NAMS Menopause Certification Actual Exam
NAMS MENOPAUSE CERTIFICATION ACTUAL EXAM NEWEST
2025/2026 WITH COMPLETE 250 QUESTIONS AND CORRECT
ANSWERS |ALREADY GRADED A+||BRAND NEW VERSION!
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
1|Page
, NAMS Menopause Certification Actual Exam
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
2|Page
, NAMS Menopause Certification Actual Exam
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?
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
3|Page
, NAMS Menopause Certification Actual Exam
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)
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?
4|Page
NAMS MENOPAUSE CERTIFICATION ACTUAL EXAM NEWEST
2025/2026 WITH COMPLETE 250 QUESTIONS AND CORRECT
ANSWERS |ALREADY GRADED A+||BRAND NEW VERSION!
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
1|Page
, NAMS Menopause Certification Actual Exam
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
2|Page
, NAMS Menopause Certification Actual Exam
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?
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
3|Page
, NAMS Menopause Certification Actual Exam
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)
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?
4|Page
