NAMS MENOPAUSE CERIFICATION EXAM |
2026/2027 WITH ACTUAL QUESTIONS AND
VERIFIED DETAILED ANSWERS|100%
CORRECT |ALREADY GRADED A
Climacteric phase
The period of endrocrinologic, somatic, and transitory psychologic changes that occur around the
time of menopause.
Perimenopause Menopause Transition, Early
List the STRAW Stage
What defines the phase?
STRAW Stage: (Stage -2)
Persistent difference of 7 days or more in the length of consecutive cycles.
Perimenopause Menopause Transition, Late
List the STRAW Stage
What defines the phase?
STRAW Stage: (Stage -1)
60 or more consecutive days of amenorrhea
Luteal out of phase event (LOOP)
,NAMS MENOPAUSE CERIFICATION EXAM |
2026/2027 WITH ACTUAL QUESTIONS AND
VERIFIED DETAILED ANSWERS|100%
CORRECT |ALREADY GRADED A
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.
Describe the E2 level during the life of a patient with obesity.
They are also more likely to have lower premenopause/perimenopausal estradiol levels
compared to patients with average BMIs. However, the level is the highest in postmenopausal
patients with obesity.
In comparison to other ethnicities, Chinese and Japanese women have ___ E2 levels?
These ethnic groups have lower estradiol levels than white, black and hispanic women.
STRAW Stage +2, describe the timeline as well as the predominant symptoms.
Postmenopause, Late. (Remaining Lifespan) 5-8 years after FMP. Somatic aging predominates.
Increased genitourinary symptoms.
Stages +1a, +1b, +1c, describe the timeline as well as the supportive criteria and the symptoms.
Postmenopause, Early. 2 years after FMP.
+1a/b (2yrs) FSH variable where as the AMH and InhB are low. The AFC are very low. VMS
predominate.
,NAMS MENOPAUSE CERIFICATION EXAM |
2026/2027 WITH ACTUAL QUESTIONS AND
VERIFIED DETAILED ANSWERS|100%
CORRECT |ALREADY GRADED A
1c (3-6yrs) FSH levels stabilize. The other measures continue as previous.
Elevated FSH, LH
Endocrine labs after menopause
AMH, Inhibin B
These hormones work during reproductive years to not deplete follicle pool too quickly.
Describe the phases during the early menopause transition and what happens with PMS
symptoms
Menstrual cycle shortens. Due to unrestrained FSH, follicular phase compresses. More
premenstrual symptoms due to the longer luteal phase. Cycle irregularity and skipped cycles
because of ovulatory failure and increased atresia.
How to respond if a patient requests FSH lab?
many pitfalls, variable depending on the day of the cycle you draw the lab, normal or low FSH is
not helpful.
What lab is potentially the superior marker of time to menopause?
, NAMS MENOPAUSE CERIFICATION EXAM |
2026/2027 WITH ACTUAL QUESTIONS AND
VERIFIED DETAILED ANSWERS|100%
CORRECT |ALREADY GRADED A
AMH
DHEA (dehydroepiandrosterone)
Adrenal androgens: precursor hromones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues.
Location of GU estrogen receptors (4)
Vagina, vulva, urethra, trigone of the bladder
List the effects of estrogen on tissue (4+2)
1 ) maintains blood flow to tissue, maintains the collagen within the epithelium, and maintains
the hyaluronic acid and mucopolysaccharides within the moistened epithelial surface, maintains
pH (4.5) 2) supports microbiome and protects tissue from pathogens
List the vaginal changes with menopause you might note on clinical/microscopic exam.
Thinning of the epithelial layer, loss of elasticity with narrowing of the canal and poor distention,
noted on pelvic exam with loss or absence or rugae. Due to the decrease in glycogen content, the
lactobacilli are decreased resulting in higher pH.
2026/2027 WITH ACTUAL QUESTIONS AND
VERIFIED DETAILED ANSWERS|100%
CORRECT |ALREADY GRADED A
Climacteric phase
The period of endrocrinologic, somatic, and transitory psychologic changes that occur around the
time of menopause.
Perimenopause Menopause Transition, Early
List the STRAW Stage
What defines the phase?
STRAW Stage: (Stage -2)
Persistent difference of 7 days or more in the length of consecutive cycles.
Perimenopause Menopause Transition, Late
List the STRAW Stage
What defines the phase?
STRAW Stage: (Stage -1)
60 or more consecutive days of amenorrhea
Luteal out of phase event (LOOP)
,NAMS MENOPAUSE CERIFICATION EXAM |
2026/2027 WITH ACTUAL QUESTIONS AND
VERIFIED DETAILED ANSWERS|100%
CORRECT |ALREADY GRADED A
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.
Describe the E2 level during the life of a patient with obesity.
They are also more likely to have lower premenopause/perimenopausal estradiol levels
compared to patients with average BMIs. However, the level is the highest in postmenopausal
patients with obesity.
In comparison to other ethnicities, Chinese and Japanese women have ___ E2 levels?
These ethnic groups have lower estradiol levels than white, black and hispanic women.
STRAW Stage +2, describe the timeline as well as the predominant symptoms.
Postmenopause, Late. (Remaining Lifespan) 5-8 years after FMP. Somatic aging predominates.
Increased genitourinary symptoms.
Stages +1a, +1b, +1c, describe the timeline as well as the supportive criteria and the symptoms.
Postmenopause, Early. 2 years after FMP.
+1a/b (2yrs) FSH variable where as the AMH and InhB are low. The AFC are very low. VMS
predominate.
,NAMS MENOPAUSE CERIFICATION EXAM |
2026/2027 WITH ACTUAL QUESTIONS AND
VERIFIED DETAILED ANSWERS|100%
CORRECT |ALREADY GRADED A
1c (3-6yrs) FSH levels stabilize. The other measures continue as previous.
Elevated FSH, LH
Endocrine labs after menopause
AMH, Inhibin B
These hormones work during reproductive years to not deplete follicle pool too quickly.
Describe the phases during the early menopause transition and what happens with PMS
symptoms
Menstrual cycle shortens. Due to unrestrained FSH, follicular phase compresses. More
premenstrual symptoms due to the longer luteal phase. Cycle irregularity and skipped cycles
because of ovulatory failure and increased atresia.
How to respond if a patient requests FSH lab?
many pitfalls, variable depending on the day of the cycle you draw the lab, normal or low FSH is
not helpful.
What lab is potentially the superior marker of time to menopause?
, NAMS MENOPAUSE CERIFICATION EXAM |
2026/2027 WITH ACTUAL QUESTIONS AND
VERIFIED DETAILED ANSWERS|100%
CORRECT |ALREADY GRADED A
AMH
DHEA (dehydroepiandrosterone)
Adrenal androgens: precursor hromones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues.
Location of GU estrogen receptors (4)
Vagina, vulva, urethra, trigone of the bladder
List the effects of estrogen on tissue (4+2)
1 ) maintains blood flow to tissue, maintains the collagen within the epithelium, and maintains
the hyaluronic acid and mucopolysaccharides within the moistened epithelial surface, maintains
pH (4.5) 2) supports microbiome and protects tissue from pathogens
List the vaginal changes with menopause you might note on clinical/microscopic exam.
Thinning of the epithelial layer, loss of elasticity with narrowing of the canal and poor distention,
noted on pelvic exam with loss or absence or rugae. Due to the decrease in glycogen content, the
lactobacilli are decreased resulting in higher pH.
