2025-2026 NAMs Menopause
Certification Exam
The period of endrocrino-
logic, somatic, and transi-
Climacteric phase tory psychologic changes
that occur around the time
of menopause.
Early menopause LMP before age 45
Late menopause LMP after age 54
Primary ovarian insuffi- Menopause that occurs
ciency before age 40
Persistent difference of 7
Early menopause transi-
days or more in the length
tion (stage -2)
of consecutive cycles.
Late menopause transi- 60 or more consecutive
tion (stage -1) days of amenorrhea
Explains why some peri-
menopausal women have
elevated estrogen level
sometimes...In the early
Luteal out of phase event menopause transition, ele-
(LOOP) vated FSH levels are ade-
quate to recruit a second
follicle which results in a
follicular phase-like rise in
, NAMs Menopause Certification Exam
Study online at https:// /_8noo5k
estradiol secretion super-
imposed on the mid-to-late
luteal phase of the ongo-
ing ovulatory cycle.
Obese women are more
likely to have anovulato-
ry cycles with high estra-
diol levels. They are also
Obese women and more likely to have low-
estradiol levels during er premenopause yet high-
menopause er postmenopause estra-
diol levels compared with
women of normal weight.
(why they are at higher risk
of endometrial cancer)
These ethnic groups have
Chinese and Japanese lower estradiol levels then
women white, black and hispanic
women.
late menopause stage:
5-8 years after FMP.
stage +2 Somatic aging predomi-
nates. Increased genitouri-
nary symptoms.
Stages +1a, +1b, +1c
Certification Exam
The period of endrocrino-
logic, somatic, and transi-
Climacteric phase tory psychologic changes
that occur around the time
of menopause.
Early menopause LMP before age 45
Late menopause LMP after age 54
Primary ovarian insuffi- Menopause that occurs
ciency before age 40
Persistent difference of 7
Early menopause transi-
days or more in the length
tion (stage -2)
of consecutive cycles.
Late menopause transi- 60 or more consecutive
tion (stage -1) days of amenorrhea
Explains why some peri-
menopausal women have
elevated estrogen level
sometimes...In the early
Luteal out of phase event menopause transition, ele-
(LOOP) vated FSH levels are ade-
quate to recruit a second
follicle which results in a
follicular phase-like rise in
, NAMs Menopause Certification Exam
Study online at https:// /_8noo5k
estradiol secretion super-
imposed on the mid-to-late
luteal phase of the ongo-
ing ovulatory cycle.
Obese women are more
likely to have anovulato-
ry cycles with high estra-
diol levels. They are also
Obese women and more likely to have low-
estradiol levels during er premenopause yet high-
menopause er postmenopause estra-
diol levels compared with
women of normal weight.
(why they are at higher risk
of endometrial cancer)
These ethnic groups have
Chinese and Japanese lower estradiol levels then
women white, black and hispanic
women.
late menopause stage:
5-8 years after FMP.
stage +2 Somatic aging predomi-
nates. Increased genitouri-
nary symptoms.
Stages +1a, +1b, +1c
