NAMs Menopause Certification ACTUAL EXAM Questions
And Correct Answers (Verified Answers) 2026
The period of endrocrinologic, somatic, and transitory psychologic changes that occur around the
time of menopause. - CORRECT ANSWER -Climacteric phase
LMP before age 45 - CORRECT ANSWER -Early menopause
LMP after age 54 - CORRECT ANSWER -Late menopause
Menopause that occurs before age 40 - CORRECT ANSWER -Primary ovarian insufficiency
Persistent difference of 7 days or more in the length of consecutive cycles. - CORRECT
ANSWER -Early menopause transition (stage -2)
60 or more consecutive days of amenorrhea - CORRECT ANSWER -Late menopause transition
(stage -1)
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. - CORRECT ANSWER -Luteal out of phase event (LOOP)
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) -
CORRECT ANSWER -Obese women and estradiol levels during menopause
These ethnic groups have lower estradiol levels then white, black and hispanic women. -
CORRECT ANSWER -Chinese and Japanese women
,late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased genitourinary
symptoms. - CORRECT ANSWER -stage +2
early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS predominate. -
CORRECT ANSWER -Stages +1a, +1b, +1c
Endocrine labs after menopause - CORRECT ANSWER -Elevated FSH, LH
These hormones work during reproductive years to not deplete follicle pool too quickly. -
CORRECT ANSWER -AMH, inhibin B
Menstrual cycle variable, persistent >7 day difference between difference in length of
consecutive cycles. - CORRECT ANSWER -Phases during menopause transition and PMS
symptoms
many pitfalls, variable depending on the day of the cycle you draw the lab, normal or low FSH is
not helpful. - CORRECT ANSWER -How to respond if a patient requests FSH lab?
AMH - CORRECT ANSWER -The potentially superior marker of menopause, a lab.
Adrenal androgens: precursor hromones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues. - CORRECT ANSWER -DHEA
(dehydroepiandrosterone)
Vagina, vulva, urethra, trigone of the bladder - CORRECT ANSWER -Location of estrogen
receptors
maintain blood flow, the collagen, and HA within the epithelial surfaces. Supports microbiome
which supports acidity of vagina and protects tissue from pathogens. - CORRECT ANSWER -
Effects of estrogen on tissue
,Thinning, loss of elasticity, loss or absence or rugae. - CORRECT ANSWER -Vaginal changes
with menopause
vagina narrows, urethra moves closer to the introitus. - CORRECT ANSWER -Vagina and
urethra in menopause
Vaginal estrogen and urinary incontinence: what type does it help with? - CORRECT ANSWER
-Stress urinary incontinence
Minoxidil, spironolactone, finasteride, estrogen therapy - CORRECT ANSWER -Treatment for
FPHL
-3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low. - CORRECT
ANSWER -Late reporoductive years -3b and -3a. What happens with menstrual cycles, FSH,
AMH, AFC, inhibin?
Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH level. -
CORRECT ANSWER -When it is appropriate to check an FSH during the cycle if you check it?
and why?
produced by granulosa cells
used to test damage to ovarian follicle reserve. If AMH is low, the woman has a low ovarian
reserve.
not recommended as a screening tool to predict fertility.
, Peaks at around 25 years old. So before age 25, this test is not helpful.
It is influenced by exogenous hormones. Lower in hormonal contraception users, but increases
after d/cing. - CORRECT ANSWER -AMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak?
Antral follicle count
Number of follicles that are detectable with ultrasound.
They are sensitive to FSH and considered to represent the availability pool of follicles. -
CORRECT ANSWER -AFC
25 or higher - CORRECT ANSWER -Late menopause transition (-1) FSH level on random draw
Higher - CORRECT ANSWER -Black women have higher or lower FSH levels?
lower - CORRECT ANSWER -Chinese and Japanese women have higher or lower estradiol
levels compared to white, black and hispanic women?
SHBG decreases
Testosterone/SHBG ratio increases by 80%. - CORRECT ANSWER -Menopause transition-
changes in SHBG and testosterone? ratio?
The free androgen index - CORRECT ANSWER -Testosterone/SHGB ratio is called what?
+1b (generally last 2 years) - CORRECT ANSWER -What stage are VMS more likely?
And Correct Answers (Verified Answers) 2026
The period of endrocrinologic, somatic, and transitory psychologic changes that occur around the
time of menopause. - CORRECT ANSWER -Climacteric phase
LMP before age 45 - CORRECT ANSWER -Early menopause
LMP after age 54 - CORRECT ANSWER -Late menopause
Menopause that occurs before age 40 - CORRECT ANSWER -Primary ovarian insufficiency
Persistent difference of 7 days or more in the length of consecutive cycles. - CORRECT
ANSWER -Early menopause transition (stage -2)
60 or more consecutive days of amenorrhea - CORRECT ANSWER -Late menopause transition
(stage -1)
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. - CORRECT ANSWER -Luteal out of phase event (LOOP)
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) -
CORRECT ANSWER -Obese women and estradiol levels during menopause
These ethnic groups have lower estradiol levels then white, black and hispanic women. -
CORRECT ANSWER -Chinese and Japanese women
,late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased genitourinary
symptoms. - CORRECT ANSWER -stage +2
early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS predominate. -
CORRECT ANSWER -Stages +1a, +1b, +1c
Endocrine labs after menopause - CORRECT ANSWER -Elevated FSH, LH
These hormones work during reproductive years to not deplete follicle pool too quickly. -
CORRECT ANSWER -AMH, inhibin B
Menstrual cycle variable, persistent >7 day difference between difference in length of
consecutive cycles. - CORRECT ANSWER -Phases during menopause transition and PMS
symptoms
many pitfalls, variable depending on the day of the cycle you draw the lab, normal or low FSH is
not helpful. - CORRECT ANSWER -How to respond if a patient requests FSH lab?
AMH - CORRECT ANSWER -The potentially superior marker of menopause, a lab.
Adrenal androgens: precursor hromones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues. - CORRECT ANSWER -DHEA
(dehydroepiandrosterone)
Vagina, vulva, urethra, trigone of the bladder - CORRECT ANSWER -Location of estrogen
receptors
maintain blood flow, the collagen, and HA within the epithelial surfaces. Supports microbiome
which supports acidity of vagina and protects tissue from pathogens. - CORRECT ANSWER -
Effects of estrogen on tissue
,Thinning, loss of elasticity, loss or absence or rugae. - CORRECT ANSWER -Vaginal changes
with menopause
vagina narrows, urethra moves closer to the introitus. - CORRECT ANSWER -Vagina and
urethra in menopause
Vaginal estrogen and urinary incontinence: what type does it help with? - CORRECT ANSWER
-Stress urinary incontinence
Minoxidil, spironolactone, finasteride, estrogen therapy - CORRECT ANSWER -Treatment for
FPHL
-3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low. - CORRECT
ANSWER -Late reporoductive years -3b and -3a. What happens with menstrual cycles, FSH,
AMH, AFC, inhibin?
Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH level. -
CORRECT ANSWER -When it is appropriate to check an FSH during the cycle if you check it?
and why?
produced by granulosa cells
used to test damage to ovarian follicle reserve. If AMH is low, the woman has a low ovarian
reserve.
not recommended as a screening tool to predict fertility.
, Peaks at around 25 years old. So before age 25, this test is not helpful.
It is influenced by exogenous hormones. Lower in hormonal contraception users, but increases
after d/cing. - CORRECT ANSWER -AMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak?
Antral follicle count
Number of follicles that are detectable with ultrasound.
They are sensitive to FSH and considered to represent the availability pool of follicles. -
CORRECT ANSWER -AFC
25 or higher - CORRECT ANSWER -Late menopause transition (-1) FSH level on random draw
Higher - CORRECT ANSWER -Black women have higher or lower FSH levels?
lower - CORRECT ANSWER -Chinese and Japanese women have higher or lower estradiol
levels compared to white, black and hispanic women?
SHBG decreases
Testosterone/SHBG ratio increases by 80%. - CORRECT ANSWER -Menopause transition-
changes in SHBG and testosterone? ratio?
The free androgen index - CORRECT ANSWER -Testosterone/SHGB ratio is called what?
+1b (generally last 2 years) - CORRECT ANSWER -What stage are VMS more likely?
