NAMS MENOPAUSE CERTIFICATION EXAM
FINAL STUDY PAPER 2026 COMPLETE
QUESTIONS AND ANSWERS
◉ Cognition and surgical menopause. Answer: Memory for verbal
information can be compromised immediately after surgical
menopause.
◉ Mediterranean diet and cognition. Answer: Small benefit for
global cognition and memory.
◉ Effect of HRT on cognition. Answer: Small or no overall effect.
◉ HRT and dementia risk. Answer: EPT replacement was shown to
double the risk of developing dementia.
◉ Reasons HRT may decrease Alzheimer's risk. Answer:
Observational studies imply it; clinical trial data supports it.
◉ Migraine headache and pregnancy. Answer: Typically migraines
improve as estrogen levels stabilize.
,◉ Menstrual migraine treatment. Answer: NSAID or triptan 2 days
before expected period.
◉ Most common form of arthritis. Answer: Osteoarthritis.
◉ Common thyroid disorder in women. Answer: Hashimoto
thyroiditis.
◉ Cold thyroid nodules. Answer: Typically most likely to be
malignant.
◉ HRT impact on gallbladder disease. Answer: Increases risk of
gallstones with oral HRT.
◉ Screening for Hep C start year. Answer: 1992.
◉ High-risk HPV types. Answer: 16 and 18.
◉ Percentage of women with genital HPV by age 50. Answer: 80%.
◉ Most commonly sexually transmitted infection in the US. Answer:
HPV.
,◉ Percentage of bone loss from menopause transition. Answer: 10-
12% on average.
◉ T score defining osteopenia. Answer: -1.5 to -2.5.
◉ T score defining osteoporosis. Answer: Less than -2.5.
◉ Z score defining osteoporosis before menopause. Answer: Less
than 2.0 with a history of a fragility fracture.
◉ z score less than 2.0. Answer: Indicates a history of a fragility
fracture.
◉ Highest risk of osteoporosis. Answer: White and Hispanic
populations.
◉ Long term care after hip fracture in women. Answer: 1 in 4
women (25%) require long term care.
◉ Long term loss of mobility after hip fracture in women. Answer: 1
in 2 women (50%) have long term loss of mobility.
◉ BMD comparison of Asians to white people. Answer: Asians have
lower BMD than white people.
, ◉ BMD comparison of Black women to white people. Answer: Black
women have higher BMD than white people.
◉ Risk for fracture with over 3 servings of alcohol daily. Answer:
38% for osteoporotic fracture and 68% for hip fracture.
◉ Ethnic specific versions of FRAX. Answer: White, Asian, Black,
Hispanic.
◉ Calcium needs for dairy free diet. Answer: 300mg calcium daily;
needs 800-1200mg.
◉ Tibolone and osteoporosis approval. Answer: Approved in
Mexico; decreases risk of vertebral and nonvertebral fracture but
increases risk of stroke.
◉ Estrogen approval for osteoporosis. Answer: Decreased risk of
vertebral and hip fracture in low fracture risk population, but not
shown to decrease fracture risk in women with osteoporosis.
◉ Black box warning for PTH receptor agonists. Answer:
Osteosarcoma.
FINAL STUDY PAPER 2026 COMPLETE
QUESTIONS AND ANSWERS
◉ Cognition and surgical menopause. Answer: Memory for verbal
information can be compromised immediately after surgical
menopause.
◉ Mediterranean diet and cognition. Answer: Small benefit for
global cognition and memory.
◉ Effect of HRT on cognition. Answer: Small or no overall effect.
◉ HRT and dementia risk. Answer: EPT replacement was shown to
double the risk of developing dementia.
◉ Reasons HRT may decrease Alzheimer's risk. Answer:
Observational studies imply it; clinical trial data supports it.
◉ Migraine headache and pregnancy. Answer: Typically migraines
improve as estrogen levels stabilize.
,◉ Menstrual migraine treatment. Answer: NSAID or triptan 2 days
before expected period.
◉ Most common form of arthritis. Answer: Osteoarthritis.
◉ Common thyroid disorder in women. Answer: Hashimoto
thyroiditis.
◉ Cold thyroid nodules. Answer: Typically most likely to be
malignant.
◉ HRT impact on gallbladder disease. Answer: Increases risk of
gallstones with oral HRT.
◉ Screening for Hep C start year. Answer: 1992.
◉ High-risk HPV types. Answer: 16 and 18.
◉ Percentage of women with genital HPV by age 50. Answer: 80%.
◉ Most commonly sexually transmitted infection in the US. Answer:
HPV.
,◉ Percentage of bone loss from menopause transition. Answer: 10-
12% on average.
◉ T score defining osteopenia. Answer: -1.5 to -2.5.
◉ T score defining osteoporosis. Answer: Less than -2.5.
◉ Z score defining osteoporosis before menopause. Answer: Less
than 2.0 with a history of a fragility fracture.
◉ z score less than 2.0. Answer: Indicates a history of a fragility
fracture.
◉ Highest risk of osteoporosis. Answer: White and Hispanic
populations.
◉ Long term care after hip fracture in women. Answer: 1 in 4
women (25%) require long term care.
◉ Long term loss of mobility after hip fracture in women. Answer: 1
in 2 women (50%) have long term loss of mobility.
◉ BMD comparison of Asians to white people. Answer: Asians have
lower BMD than white people.
, ◉ BMD comparison of Black women to white people. Answer: Black
women have higher BMD than white people.
◉ Risk for fracture with over 3 servings of alcohol daily. Answer:
38% for osteoporotic fracture and 68% for hip fracture.
◉ Ethnic specific versions of FRAX. Answer: White, Asian, Black,
Hispanic.
◉ Calcium needs for dairy free diet. Answer: 300mg calcium daily;
needs 800-1200mg.
◉ Tibolone and osteoporosis approval. Answer: Approved in
Mexico; decreases risk of vertebral and nonvertebral fracture but
increases risk of stroke.
◉ Estrogen approval for osteoporosis. Answer: Decreased risk of
vertebral and hip fracture in low fracture risk population, but not
shown to decrease fracture risk in women with osteoporosis.
◉ Black box warning for PTH receptor agonists. Answer:
Osteosarcoma.
