NAMs Menopause Certification Exam
Questions and Answers 100% Solved
Climacteric phase --*correct answer*-- The period of endrocrinologic,
somatic, and transitory psychologic changes that occur around the time of
menopause.
Early menopause --*correct answer*-- LMP before age 45
Late menopause --*correct answer*-- LMP after age 54
Primary ovarian insufficiency --*correct answer*-- Menopause that occurs
before age 40
Early menopause transition (stage -2) --*correct answer*-- Persistent
difference of 7 days or more in the length of consecutive cycles.
Late menopause transition (stage -1) --*correct answer*-- 60 or more
consecutive days of amenorrhea
Luteal out of phase event (LOOP) --*correct answer*-- 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.
Obese women and estradiol levels during menopause --*correct answer*--
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)
Chinese and Japanese women --*correct answer*-- These ethnic groups have
lower estradiol levels then white, black and hispanic women.
,stage +2 --*correct answer*-- late menopause stage: 5-8 years after FMP.
Somatic aging predominates. Increased genitourinary symptoms.
Stages +1a, +1b, +1c --*correct answer*-- early post menopause: 2 years
after FMP. FSH rises, estradiol decreases. VMS predominate.
Elevated FSH, LH --*correct answer*-- Endocrine labs after menopause
AMH, inhibin B --*correct answer*-- These hormones work during
reproductive years to not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms --*correct 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? --*correct 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. --*correct answer*--
AMH
DHEA (dehydroepiandrosterone) --*correct 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 --*correct answer*-- Vagina, vulva, urethra,
trigone of the bladder
Effects of estrogen on tissue --*correct answer*-- maintain blood flow, the
collagen, and HA within the epithelial surfaces. Supports microbiome and
protects tissue from pathogens.
Vaginal changes with menopause --*correct answer*-- Thinning, loss of
elasticity, loss or absence or rugae.
Vagina and urethra in menopause --*correct answer*-- vagina narrows,
urethra moves closer to the introitus.
, Stress urinary incontinence --*correct answer*-- Vaginal estrogen and
urinary incontinence: what type does it help with?
Treatment for FPHL --*correct answer*-- Minoxidil, spironolactone,
finasteride, estrogen therapy
Late reporoductive years -3b and -3a. What happens with menstrual cycles,
FSH, AMH, AFC, inhibin? --*correct 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? --*correct 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? --*correct answer*-- 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.
AFC --*correct answer*-- Antral follicle count
Questions and Answers 100% Solved
Climacteric phase --*correct answer*-- The period of endrocrinologic,
somatic, and transitory psychologic changes that occur around the time of
menopause.
Early menopause --*correct answer*-- LMP before age 45
Late menopause --*correct answer*-- LMP after age 54
Primary ovarian insufficiency --*correct answer*-- Menopause that occurs
before age 40
Early menopause transition (stage -2) --*correct answer*-- Persistent
difference of 7 days or more in the length of consecutive cycles.
Late menopause transition (stage -1) --*correct answer*-- 60 or more
consecutive days of amenorrhea
Luteal out of phase event (LOOP) --*correct answer*-- 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.
Obese women and estradiol levels during menopause --*correct answer*--
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)
Chinese and Japanese women --*correct answer*-- These ethnic groups have
lower estradiol levels then white, black and hispanic women.
,stage +2 --*correct answer*-- late menopause stage: 5-8 years after FMP.
Somatic aging predominates. Increased genitourinary symptoms.
Stages +1a, +1b, +1c --*correct answer*-- early post menopause: 2 years
after FMP. FSH rises, estradiol decreases. VMS predominate.
Elevated FSH, LH --*correct answer*-- Endocrine labs after menopause
AMH, inhibin B --*correct answer*-- These hormones work during
reproductive years to not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms --*correct 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? --*correct 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. --*correct answer*--
AMH
DHEA (dehydroepiandrosterone) --*correct 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 --*correct answer*-- Vagina, vulva, urethra,
trigone of the bladder
Effects of estrogen on tissue --*correct answer*-- maintain blood flow, the
collagen, and HA within the epithelial surfaces. Supports microbiome and
protects tissue from pathogens.
Vaginal changes with menopause --*correct answer*-- Thinning, loss of
elasticity, loss or absence or rugae.
Vagina and urethra in menopause --*correct answer*-- vagina narrows,
urethra moves closer to the introitus.
, Stress urinary incontinence --*correct answer*-- Vaginal estrogen and
urinary incontinence: what type does it help with?
Treatment for FPHL --*correct answer*-- Minoxidil, spironolactone,
finasteride, estrogen therapy
Late reporoductive years -3b and -3a. What happens with menstrual cycles,
FSH, AMH, AFC, inhibin? --*correct 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? --*correct 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? --*correct answer*-- 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.
AFC --*correct answer*-- Antral follicle count
