral and hip fracture in low fracture risk population, but estrogen
has not been shown to decrease fracture risk in women with osteoporosis.
More prevention than treatment.
Black box warning for PTH receptor agonists? - answer>>>osteosarcoma
caution using PTH receptor agonists in what condition? -
answer>>>hypercalcemia
when would you use PTH receptor agonists? - answer>>>someone incredibly
high risk for vertebral fracture
raloxifene helps with what kind of fractures? - answer>>>vertebral fractures
raloxifene risk factors - answer>>>increased risk of death from stroke in high
risk patients, estrogen like risk of VTE, worsens hot flashes
,atypical femur risk in women on bisphosphonate? - answer>>>1 in 1000 after 2-
3 years.
Salmon calcitonin and osteoporosis? - answer>>>small increase in spine BMD.
daily SQ injections or nasal.
Implications of estrogen drop on skin during menopause - answer>>>Decreased
fibroblast activity
disrupted elastin
decreased GAG
production
Disrupted melanocyte regulation
Decreased blood flow and cellular oxygenation effects on
keratinocytes Disruption of cellular growth factors and
repair enzymes
accelerated
lipoatrophy Fat
pad modification
Bone resorptuon
Definition of stress incontinence - answer>>>Involuntary loss of urine that
occurs with an activity such as coughing or sneezing that increases
intraabdominal pressure. Leakage is in drops, usually 2/2 to poor
urethral support, urethral sphincter weakness, dysfunction of pelvic floor
Definition of urgency incontinence - answer>>>Involuntary loss of
urine preceded by sensation of urgency to urinate. Generally
associated with losses of larger volumes of urine that soak through
pads and clothing.
Leakage results from detrusor (bladder) overactivity/uninhabited
contractions of detrusser
,Definition of mixed incontinence - answer>>>includes stress and urgency
A postvoid residuals (w/in 15 minutes of emptying) of what volume is considered
normal - answer>>>100 or less, whereas >200 is abnormal, between 100-200
advised to repeat on different day
how to test for incontinence - answer>>>pyridium challenge
OAB - answer>>>Term used to describe idiopathic urinary urgency (w
or w/o incontinennce) with urinary frequency (>8voids w/in 24h) adn
sometimes nocturia (awakening to urinate more than 2x/night
ISSWSH Sexual Disorders in Menopause - answer>>>Hypoactive sexual
desire disorder Female genital arousal disorder
Persistent genital arousal
disorder Female orgasm
disorder
Femal orgasmic illness syndrome
Pelvic floor muscles - answer>>>Levator ani
superficial (transverse perineal, bulbospongiosus, ischiocavernosus)
Deep (pubococcygeus, iliococcygeus, obturator internus, coccygeus( muscles
PALM COEIN causes of AUB -
answer>>>P: Polyp A: Adenomyosis
L: Leiomyoma
M:
Malignancy/hyperpla
sia C: Coagulopathy
O: ovulatory
, dysfunction E:
Endometrial
I: Iatrogenic
N: Not yet classified
When is EMB not needed? - answer>>>When <4mm
Management of AUB - answer>>>Cocs decrease 7 to 4 days; IUD
NSAID - reduce prostaglandin synthesiss which may have a role in
aberrant neovasculariation
Dosing of NSAIDS for AUB - answer>>>Mefenamic acid 500 mg TID for 5
days or Ibuprofen 600 mg Q6h or 800mg Q8 h for first 3 days
Dosing of tranexamic acid for AUB - answer>>>1300 mg TID for 5 days of
menstrual cycle ; causes GI upset
GnRH therapy for fibroids - answer>>>Addback therapy can be used to
protect against VMS and bone mineral density losss
Nonsurgical treatment of fibroids - answer>>>Tranexamic acid and
mefenamic acid mirena
GnRH
Selective progesterone receptor
modulators Uterine artery embolization
Hysteroscopic myomectomy is most suitable for fibroids smaller than -
answer>>>5cm in diameter
Lichen Planus - answer>>>Pruritic, purple, polygonal planar papules and plaques
(6 P's)
Questions and Answers | Fall 2025/2026
Update | 100% Correct
Dairy free diet amount of calicum. How much do they need to supplement? -
answer>>>dairy free diet-300mg calcium daily.
Needs 800-1200mg
Tibolone and
osteoporosis where is
it approved?
why wasn't it submitted for approval in the US and canada? -
answer>>>approved in mexico
decreased risk of vertebral and nonvertebral
fracture increased risk of stroke
Why was estrogen not approved for osteoporosis? - answer>>>decreased risk
of vertebral and hip fracture in low fracture risk population, but estrogen
has not been shown to decrease fracture risk in women with osteoporosis.
More prevention than treatment.
Black box warning for PTH receptor agonists? - answer>>>osteosarcoma
caution using PTH receptor agonists in what condition? -
answer>>>hypercalcemia
when would you use PTH receptor agonists? - answer>>>someone incredibly
high risk for vertebral fracture
raloxifene helps with what kind of fractures? - answer>>>vertebral fractures
raloxifene risk factors - answer>>>increased risk of death from stroke in high
risk patients, estrogen like risk of VTE, worsens hot flashes
,atypical femur risk in women on bisphosphonate? - answer>>>1 in 1000 after 2-
3 years.
Salmon calcitonin and osteoporosis? - answer>>>small increase in spine BMD.
daily SQ injections or nasal.
Implications of estrogen drop on skin during menopause - answer>>>Decreased
fibroblast activity
disrupted elastin
decreased GAG
production
Disrupted melanocyte regulation
Decreased blood flow and cellular oxygenation effects on
keratinocytes Disruption of cellular growth factors and
repair enzymes
accelerated
lipoatrophy Fat
pad modification
Bone resorptuon
Definition of stress incontinence - answer>>>Involuntary loss of urine that
occurs with an activity such as coughing or sneezing that increases
intraabdominal pressure. Leakage is in drops, usually 2/2 to poor
urethral support, urethral sphincter weakness, dysfunction of pelvic floor
Definition of urgency incontinence - answer>>>Involuntary loss of
urine preceded by sensation of urgency to urinate. Generally
associated with losses of larger volumes of urine that soak through
pads and clothing.
Leakage results from detrusor (bladder) overactivity/uninhabited
contractions of detrusser
,Definition of mixed incontinence - answer>>>includes stress and urgency
A postvoid residuals (w/in 15 minutes of emptying) of what volume is considered
normal - answer>>>100 or less, whereas >200 is abnormal, between 100-200
advised to repeat on different day
how to test for incontinence - answer>>>pyridium challenge
OAB - answer>>>Term used to describe idiopathic urinary urgency (w
or w/o incontinennce) with urinary frequency (>8voids w/in 24h) adn
sometimes nocturia (awakening to urinate more than 2x/night
ISSWSH Sexual Disorders in Menopause - answer>>>Hypoactive sexual
desire disorder Female genital arousal disorder
Persistent genital arousal
disorder Female orgasm
disorder
Femal orgasmic illness syndrome
Pelvic floor muscles - answer>>>Levator ani
superficial (transverse perineal, bulbospongiosus, ischiocavernosus)
Deep (pubococcygeus, iliococcygeus, obturator internus, coccygeus( muscles
PALM COEIN causes of AUB -
answer>>>P: Polyp A: Adenomyosis
L: Leiomyoma
M:
Malignancy/hyperpla
sia C: Coagulopathy
O: ovulatory
, dysfunction E:
Endometrial
I: Iatrogenic
N: Not yet classified
When is EMB not needed? - answer>>>When <4mm
Management of AUB - answer>>>Cocs decrease 7 to 4 days; IUD
NSAID - reduce prostaglandin synthesiss which may have a role in
aberrant neovasculariation
Dosing of NSAIDS for AUB - answer>>>Mefenamic acid 500 mg TID for 5
days or Ibuprofen 600 mg Q6h or 800mg Q8 h for first 3 days
Dosing of tranexamic acid for AUB - answer>>>1300 mg TID for 5 days of
menstrual cycle ; causes GI upset
GnRH therapy for fibroids - answer>>>Addback therapy can be used to
protect against VMS and bone mineral density losss
Nonsurgical treatment of fibroids - answer>>>Tranexamic acid and
mefenamic acid mirena
GnRH
Selective progesterone receptor
modulators Uterine artery embolization
Hysteroscopic myomectomy is most suitable for fibroids smaller than -
answer>>>5cm in diameter
Lichen Planus - answer>>>Pruritic, purple, polygonal planar papules and plaques
(6 P's)
