MENOPAUSE SOCIETY EXAM QUESTIONS AND
ANSWERS
What is the World Health Organization (WHO) definition of osteoporosis based on bone
mineral density (BMD) T-score? - Answers - A T-score ≤ -2.5 at the lumbar spine,
femoral neck, or total hip defines osteoporosis per WHO criteria.
At what age does the North American Menopause Society recommend routine DXA
screening for osteoporosis in postmenopausal women? - Answers - Age 65 years or
older is the threshold for routine DXA screening in postmenopausal women, or younger
if risk factors are present.
How is osteopenia defined by T-score on DXA? - Answers - A T-score between -1.0 and
-2.5 defines osteopenia.
What is the primary effect of menopause on bone health? - Answers - Estrogen
deficiency after menopause accelerates bone resorption, leading to rapid bone loss.
List three major risk factors for low bone mass and fracture in postmenopausal women.
- Answers - Advanced age, prior fragility fracture, and glucocorticoid use are major risk
factors.
Which tool is commonly used to estimate 10-year fracture risk in clinical practice? -
Answers - FRAX (Fracture Risk Assessment Tool) is commonly used to estimate 10-
year fracture risk.
What is the threshold 10-year risk of hip fracture or major osteoporotic fracture that
indicates pharmacologic therapy according to FRAX? - Answers - A 10-year hip fracture
risk ≥3% or major osteoporotic fracture risk ≥20% indicates pharmacologic therapy per
FRAX.
Name two first-line pharmacologic therapies for osteoporosis in postmenopausal
women. - Answers - Bisphosphonates (e.g., alendronate, risedronate, zoledronic acid)
and denosumab are first-line therapies.
What is the role of hormone therapy in the prevention of postmenopausal osteoporosis?
- Answers - Hormone therapy is effective for prevention of bone loss in early
postmenopausal women at risk, but not first-line for osteoporosis treatment.
Which pharmacologic agent is preferred for women at very high risk of fracture? -
Answers - Anabolic agents (e.g., teriparatide, abaloparatide, romosozumab) are
preferred for women at very high fracture risk.
, What are the main contraindications to menopausal hormone therapy? - Answers -
Active or recent breast cancer, unexplained vaginal bleeding, active thromboembolic
disease, and liver dysfunction are main contraindications to hormone therapy.
Why is progestogen added to estrogen therapy in women with an intact uterus? -
Answers - Progestogen is needed with estrogen therapy in women with a uterus to
prevent endometrial hyperplasia/cancer.
Compare the risks of oral versus transdermal estrogen therapy. - Answers -
Transdermal estrogen has a lower risk of venous thromboembolism and stroke
compared to oral estrogen.
What is the recommended duration of systemic hormone therapy for vasomotor
symptoms? - Answers - The shortest duration necessary to control symptoms, typically
reassessed annually; often 3-5 years for systemic therapy.
Describe the difference between continuous and sequential hormone therapy regimens.
- Answers - Continuous regimens provide daily estrogen and progestogen; sequential
regimens provide estrogen daily and progestogen for 10-14 days/month.
List two common side effects of systemic hormone therapy. - Answers - Breast
tenderness and vaginal bleeding are common side effects of systemic hormone therapy.
Name two types of selective estrogen receptor modulators (SERMs) used in
menopause management. - Answers - Raloxifene and bazedoxifene are SERMs used
in menopause management.
What are the risks associated with compounded or non-approved hormone therapy
preparations? - Answers - Compounded or non-approved hormone therapies carry risks
of inconsistent dosing, lack of efficacy, and increased adverse effects.
Which local therapy is recommended for genitourinary syndrome of menopause? -
Answers - Vaginal estrogen is recommended for genitourinary syndrome of menopause
(GSM).
Name two nonhormonal prescription options for vasomotor symptom management. -
Answers - SSRIs (e.g., paroxetine) and SNRIs (e.g., venlafaxine) are nonhormonal
prescription options for vasomotor symptoms.
What is the evidence for the efficacy of over-the-counter herbal supplements in
menopause symptom relief? - Answers - There is insufficient evidence for efficacy of
most herbal supplements (e.g., black cohosh, soy) in menopause symptom relief.
What is the role of vaginal moisturizers and lubricants in managing genitourinary
syndrome of menopause? - Answers - Vaginal moisturizers and lubricants are first-line
for mild GSM symptoms and safe for long-term use.
ANSWERS
What is the World Health Organization (WHO) definition of osteoporosis based on bone
mineral density (BMD) T-score? - Answers - A T-score ≤ -2.5 at the lumbar spine,
femoral neck, or total hip defines osteoporosis per WHO criteria.
At what age does the North American Menopause Society recommend routine DXA
screening for osteoporosis in postmenopausal women? - Answers - Age 65 years or
older is the threshold for routine DXA screening in postmenopausal women, or younger
if risk factors are present.
How is osteopenia defined by T-score on DXA? - Answers - A T-score between -1.0 and
-2.5 defines osteopenia.
What is the primary effect of menopause on bone health? - Answers - Estrogen
deficiency after menopause accelerates bone resorption, leading to rapid bone loss.
List three major risk factors for low bone mass and fracture in postmenopausal women.
- Answers - Advanced age, prior fragility fracture, and glucocorticoid use are major risk
factors.
Which tool is commonly used to estimate 10-year fracture risk in clinical practice? -
Answers - FRAX (Fracture Risk Assessment Tool) is commonly used to estimate 10-
year fracture risk.
What is the threshold 10-year risk of hip fracture or major osteoporotic fracture that
indicates pharmacologic therapy according to FRAX? - Answers - A 10-year hip fracture
risk ≥3% or major osteoporotic fracture risk ≥20% indicates pharmacologic therapy per
FRAX.
Name two first-line pharmacologic therapies for osteoporosis in postmenopausal
women. - Answers - Bisphosphonates (e.g., alendronate, risedronate, zoledronic acid)
and denosumab are first-line therapies.
What is the role of hormone therapy in the prevention of postmenopausal osteoporosis?
- Answers - Hormone therapy is effective for prevention of bone loss in early
postmenopausal women at risk, but not first-line for osteoporosis treatment.
Which pharmacologic agent is preferred for women at very high risk of fracture? -
Answers - Anabolic agents (e.g., teriparatide, abaloparatide, romosozumab) are
preferred for women at very high fracture risk.
, What are the main contraindications to menopausal hormone therapy? - Answers -
Active or recent breast cancer, unexplained vaginal bleeding, active thromboembolic
disease, and liver dysfunction are main contraindications to hormone therapy.
Why is progestogen added to estrogen therapy in women with an intact uterus? -
Answers - Progestogen is needed with estrogen therapy in women with a uterus to
prevent endometrial hyperplasia/cancer.
Compare the risks of oral versus transdermal estrogen therapy. - Answers -
Transdermal estrogen has a lower risk of venous thromboembolism and stroke
compared to oral estrogen.
What is the recommended duration of systemic hormone therapy for vasomotor
symptoms? - Answers - The shortest duration necessary to control symptoms, typically
reassessed annually; often 3-5 years for systemic therapy.
Describe the difference between continuous and sequential hormone therapy regimens.
- Answers - Continuous regimens provide daily estrogen and progestogen; sequential
regimens provide estrogen daily and progestogen for 10-14 days/month.
List two common side effects of systemic hormone therapy. - Answers - Breast
tenderness and vaginal bleeding are common side effects of systemic hormone therapy.
Name two types of selective estrogen receptor modulators (SERMs) used in
menopause management. - Answers - Raloxifene and bazedoxifene are SERMs used
in menopause management.
What are the risks associated with compounded or non-approved hormone therapy
preparations? - Answers - Compounded or non-approved hormone therapies carry risks
of inconsistent dosing, lack of efficacy, and increased adverse effects.
Which local therapy is recommended for genitourinary syndrome of menopause? -
Answers - Vaginal estrogen is recommended for genitourinary syndrome of menopause
(GSM).
Name two nonhormonal prescription options for vasomotor symptom management. -
Answers - SSRIs (e.g., paroxetine) and SNRIs (e.g., venlafaxine) are nonhormonal
prescription options for vasomotor symptoms.
What is the evidence for the efficacy of over-the-counter herbal supplements in
menopause symptom relief? - Answers - There is insufficient evidence for efficacy of
most herbal supplements (e.g., black cohosh, soy) in menopause symptom relief.
What is the role of vaginal moisturizers and lubricants in managing genitourinary
syndrome of menopause? - Answers - Vaginal moisturizers and lubricants are first-line
for mild GSM symptoms and safe for long-term use.
