NAMS Certification Flashcards
QUESTIONS AND VERIFIED
CORRECT ANSWERS
GRADED A+ [LATEST 2026-
2027] 100% GUARANTEED
PASS
How does the HPA axis impact adrenal androgen production during MT? - CORRECT ANSWER-
85% of those in the late perimenopause and early menopause experience:
Marked rise in DHEA and androstenediol.
Moderate rise in DHEAS, testosterone, and androstenedione.
Adrenal androgen levels return to premenopause level within 1 to 2 years after FMP.
Marked rise in cortisol is associated with rise in FSH in late perimenopause.
Changes in cortisol patterns associated with mood, sleep, and vasomotor symptoms (VMS).
What are risk factors for vasomotor symptoms? - CORRECT ANSWER-Obesity (or weight gain).
Smoking (tobacco or nicotine).
,Low socioeconomic position.
Low education attainment.
High-fat or high-sugar diets.
Race or ethnicity.
Oophorectomy.
Medical comorbidities (thyroid disease, diabetes mellitus [DM], obstructive sleep apnea [OSA],
chronic pain conditions).
High anxiety levels.
What are other possible reasons for VMS not related to menopause? - CORRECT ANSWER-
Thyroid dysfunction, infections, malignancy, pheochromocytoma, and carcinoid syndrome.
Warning signs that trigger evaluation:
New-onset VMS in late menopause.
Younger women (premenopause or menopause transition) with persistent VMS accompanied
by nausea, vomiting, diarrhea, weight loss, fever, cough, wheezing, palpitations, tachycardia,
flushing, or persistent headache.
What are GSM signs of hypoestrogenism? - CORRECT ANSWER-Thinning loss of pubic hair
Thinning or fusion of labia
Clitoral hood retraction or fusion
Posterior fissuring
Introital retraction
Pallor or erythema, petechiae
Loss of rugae
Loss of hymenal remnants
Leukorrhea
, pH>5
Loss of vaginal and cervical secretions
Prominence of urethral meatus/caruncle
What are symptoms associated with GSM? - CORRECT ANSWER-Vulvovaginal dryness
Vulvovaginal itching, burning, or irritation
Vaginal discharge
Dysuria
Nocturia
Urinary frequency or urgency
Recurrent urinary tract infection
Decreased lubrication/arousal with sexual activity
Pain with introital insertion during sexual activity
Dyspareunia
Decreased or delayed orgasm
Postcoital bleeding
What is the Ddx for GSM? - CORRECT ANSWER-Lichen sclerosus, planus, or simplex.
Desquamative inflammatory vaginitis.
Contact dermatitis.
Vulvovaginal candidiasis and vaginitis.
Cicatricial pemphigoid.
Idiopathic overactive bladder.
Detrusor overactivity.
Vulvodynia/Vestibulodynia.
Psychological disorders.
QUESTIONS AND VERIFIED
CORRECT ANSWERS
GRADED A+ [LATEST 2026-
2027] 100% GUARANTEED
PASS
How does the HPA axis impact adrenal androgen production during MT? - CORRECT ANSWER-
85% of those in the late perimenopause and early menopause experience:
Marked rise in DHEA and androstenediol.
Moderate rise in DHEAS, testosterone, and androstenedione.
Adrenal androgen levels return to premenopause level within 1 to 2 years after FMP.
Marked rise in cortisol is associated with rise in FSH in late perimenopause.
Changes in cortisol patterns associated with mood, sleep, and vasomotor symptoms (VMS).
What are risk factors for vasomotor symptoms? - CORRECT ANSWER-Obesity (or weight gain).
Smoking (tobacco or nicotine).
,Low socioeconomic position.
Low education attainment.
High-fat or high-sugar diets.
Race or ethnicity.
Oophorectomy.
Medical comorbidities (thyroid disease, diabetes mellitus [DM], obstructive sleep apnea [OSA],
chronic pain conditions).
High anxiety levels.
What are other possible reasons for VMS not related to menopause? - CORRECT ANSWER-
Thyroid dysfunction, infections, malignancy, pheochromocytoma, and carcinoid syndrome.
Warning signs that trigger evaluation:
New-onset VMS in late menopause.
Younger women (premenopause or menopause transition) with persistent VMS accompanied
by nausea, vomiting, diarrhea, weight loss, fever, cough, wheezing, palpitations, tachycardia,
flushing, or persistent headache.
What are GSM signs of hypoestrogenism? - CORRECT ANSWER-Thinning loss of pubic hair
Thinning or fusion of labia
Clitoral hood retraction or fusion
Posterior fissuring
Introital retraction
Pallor or erythema, petechiae
Loss of rugae
Loss of hymenal remnants
Leukorrhea
, pH>5
Loss of vaginal and cervical secretions
Prominence of urethral meatus/caruncle
What are symptoms associated with GSM? - CORRECT ANSWER-Vulvovaginal dryness
Vulvovaginal itching, burning, or irritation
Vaginal discharge
Dysuria
Nocturia
Urinary frequency or urgency
Recurrent urinary tract infection
Decreased lubrication/arousal with sexual activity
Pain with introital insertion during sexual activity
Dyspareunia
Decreased or delayed orgasm
Postcoital bleeding
What is the Ddx for GSM? - CORRECT ANSWER-Lichen sclerosus, planus, or simplex.
Desquamative inflammatory vaginitis.
Contact dermatitis.
Vulvovaginal candidiasis and vaginitis.
Cicatricial pemphigoid.
Idiopathic overactive bladder.
Detrusor overactivity.
Vulvodynia/Vestibulodynia.
Psychological disorders.
