1 | Page
NAMS MENOPAUSE CERTIFICATION EXAM
2026/2027 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 | Page
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 | Page
Adrenal androgens: precursor hromones produced by the
adrenal gland that are enzymatically converted to active
androgens or estrogens in peripheral tissues. - correct answer-
DHEA (dehydroepiandrosterone)
Vagina, vulva, urethra, trigone of the bladder - correct answer-
Location 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 answer- Effects of
estrogen on tissue
Thinning, loss of elasticity, loss or absence or rugae. - correct
answer- Vaginal changes with menopause
vagina narrows, urethra moves closer to the introitus. - correct
answer- Vagina and urethra in menopause
Vaginal estrogen and urinary incontinence: what type does it
help with? - correct answer- Stress urinary incontinence
NAMS MENOPAUSE CERTIFICATION EXAM
2026/2027 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 | Page
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 | Page
Adrenal androgens: precursor hromones produced by the
adrenal gland that are enzymatically converted to active
androgens or estrogens in peripheral tissues. - correct answer-
DHEA (dehydroepiandrosterone)
Vagina, vulva, urethra, trigone of the bladder - correct answer-
Location 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 answer- Effects of
estrogen on tissue
Thinning, loss of elasticity, loss or absence or rugae. - correct
answer- Vaginal changes with menopause
vagina narrows, urethra moves closer to the introitus. - correct
answer- Vagina and urethra in menopause
Vaginal estrogen and urinary incontinence: what type does it
help with? - correct answer- Stress urinary incontinence
