NAMS MENOPAUSE CERTIFICATION EXAM
LATEST 2024 -2025 REAL ACTUAL EXAM
QUESTIONS AND CORRECT DETAILED
ANSWERS VERIFIED BY EXPERTS ( MARKING
SCHEME ) ALREADY GRADED A+
The period of endrocrinologic, somatic, and transitory psychologic changes that
occur around the time of menopause. - ANSWER>>Climacteric phase
LMP before age 45 - ANSWER>>Early menopause
LMP after age 54 - ANSWER>>Late menopause
Menopause that occurs before age 40 - ANSWER>>Primary ovarian insufficiency
Persistent difference of 7 days or more in the length of consecutive cycles. -
ANSWER>>Early menopause transition (stage -2)
60 or more consecutive days of amenorrhea - 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. - 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) - ANSWER>>Obese women and
estradiol levels during menopause
These ethnic groups have lower estradiol levels then white, black and hispanic
women. - ANSWER>>Chinese and Japanese women
late menopause stage: 5-8 years after FMP. Somatic aging predominates.
Increased genitourinary symptoms. - ANSWER>>stage +2
early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS
predominate. - ANSWER>>Stages +1a, +1b, +1c
Endocrine labs after menopause - ANSWER>>Elevated FSH, LH
These hormones work during reproductive years to not deplete follicle pool too
quickly. - ANSWER>>AMH, inhibin B
Menstrual cycle variable, persistent >7 day difference between difference in
length of consecutive cycles. - 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. - ANSWER>>How to respond if a patient requests FSH
lab?
AMH - 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. -
ANSWER>>DHEA (dehydroepiandrosterone)
Vagina, vulva, urethra, trigone of the bladder - 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.
- ANSWER>>Effects of estrogen on tissue
Thinning, loss of elasticity, loss or absence or rugae. - ANSWER>>Vaginal changes
with menopause
vagina narrows, urethra moves closer to the introitus. - ANSWER>>Vagina and
urethra in menopause
Vaginal estrogen and urinary incontinence: what type does it help with? -
ANSWER>>Stress urinary incontinence
Minoxidil, spironolactone, finasteride, estrogen therapy - 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. -
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. - 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. - 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. - ANSWER>>AFC
25 or higher - ANSWER>>Late menopause transition (-1) FSH level on random
draw
Higher - ANSWER>>Black women have higher or lower FSH levels?
lower - 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%. - ANSWER>>Menopause transition-
changes in SHBG and testosterone? ratio?
The free androgen index - ANSWER>>Testosterone/SHGB ratio is called what?
+1b (generally last 2 years) - ANSWER>>What stage are VMS more likely?
Estrone-via aromatization. - ANSWER>>What hormone is generally higher in
obese women?
LATEST 2024 -2025 REAL ACTUAL EXAM
QUESTIONS AND CORRECT DETAILED
ANSWERS VERIFIED BY EXPERTS ( MARKING
SCHEME ) ALREADY GRADED A+
The period of endrocrinologic, somatic, and transitory psychologic changes that
occur around the time of menopause. - ANSWER>>Climacteric phase
LMP before age 45 - ANSWER>>Early menopause
LMP after age 54 - ANSWER>>Late menopause
Menopause that occurs before age 40 - ANSWER>>Primary ovarian insufficiency
Persistent difference of 7 days or more in the length of consecutive cycles. -
ANSWER>>Early menopause transition (stage -2)
60 or more consecutive days of amenorrhea - 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. - 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) - ANSWER>>Obese women and
estradiol levels during menopause
These ethnic groups have lower estradiol levels then white, black and hispanic
women. - ANSWER>>Chinese and Japanese women
late menopause stage: 5-8 years after FMP. Somatic aging predominates.
Increased genitourinary symptoms. - ANSWER>>stage +2
early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS
predominate. - ANSWER>>Stages +1a, +1b, +1c
Endocrine labs after menopause - ANSWER>>Elevated FSH, LH
These hormones work during reproductive years to not deplete follicle pool too
quickly. - ANSWER>>AMH, inhibin B
Menstrual cycle variable, persistent >7 day difference between difference in
length of consecutive cycles. - 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. - ANSWER>>How to respond if a patient requests FSH
lab?
AMH - 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. -
ANSWER>>DHEA (dehydroepiandrosterone)
Vagina, vulva, urethra, trigone of the bladder - 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.
- ANSWER>>Effects of estrogen on tissue
Thinning, loss of elasticity, loss or absence or rugae. - ANSWER>>Vaginal changes
with menopause
vagina narrows, urethra moves closer to the introitus. - ANSWER>>Vagina and
urethra in menopause
Vaginal estrogen and urinary incontinence: what type does it help with? -
ANSWER>>Stress urinary incontinence
Minoxidil, spironolactone, finasteride, estrogen therapy - 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. -
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. - 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. - 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. - ANSWER>>AFC
25 or higher - ANSWER>>Late menopause transition (-1) FSH level on random
draw
Higher - ANSWER>>Black women have higher or lower FSH levels?
lower - 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%. - ANSWER>>Menopause transition-
changes in SHBG and testosterone? ratio?
The free androgen index - ANSWER>>Testosterone/SHGB ratio is called what?
+1b (generally last 2 years) - ANSWER>>What stage are VMS more likely?
Estrone-via aromatization. - ANSWER>>What hormone is generally higher in
obese women?
