1 | Page
NAMS MENOPAUSE CERTIFICATION 2025
UPDATED ACTUAL EXAM WITH CORRECT
SOLUTIONS.
The period of endrocrinologic, somatic, and transitory
psychologic changes that occur around the time of menopause.
- correct answer- Climacteric phase
LMP before age 45 - correct answer- Early menopause
LMP after age 54 - correct answer- Late menopause
Menopause that occurs before age 40 - correct answer-
Primary ovarian insufficiency
Persistent difference of 7 days or more in the length of
consecutive cycles. - correct answer- Early menopause
transition (stage -2)
60 or more consecutive days of amenorrhea - correct answer-
Late menopause transition (stage -1)
,2 | Page
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 answer- Luteal 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 answer- Obese
women and estradiol levels during menopause
These ethnic groups have lower estradiol levels then white,
black and hispanic women. - correct answer- Chinese and
Japanese women
late menopause stage: 5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms. - correct
answer- stage +2
,3 | Pq1aq1gq1e
q1 q1 q1
early post menopause: 2 years after FMP. FSH rises, estradiol
decreases. VMS predominate. - correct answer- Stages +1a,
+1b, +1c
Endocrine labs after menopause - correct answer- Elevated
FSH, LH
These hormones work during reproductive years to not deplete
follicle pool too quickly. - correct answer- AMH, inhibin B
Menstrual cycle variable, persistent >7 day difference between
difference in length of consecutive cycles. - correct answer-
Phases 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
answer- How to respond if a patient requests FSH lab?
AMH - correct answer- The potentially superior marker of
menopause, a lab.
, 4 | Pq1aq1gq1e
q1 q1 q1
Adrenalq1androgens:q1precursorq1hromonesq1producedq1byq1theq1a
drenalq1glandq1thatq1areq1enzymaticallyq1convertedq1toq1activeq1an
drogensq1orq1estrogensq1inq1peripheralq1tissues.q1-
q1correctq1answer-q1DHEAq1(dehydroepiandrosterone)
Vagina,q1vulva,q1urethra,q1trigoneq1ofq1theq1bladderq1-
q1correctq1answer-
Locationq1ofq1estrogenq1receptors
maintainq1bloodq1flow,q1theq1collagen,q1andq1HAq1withinq1theq1epith
elialq1surfaces.q1Supportsq1microbiomeq1whichq1supportsq1acidityq1
ofq1vaginaq1andq1protectsq1tissueq1fromq1pathogens.q1-
q1correctq1answer-q1Effectsq1ofq1estrogenq1onq1tissue
Thinning,q1lossq1ofq1elasticity,q1lossq1orq1absenceq1orq1rugae.q1-
q1correctq1answer-q1Vaginalq1changesq1withq1menopause
vaginaq1narrows,q1urethraq1movesq1closerq1toq1theq1introitus.q1-
q1correctq1answer-q1Vaginaq1andq1urethraq1inq1menopause
Vaginalq1estrogenq1andq1urinaryq1incontinence:q1whatq1typeq1doesq1i
tq1helpq1with?q1-q1correctq1answer-q1Stressq1urinaryq1incontinence
NAMS MENOPAUSE CERTIFICATION 2025
UPDATED ACTUAL EXAM WITH CORRECT
SOLUTIONS.
The period of endrocrinologic, somatic, and transitory
psychologic changes that occur around the time of menopause.
- correct answer- Climacteric phase
LMP before age 45 - correct answer- Early menopause
LMP after age 54 - correct answer- Late menopause
Menopause that occurs before age 40 - correct answer-
Primary ovarian insufficiency
Persistent difference of 7 days or more in the length of
consecutive cycles. - correct answer- Early menopause
transition (stage -2)
60 or more consecutive days of amenorrhea - correct answer-
Late menopause transition (stage -1)
,2 | Page
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 answer- Luteal 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 answer- Obese
women and estradiol levels during menopause
These ethnic groups have lower estradiol levels then white,
black and hispanic women. - correct answer- Chinese and
Japanese women
late menopause stage: 5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms. - correct
answer- stage +2
,3 | Pq1aq1gq1e
q1 q1 q1
early post menopause: 2 years after FMP. FSH rises, estradiol
decreases. VMS predominate. - correct answer- Stages +1a,
+1b, +1c
Endocrine labs after menopause - correct answer- Elevated
FSH, LH
These hormones work during reproductive years to not deplete
follicle pool too quickly. - correct answer- AMH, inhibin B
Menstrual cycle variable, persistent >7 day difference between
difference in length of consecutive cycles. - correct answer-
Phases 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
answer- How to respond if a patient requests FSH lab?
AMH - correct answer- The potentially superior marker of
menopause, a lab.
, 4 | Pq1aq1gq1e
q1 q1 q1
Adrenalq1androgens:q1precursorq1hromonesq1producedq1byq1theq1a
drenalq1glandq1thatq1areq1enzymaticallyq1convertedq1toq1activeq1an
drogensq1orq1estrogensq1inq1peripheralq1tissues.q1-
q1correctq1answer-q1DHEAq1(dehydroepiandrosterone)
Vagina,q1vulva,q1urethra,q1trigoneq1ofq1theq1bladderq1-
q1correctq1answer-
Locationq1ofq1estrogenq1receptors
maintainq1bloodq1flow,q1theq1collagen,q1andq1HAq1withinq1theq1epith
elialq1surfaces.q1Supportsq1microbiomeq1whichq1supportsq1acidityq1
ofq1vaginaq1andq1protectsq1tissueq1fromq1pathogens.q1-
q1correctq1answer-q1Effectsq1ofq1estrogenq1onq1tissue
Thinning,q1lossq1ofq1elasticity,q1lossq1orq1absenceq1orq1rugae.q1-
q1correctq1answer-q1Vaginalq1changesq1withq1menopause
vaginaq1narrows,q1urethraq1movesq1closerq1toq1theq1introitus.q1-
q1correctq1answer-q1Vaginaq1andq1urethraq1inq1menopause
Vaginalq1estrogenq1andq1urinaryq1incontinence:q1whatq1typeq1doesq1i
tq1helpq1with?q1-q1correctq1answer-q1Stressq1urinaryq1incontinence
