NAMS Menopause Certification Exam
(2026/2027) | Real Exam Questions |
100% Correct Answers | A+ Verified
• 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 levels sometimes.
,• Obese women and estradiol levels during menopause -✓✓Obese
women are more likely to have anovulatory cycles with high estradiol
levels.
• Chinese and Japanese women -✓✓These ethnic groups have lower
estradiol levels than white, black, and Hispanic women.
• Stage +2 -✓✓Late menopause stage: 5-8 years after FMP. Somatic
aging predominates.
• Stages +1a, +1b, +1c -✓✓Early post menopause: 2 years after FMP.
FSH rises, estradiol decreases.
• 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 variable, persistent >7 day difference between
difference in length of consecutive cycles.
• How to respond if a patient requests FSH lab? -✓✓Many pitfalls,
variable depending on the day of the cycle you draw the lab.
,• The potentially superior marker of menopause, a lab. -✓✓AMH.
• DHEA (dehydroepiandrosterone) -✓✓Adrenal androgens: precursor
hormones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues.
• Location of estrogen receptors -✓✓Vagina, vulva, urethra, trigone of
the bladder.
• Effects of estrogen on tissue -✓✓Maintain blood flow, the collagen,
and HA within the epithelial surfaces.
• Vaginal changes with menopause -✓✓Thinning, loss of elasticity, loss
or absence of rugae.
• Vagina and urethra in menopause -✓✓Vagina narrows, urethra
moves closer to the introitus.
• Stress urinary incontinence -✓✓Vaginal estrogen and urinary
incontinence: what type does it help with?
• Treatment for FPHL -✓✓Minoxidil, spironolactone, finasteride,
estrogen therapy.
, • Late reproductive years -3b and -3a -✓✓-3b: menstrual cycles
normal, FSH normal, AMH low, AFC low, inhibin low. -3a: subtle
menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
• When it is appropriate to check an FSH during the cycle if you check
it? -✓✓Cycle day #3. Elevated estradiol can suppress FSH giving a
falsely normal FSH level.
• AFC -✓✓Antral follicle count. Number of follicles that are detectable
with ultrasound.
• Late menopause transition (-1) FSH level on random draw -✓✓25 or
higher.
• Black women have higher or lower FSH levels? -✓✓Higher.
• Chinese and Japanese women have higher or lower estradiol levels
compared to white, black and Hispanic women? -✓✓Lower.
• Menopause transition-changes in SHBG and testosterone? -✓✓SHBG
decreases. Testosterone/SHBG ratio increases by 80%.
(2026/2027) | Real Exam Questions |
100% Correct Answers | A+ Verified
• 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 levels sometimes.
,• Obese women and estradiol levels during menopause -✓✓Obese
women are more likely to have anovulatory cycles with high estradiol
levels.
• Chinese and Japanese women -✓✓These ethnic groups have lower
estradiol levels than white, black, and Hispanic women.
• Stage +2 -✓✓Late menopause stage: 5-8 years after FMP. Somatic
aging predominates.
• Stages +1a, +1b, +1c -✓✓Early post menopause: 2 years after FMP.
FSH rises, estradiol decreases.
• 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 variable, persistent >7 day difference between
difference in length of consecutive cycles.
• How to respond if a patient requests FSH lab? -✓✓Many pitfalls,
variable depending on the day of the cycle you draw the lab.
,• The potentially superior marker of menopause, a lab. -✓✓AMH.
• DHEA (dehydroepiandrosterone) -✓✓Adrenal androgens: precursor
hormones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues.
• Location of estrogen receptors -✓✓Vagina, vulva, urethra, trigone of
the bladder.
• Effects of estrogen on tissue -✓✓Maintain blood flow, the collagen,
and HA within the epithelial surfaces.
• Vaginal changes with menopause -✓✓Thinning, loss of elasticity, loss
or absence of rugae.
• Vagina and urethra in menopause -✓✓Vagina narrows, urethra
moves closer to the introitus.
• Stress urinary incontinence -✓✓Vaginal estrogen and urinary
incontinence: what type does it help with?
• Treatment for FPHL -✓✓Minoxidil, spironolactone, finasteride,
estrogen therapy.
, • Late reproductive years -3b and -3a -✓✓-3b: menstrual cycles
normal, FSH normal, AMH low, AFC low, inhibin low. -3a: subtle
menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
• When it is appropriate to check an FSH during the cycle if you check
it? -✓✓Cycle day #3. Elevated estradiol can suppress FSH giving a
falsely normal FSH level.
• AFC -✓✓Antral follicle count. Number of follicles that are detectable
with ultrasound.
• Late menopause transition (-1) FSH level on random draw -✓✓25 or
higher.
• Black women have higher or lower FSH levels? -✓✓Higher.
• Chinese and Japanese women have higher or lower estradiol levels
compared to white, black and Hispanic women? -✓✓Lower.
• Menopause transition-changes in SHBG and testosterone? -✓✓SHBG
decreases. Testosterone/SHBG ratio increases by 80%.
