NAMS MENOPAUSE CERTIFICATION Exam 2025–
2026 Accurate Real Exam Questions and Verified
Correct Answers (Graded A+)
Estrogen therapy in premature menopause
CORRECT ANSWER ✓✓ Transdermal 17 (100 mcg/d patch or gel). Oral 17B
estradiol 2mg/day. Vaginal ring: 17B 0.1mg/day. Oral CEE: 0.9-1.25mg/day
Should you check estradiol levels for prematures
CORRECT ANSWER ✓✓ Can consider, adjust therapy to achieve goal range of
80-120 pg/ml
Diagnosis of POI
CORRECT ANSWER ✓✓ H&P Labs:
- TSH
- Prolactin
- Pregnancy test
- Elevated FSH (>25 IU/L on 2 checks/4-6 weeks apart)
- AMH
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,- E2 can fluctuate greatly
- Low AFC
Assessment of etiology of POI
CORRECT ANSWER ✓✓ Genetic testing. Autoimmune workup
- TSH, thyroperoxidase antibody, 21-OH antibodies, fasting glucose, HbA1C
- Ovarian antibodies lack sensitivity and specificity
Rate of bone loss at menopause
CORRECT ANSWER ✓✓ An average annual loss of about 2% beginning 1-3
years before menopause and lasting 5-10 years. Across the menopause
transition women lose up to 10-12% of bone loss (one T-score)
After this, women lose about 0.5% per year
By the time a woman is 80, how much bone loss has she lost?
CORRECT ANSWER ✓✓ 30%
Normal T score range for BMD
CORRECT ANSWER ✓✓ -2 to +2 (comparison to a young white woman)
Normal PVR
CORRECT ANSWER ✓✓ <100mL
Systemic and vaginal estrogen will not help with this type of urinary
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,incontinence?
CORRECT ANSWER ✓✓ Will NOT help with stress incontinence
Stress urinary incontinence
CORRECT ANSWER ✓✓ Vaginal estrogen and urinary incontinence: what type
does it help with?
ISSWSH Sexual Disorders in Menopause
CORRECT ANSWER ✓✓ Hypoactive sexual desire disorder. Female genital
arousal disorder. Persistent genital arousal disorder. Female orgasm disorder.
Female orgasmic illness syndrome
What hormones are associated with sexual desire in women?
CORRECT ANSWER ✓✓ Circulating androgens
Women who have had a BSO experience an abrupt and persistent decline in
what hormone?
CORRECT ANSWER ✓✓ Circulating androgen levels
HSDD and FSAD were combined into a single dysfunction called
CORRECT ANSWER ✓✓ Female sexual interest/arousal disorder
HSDD treatments
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, CORRECT ANSWER ✓✓ Flibanserin and bremelanotide
What is a z-score?
CORRECT ANSWER ✓✓ Is the number of standard deviations above or below
the average BMD for the average person of the same age, gender, and
ethnicity, the normal is also -2 to +2
Definition of osteoporosis
CORRECT ANSWER ✓✓ T score < -2.5
Definition of osteopenia
CORRECT ANSWER ✓✓ T score between -1 and -2.5
Definition of osteoporosis in premenopausal women
CORRECT ANSWER ✓✓ Women who have a low BMD (z-score < -2) and have
a history of fragility fracture
FRAX score
CORRECT ANSWER ✓✓ Used to predict the 10 year risk of fracture. Elements
include
• Age - 40-90
• Gender
• BMI
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2026 Accurate Real Exam Questions and Verified
Correct Answers (Graded A+)
Estrogen therapy in premature menopause
CORRECT ANSWER ✓✓ Transdermal 17 (100 mcg/d patch or gel). Oral 17B
estradiol 2mg/day. Vaginal ring: 17B 0.1mg/day. Oral CEE: 0.9-1.25mg/day
Should you check estradiol levels for prematures
CORRECT ANSWER ✓✓ Can consider, adjust therapy to achieve goal range of
80-120 pg/ml
Diagnosis of POI
CORRECT ANSWER ✓✓ H&P Labs:
- TSH
- Prolactin
- Pregnancy test
- Elevated FSH (>25 IU/L on 2 checks/4-6 weeks apart)
- AMH
1|Page
,- E2 can fluctuate greatly
- Low AFC
Assessment of etiology of POI
CORRECT ANSWER ✓✓ Genetic testing. Autoimmune workup
- TSH, thyroperoxidase antibody, 21-OH antibodies, fasting glucose, HbA1C
- Ovarian antibodies lack sensitivity and specificity
Rate of bone loss at menopause
CORRECT ANSWER ✓✓ An average annual loss of about 2% beginning 1-3
years before menopause and lasting 5-10 years. Across the menopause
transition women lose up to 10-12% of bone loss (one T-score)
After this, women lose about 0.5% per year
By the time a woman is 80, how much bone loss has she lost?
CORRECT ANSWER ✓✓ 30%
Normal T score range for BMD
CORRECT ANSWER ✓✓ -2 to +2 (comparison to a young white woman)
Normal PVR
CORRECT ANSWER ✓✓ <100mL
Systemic and vaginal estrogen will not help with this type of urinary
2|Page
,incontinence?
CORRECT ANSWER ✓✓ Will NOT help with stress incontinence
Stress urinary incontinence
CORRECT ANSWER ✓✓ Vaginal estrogen and urinary incontinence: what type
does it help with?
ISSWSH Sexual Disorders in Menopause
CORRECT ANSWER ✓✓ Hypoactive sexual desire disorder. Female genital
arousal disorder. Persistent genital arousal disorder. Female orgasm disorder.
Female orgasmic illness syndrome
What hormones are associated with sexual desire in women?
CORRECT ANSWER ✓✓ Circulating androgens
Women who have had a BSO experience an abrupt and persistent decline in
what hormone?
CORRECT ANSWER ✓✓ Circulating androgen levels
HSDD and FSAD were combined into a single dysfunction called
CORRECT ANSWER ✓✓ Female sexual interest/arousal disorder
HSDD treatments
3|Page
, CORRECT ANSWER ✓✓ Flibanserin and bremelanotide
What is a z-score?
CORRECT ANSWER ✓✓ Is the number of standard deviations above or below
the average BMD for the average person of the same age, gender, and
ethnicity, the normal is also -2 to +2
Definition of osteoporosis
CORRECT ANSWER ✓✓ T score < -2.5
Definition of osteopenia
CORRECT ANSWER ✓✓ T score between -1 and -2.5
Definition of osteoporosis in premenopausal women
CORRECT ANSWER ✓✓ Women who have a low BMD (z-score < -2) and have
a history of fragility fracture
FRAX score
CORRECT ANSWER ✓✓ Used to predict the 10 year risk of fracture. Elements
include
• Age - 40-90
• Gender
• BMI
4|Page
