NAMS MENOPAUSE CERTIFICATION EXAM
2026/2027 WITH ACTUAL CORRECT
QUESTIONS AND VERIFIED DETAILED
ANSWERS |CURRENTLY TESTING
QUESTIONS AND SOLUTIONS|ALREADY
GRADED A+|NEWEST |BRAND NEW
VERSION|JUST RELEASED!!
What ethnicity has the least likely chance of having bad hot flashes?
Japanese
What ethnicity is the most likely to have bad hot flashes?
black
more frequent, longer duration.
Median length of hot flashes
10 years, early menopause transition women have them the longest.
Theories about etiology of hot flashes (6)
lower ovarian estradiol
thermoregulation zone is narrowed
neurokinins-regulate GnRH secretion. KNDy new meds
serotonin
cortisol and HPI axis dysregulation
endothelial dysfunction.
VIN
low grade-what to do
1|Page
,high grade-what to do
differentiated VIN-what to do
low grade is not precancerous
high grade is precancerous-GYN ONC
differentiated-wide local excision-high risk of invasive carcinoma.
most common type of vulvar cancer
squamous cell carcinoma
Vulvar disorder commonly misdiagnosed as eczema or dermatitis?
paget's disease
will not improve on steroids
screen for co-existing breast, GI or GU cancer. They are present 20-30% of the time.
Normal PVR
<100mL
systemic and vaginal estrogen will not help with this type of urinary incontinence?
will NOT help with stress incontinence.
Which topical vaginal estrogen has the highest dose?
the vaginal rings
FEMRING IS THE HIGHEST
Most common cause of vulvovaginitis?
BV
post menopause burning and diffuse yellow/brown discharge and dyspareunia that does not
respond to local ET?
2|Page
,desquamative inflammatory vaginitis. treat different with clindamycin or hydrocortisone+ET
What hormones are associated with sexual desire in women?
circulating androgens
Women who have had a BSO experience an abrupt and persistent decline in what hormone?
circulating androgen levels
HSDD and FSAD were combined into a single dysrunction called
female sexual interest/arousal disorder
HSDD treatments
flibanserin and bremelanotide
FGAD treatments (genital arousal disorder)
L-arginine, topical alprostadil, wellbutrin, oxytosin.
phosphodiesterase inhibitors-lacking in efficacy
Eros therapy device $300- vaccum-like the penis pump
FOD (orgasmic disorder) treatments
directed masturbation is most researched behavioral treatment.
Does systemic ET cause fibroids to resume growth?
Rarely. They often shrink after menopause.
What is true about cognition and menopause?
Difficulty concentrating and remembering are common.
What is true about cognition and surgical menopause
memory for verbal information can be compromised immediately after surgical menopause,
especially if it is before the typical age of mesopause.
3|Page
, Meta analysis of RCTs have shown small benefit of what diet/exercise for global cognition and
memory?
Mediterranean diet with olive oil and tai chi exercise helps with global cognition
Mediterranean diet with olive oil and isoflavone supplements helps with memory.
effect of HRT on cognition
small or no overall effect on cognition
What HRT can increase your risk for dementia based on the WHIMS study in 65+ year old
healthy women?
EPT replacement was shown to double the risk of developing dementia.
There was no significant increased risk in ET alone.
this is why HRT is not recommended after 65 for primary prevention of dementia
3 reasons supporting the idea that HRT in early menopause may decrease a woman's chance of
developing alzheimer's disease?
1. Observational studies imply it
2. Clinical trial of transdermal estradiol during the early postmenopause stage is associated with
reductions in AD pathology.
3. 18 year cumulative follow up data from WHI found that women randomized to ET had
significantly lower risk of dying from AD or dementia compared with women randomized to
receive placebo.
Migraine headache and pregnancy
typically migraines improve-estrogen levels stabilize
Migraine without aura after menopause
4|Page
2026/2027 WITH ACTUAL CORRECT
QUESTIONS AND VERIFIED DETAILED
ANSWERS |CURRENTLY TESTING
QUESTIONS AND SOLUTIONS|ALREADY
GRADED A+|NEWEST |BRAND NEW
VERSION|JUST RELEASED!!
What ethnicity has the least likely chance of having bad hot flashes?
Japanese
What ethnicity is the most likely to have bad hot flashes?
black
more frequent, longer duration.
Median length of hot flashes
10 years, early menopause transition women have them the longest.
Theories about etiology of hot flashes (6)
lower ovarian estradiol
thermoregulation zone is narrowed
neurokinins-regulate GnRH secretion. KNDy new meds
serotonin
cortisol and HPI axis dysregulation
endothelial dysfunction.
VIN
low grade-what to do
1|Page
,high grade-what to do
differentiated VIN-what to do
low grade is not precancerous
high grade is precancerous-GYN ONC
differentiated-wide local excision-high risk of invasive carcinoma.
most common type of vulvar cancer
squamous cell carcinoma
Vulvar disorder commonly misdiagnosed as eczema or dermatitis?
paget's disease
will not improve on steroids
screen for co-existing breast, GI or GU cancer. They are present 20-30% of the time.
Normal PVR
<100mL
systemic and vaginal estrogen will not help with this type of urinary incontinence?
will NOT help with stress incontinence.
Which topical vaginal estrogen has the highest dose?
the vaginal rings
FEMRING IS THE HIGHEST
Most common cause of vulvovaginitis?
BV
post menopause burning and diffuse yellow/brown discharge and dyspareunia that does not
respond to local ET?
2|Page
,desquamative inflammatory vaginitis. treat different with clindamycin or hydrocortisone+ET
What hormones are associated with sexual desire in women?
circulating androgens
Women who have had a BSO experience an abrupt and persistent decline in what hormone?
circulating androgen levels
HSDD and FSAD were combined into a single dysrunction called
female sexual interest/arousal disorder
HSDD treatments
flibanserin and bremelanotide
FGAD treatments (genital arousal disorder)
L-arginine, topical alprostadil, wellbutrin, oxytosin.
phosphodiesterase inhibitors-lacking in efficacy
Eros therapy device $300- vaccum-like the penis pump
FOD (orgasmic disorder) treatments
directed masturbation is most researched behavioral treatment.
Does systemic ET cause fibroids to resume growth?
Rarely. They often shrink after menopause.
What is true about cognition and menopause?
Difficulty concentrating and remembering are common.
What is true about cognition and surgical menopause
memory for verbal information can be compromised immediately after surgical menopause,
especially if it is before the typical age of mesopause.
3|Page
, Meta analysis of RCTs have shown small benefit of what diet/exercise for global cognition and
memory?
Mediterranean diet with olive oil and tai chi exercise helps with global cognition
Mediterranean diet with olive oil and isoflavone supplements helps with memory.
effect of HRT on cognition
small or no overall effect on cognition
What HRT can increase your risk for dementia based on the WHIMS study in 65+ year old
healthy women?
EPT replacement was shown to double the risk of developing dementia.
There was no significant increased risk in ET alone.
this is why HRT is not recommended after 65 for primary prevention of dementia
3 reasons supporting the idea that HRT in early menopause may decrease a woman's chance of
developing alzheimer's disease?
1. Observational studies imply it
2. Clinical trial of transdermal estradiol during the early postmenopause stage is associated with
reductions in AD pathology.
3. 18 year cumulative follow up data from WHI found that women randomized to ET had
significantly lower risk of dying from AD or dementia compared with women randomized to
receive placebo.
Migraine headache and pregnancy
typically migraines improve-estrogen levels stabilize
Migraine without aura after menopause
4|Page
