NAMS MENOPAUSE CERTIFICATION EXAM .

NAMS MENOPAUSE
CERTIFICATION EXAM

,The period of endrocrinologic, Climacteric phase
somatic, and transitory psychologic
changes that occur around the time
of menopause.
LMP before age 45 Early menopause
LMP after age 54 Late menopause
Menopause that occurs before age Primary ovarian insufficiency
40
Persistent difference of 7 days or Early menopause transition (stage -
more in the length of consecutive 2)
cycles.
60 or more consecutive days of Late menopause transition (stage -1)
amenorrhea
Explains why some perimenopausal Luteal out of phase event (LOOP)
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-tolate luteal phase of the
ongoing ovulatory cycle.

, Obese women are more Obese women and estradiol levels during
likely to have menopause
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)
These ethnic groups Chinese and Japanese women
have lower estradiol
levels then white, black
and hispanic women.
late menopause stage: stage +2
5-8 years after FMP.
Somatic aging
predominates.
Increased genitourinary
symptoms.
early post menopause: Stages +1a, +1b, +1c
2 years after FMP. FSH
rises, estradiol
decreases. VMS
predominate.