NAMS MENOPAUSE CERTIFICATION EXAM
WITH QUESTIONS AND VERIFIED ANSWERS
LATEST UPDATE
Climacteric phase
The period of endocrinologic, somatic, and transitory psychologic changes that occur
around the time of menopause.
Early menopause
LMP before age 45
Late menopause
LMP after age 54
Primary ovarian insufficiency
Menopause that occurs before age 40
Early menopause transition (stage -2)
Persistent difference of 7 days or more in the length of consecutive cycles.
,Late menopause transition (stage -1)
60 or more consecutive days of amenorrhea
Luteal out of phase event (LOOP)
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.
Obese women and estradiol levels during menopause
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)
Chinese and Japanese women
These ethnic groups have lower estradiol levels then white, black and hispanic women.
stage +2
late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased
genitourinary symptoms.
, Stages +1a, +1b, +1c
early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS
predominate.
Elevated FSH, LH
Endocrine labs after menopause
AMH, inhibin B
These hormones work during reproductive years to not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms
Menstrual cycle shortenes, follicular phase compresses, women spend more time in
luteal phase.. meaning more premenstrual symptoms and more frequent menstrual
periods.
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.
The potentially superior marker of menopause, a lab.
AMH
WITH QUESTIONS AND VERIFIED ANSWERS
LATEST UPDATE
Climacteric phase
The period of endocrinologic, somatic, and transitory psychologic changes that occur
around the time of menopause.
Early menopause
LMP before age 45
Late menopause
LMP after age 54
Primary ovarian insufficiency
Menopause that occurs before age 40
Early menopause transition (stage -2)
Persistent difference of 7 days or more in the length of consecutive cycles.
,Late menopause transition (stage -1)
60 or more consecutive days of amenorrhea
Luteal out of phase event (LOOP)
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.
Obese women and estradiol levels during menopause
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)
Chinese and Japanese women
These ethnic groups have lower estradiol levels then white, black and hispanic women.
stage +2
late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased
genitourinary symptoms.
, Stages +1a, +1b, +1c
early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS
predominate.
Elevated FSH, LH
Endocrine labs after menopause
AMH, inhibin B
These hormones work during reproductive years to not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms
Menstrual cycle shortenes, follicular phase compresses, women spend more time in
luteal phase.. meaning more premenstrual symptoms and more frequent menstrual
periods.
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.
The potentially superior marker of menopause, a lab.
AMH
