NAMS MENOPAUSE CERTIFICATION FINAL
PAPER 2026 COMPLETE ANSWERS MIDLIFE
HEALTH PRACTICE RESOURCE
◉ Elevated FSH, LH.
Answer: Endocrine labs after menopause
◉ AMH, inhibin B.
Answer: These hormones work during reproductive years to not
deplete follicle pool too quickly.
◉ Phases during menopause transition and PMS symptoms.
Answer: Menstrual cycle shortenes, follicular phase compresses,
women spend more time in luteal phase.. meaning more
premenstrual symptoms and more frequent menstrual periods.
◉ How to respond if a patient requests FSH lab?.
Answer: many pitfalls, variable depending on the day of the cycle
you draw the lab, normal or low FSH is not helpful.
◉ The potentially superior marker of menopause, a lab..
Answer: AMH
,◉ DHEA (dehydroepiandrosterone).
Answer: Adrenal androgens: precursor hromones produced by the
adrenal gland that are enzymatically converted to active androgens
or estrogens in peripheral tissues.
◉ Location of estrogen receptors.
Answer: Vagina, vulva, urethra, trigone of the bladder
◉ Effects of estrogen on tissue.
Answer: maintain blood flow, the collagen, and HA within the
epithelial surfaces. Supports microbiome and protects tissue from
pathogens.
◉ Vaginal changes with menopause.
Answer: Thinning, loss of elasticity, loss or absence or rugae.
◉ Vagina and urethra in menopause.
Answer: vagina narrows, urethra moves closer to the introitus.
◉ Stress urinary incontinence.
Answer: Vaginal estrogen and urinary incontinence: what type does
it help with?
, ◉ Treatment for FPHL.
Answer: Minoxidil, spironolactone, finasteride, estrogen therapy
◉ Late reporoductive years -3b and -3a. What happens with
menstrual cycles, FSH, AMH, AFC, inhibin?.
Answer: -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? and why?.
Answer: Cycle day #3. Elevated estradiol can suppress FSH giving a
falsely normal FSH level.
◉ AMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak?.
Answer: produced by granulosa cells
PAPER 2026 COMPLETE ANSWERS MIDLIFE
HEALTH PRACTICE RESOURCE
◉ Elevated FSH, LH.
Answer: Endocrine labs after menopause
◉ AMH, inhibin B.
Answer: These hormones work during reproductive years to not
deplete follicle pool too quickly.
◉ Phases during menopause transition and PMS symptoms.
Answer: Menstrual cycle shortenes, follicular phase compresses,
women spend more time in luteal phase.. meaning more
premenstrual symptoms and more frequent menstrual periods.
◉ How to respond if a patient requests FSH lab?.
Answer: many pitfalls, variable depending on the day of the cycle
you draw the lab, normal or low FSH is not helpful.
◉ The potentially superior marker of menopause, a lab..
Answer: AMH
,◉ DHEA (dehydroepiandrosterone).
Answer: Adrenal androgens: precursor hromones produced by the
adrenal gland that are enzymatically converted to active androgens
or estrogens in peripheral tissues.
◉ Location of estrogen receptors.
Answer: Vagina, vulva, urethra, trigone of the bladder
◉ Effects of estrogen on tissue.
Answer: maintain blood flow, the collagen, and HA within the
epithelial surfaces. Supports microbiome and protects tissue from
pathogens.
◉ Vaginal changes with menopause.
Answer: Thinning, loss of elasticity, loss or absence or rugae.
◉ Vagina and urethra in menopause.
Answer: vagina narrows, urethra moves closer to the introitus.
◉ Stress urinary incontinence.
Answer: Vaginal estrogen and urinary incontinence: what type does
it help with?
, ◉ Treatment for FPHL.
Answer: Minoxidil, spironolactone, finasteride, estrogen therapy
◉ Late reporoductive years -3b and -3a. What happens with
menstrual cycles, FSH, AMH, AFC, inhibin?.
Answer: -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? and why?.
Answer: Cycle day #3. Elevated estradiol can suppress FSH giving a
falsely normal FSH level.
◉ AMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak?.
Answer: produced by granulosa cells
