NAMS Certification Latest Questions and
Answers (2026) | Updated Comprehensive
Review with Detailed Rationales | A+ Verified
• Physiology of VMS -✓✓-thermoregulatory center altered by increase in KNDy neurons
-activation of NK3R causes hot flashes
-blockade of NK3R reduces/eliminates hot flashes
-may also be affected by: serotonin, epinephrine, and norepinephrine; parasympathetic
nerve activity
• Off label rx for VMS -✓✓-SSRIs
-SNRIs
-Gabapentinoids
-Clonidine
-Oxybutynin
• Studies on Fractional Co2 Laser for GSM -✓✓-not FDA approved
-vaginal symptoms and sexual function scores increased significantly at 3 mon; noted
continued improvement at 1y
• Ospemifene (Osphena) indications and MOA -✓✓-for treatment of dyspareunia
-decreases vaginal pH
-improves vaginal dryness
-shifts vaginal maturational index to superficial cells
-estrogen agonist/antagonist
• Ospemifene (Osphena) adverse effects -✓✓-increase in uterine polyps
-proliferative endometrium
-slight increased risk of hemorrhagic stroke and VTE
-can increase VMS
• treatment of urge incontinence -✓✓-behavioral modifications
-overactivity of the detrusor muscle
-antimuscarinics: *oxybutynin*
-nerve stimulation
-botox
• pelvic floor muscles - superficial -✓✓-transverse perineal
-bulbospongiosus,
-ischiocavernosus
• pelvic floor muscles - deep -✓✓-pubococcygeus
-iliococcygeus
, -obturator internus
-coccygeus
• What is low-tone pelvic floor dysfunction? -✓✓-weak, underactive and hypotonic
muscles that cannot maintain adequate contraction
• What is high-tone Pelvic Floor Dysfunction? -✓✓-weak pelvic floor muscles cannot
attain or maintain adequate relaxation
-muscles are overactive, hypertonic, spastic, shortened
• What are the symptoms of low-tone PFD? -✓✓-heaviness
-pressure
-pelvic organ prolapse
-incontinence
-altered sexual sensation
• What are the symptoms of high-tone PFD? -✓✓-urinary retention
-frequency
-urgency
-dysuria
-fecal retention/constipation
-penetrative dyspareunia and/or vaginismus
• Vaginal dilators for PFD -✓✓-Choose size that does not cause pain
-Show how to insert with a mirror
-Apply lubricant to dilator, insert dilator as far as is comfortable, leave dilator in place
for 5-10 min 1-2 times daily
-Use each for 4 wk before progressing to a size similar to partner size
• HRT and cognition - natural menopause -✓✓In RCT, HRT has little or no overall effect
on short or long-term cognition
• HRT and cognition - surgical menopause -✓✓HRT may be beneficial in improving
verbal memory in the short term
• In the SWANN survey, which groups of women were most likely to experience sleep
disturbance? -✓✓-late perimenopause (45%)
-surgical menopause (47%)
• non-menopausal causes of chronic myalgia -✓✓-fibromyalgia
-arthritis
-statins
-biphosphonates
• 3 simple questions to dx arthritis -✓✓1. Does pt have joint-based pain?
Answers (2026) | Updated Comprehensive
Review with Detailed Rationales | A+ Verified
• Physiology of VMS -✓✓-thermoregulatory center altered by increase in KNDy neurons
-activation of NK3R causes hot flashes
-blockade of NK3R reduces/eliminates hot flashes
-may also be affected by: serotonin, epinephrine, and norepinephrine; parasympathetic
nerve activity
• Off label rx for VMS -✓✓-SSRIs
-SNRIs
-Gabapentinoids
-Clonidine
-Oxybutynin
• Studies on Fractional Co2 Laser for GSM -✓✓-not FDA approved
-vaginal symptoms and sexual function scores increased significantly at 3 mon; noted
continued improvement at 1y
• Ospemifene (Osphena) indications and MOA -✓✓-for treatment of dyspareunia
-decreases vaginal pH
-improves vaginal dryness
-shifts vaginal maturational index to superficial cells
-estrogen agonist/antagonist
• Ospemifene (Osphena) adverse effects -✓✓-increase in uterine polyps
-proliferative endometrium
-slight increased risk of hemorrhagic stroke and VTE
-can increase VMS
• treatment of urge incontinence -✓✓-behavioral modifications
-overactivity of the detrusor muscle
-antimuscarinics: *oxybutynin*
-nerve stimulation
-botox
• pelvic floor muscles - superficial -✓✓-transverse perineal
-bulbospongiosus,
-ischiocavernosus
• pelvic floor muscles - deep -✓✓-pubococcygeus
-iliococcygeus
, -obturator internus
-coccygeus
• What is low-tone pelvic floor dysfunction? -✓✓-weak, underactive and hypotonic
muscles that cannot maintain adequate contraction
• What is high-tone Pelvic Floor Dysfunction? -✓✓-weak pelvic floor muscles cannot
attain or maintain adequate relaxation
-muscles are overactive, hypertonic, spastic, shortened
• What are the symptoms of low-tone PFD? -✓✓-heaviness
-pressure
-pelvic organ prolapse
-incontinence
-altered sexual sensation
• What are the symptoms of high-tone PFD? -✓✓-urinary retention
-frequency
-urgency
-dysuria
-fecal retention/constipation
-penetrative dyspareunia and/or vaginismus
• Vaginal dilators for PFD -✓✓-Choose size that does not cause pain
-Show how to insert with a mirror
-Apply lubricant to dilator, insert dilator as far as is comfortable, leave dilator in place
for 5-10 min 1-2 times daily
-Use each for 4 wk before progressing to a size similar to partner size
• HRT and cognition - natural menopause -✓✓In RCT, HRT has little or no overall effect
on short or long-term cognition
• HRT and cognition - surgical menopause -✓✓HRT may be beneficial in improving
verbal memory in the short term
• In the SWANN survey, which groups of women were most likely to experience sleep
disturbance? -✓✓-late perimenopause (45%)
-surgical menopause (47%)
• non-menopausal causes of chronic myalgia -✓✓-fibromyalgia
-arthritis
-statins
-biphosphonates
• 3 simple questions to dx arthritis -✓✓1. Does pt have joint-based pain?
