Page 1 of 63
NAMS MENOPAUSE CERTIFICATION EXAM
QUESTIONS WITH VERIFIED SOLUTIONS
TESTED AND APPROVED!!!
Late menopause transition (-1) FSH level on random draw --
ANSWER--25 or higher
Black women have higher or lower FSH levels? -- ANSWER--Higher
Chinese and Japanese women have higher or lower estradiol levels
compared to white, black and hispanic women? -- ANSWER--lower
Menopause transition-changes in SHBG and testosterone? ratio? --
ANSWER--
SHBG decreases
Testosterone/SHBG ratio increases by 80%.
, Page 2 of 63
Testosterone/SHGB ratio is called what? -- ANSWER--The free
androgen index
The potentially superior marker of menopause, a lab. -- ANSWER--
AMH
DHEA (dehydroepiandrosterone) -- 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 -- ANSWER--Vagina, vulva, urethra,
trigone of the bladder
Effects of estrogen on tissue -- ANSWER--maintain blood flow, the
collagen, and HA within the epithelial surfaces. Supports microbiome
which supports acidity of vagina and protects tissue from pathogens.
, Page 3 of 63
Vaginal changes with menopause -- ANSWER--Thinning, loss of
elasticity, loss or absence or rugae.
Vagina and urethra in menopause -- ANSWER--vagina narrows,
urethra moves closer to the introitus.
Stress urinary incontinence -- ANSWER--Vaginal estrogen and
urinary incontinence: what type does it help with?
Phases during menopause transition and PMS symptoms --
ANSWER--
Menstrual cycle variable, persistent >7-day difference between
difference in length of consecutive cycles.
How to respond if a patient requests FSH lab? -- ANSWER--many
pitfalls, variable depending on the day of the cycle you draw the lab,
normal or low FSH is not helpful.
, Page 4 of 63
Treatment for FPHL -- ANSWER--Minoxidil, spironolactone,
finasteride, estrogen therapy
Late reporoductive years -3b and -3a. What happens with menstrual
cycles, FSH, AMH, AFC, inhibin? -- 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? -- ANSWER--Cycle day #3. Elevated estradiol can
suppress FSH giving a falsely normal FSH level.
AMH
produced by...
used to test...
NAMS MENOPAUSE CERTIFICATION EXAM
QUESTIONS WITH VERIFIED SOLUTIONS
TESTED AND APPROVED!!!
Late menopause transition (-1) FSH level on random draw --
ANSWER--25 or higher
Black women have higher or lower FSH levels? -- ANSWER--Higher
Chinese and Japanese women have higher or lower estradiol levels
compared to white, black and hispanic women? -- ANSWER--lower
Menopause transition-changes in SHBG and testosterone? ratio? --
ANSWER--
SHBG decreases
Testosterone/SHBG ratio increases by 80%.
, Page 2 of 63
Testosterone/SHGB ratio is called what? -- ANSWER--The free
androgen index
The potentially superior marker of menopause, a lab. -- ANSWER--
AMH
DHEA (dehydroepiandrosterone) -- 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 -- ANSWER--Vagina, vulva, urethra,
trigone of the bladder
Effects of estrogen on tissue -- ANSWER--maintain blood flow, the
collagen, and HA within the epithelial surfaces. Supports microbiome
which supports acidity of vagina and protects tissue from pathogens.
, Page 3 of 63
Vaginal changes with menopause -- ANSWER--Thinning, loss of
elasticity, loss or absence or rugae.
Vagina and urethra in menopause -- ANSWER--vagina narrows,
urethra moves closer to the introitus.
Stress urinary incontinence -- ANSWER--Vaginal estrogen and
urinary incontinence: what type does it help with?
Phases during menopause transition and PMS symptoms --
ANSWER--
Menstrual cycle variable, persistent >7-day difference between
difference in length of consecutive cycles.
How to respond if a patient requests FSH lab? -- ANSWER--many
pitfalls, variable depending on the day of the cycle you draw the lab,
normal or low FSH is not helpful.
, Page 4 of 63
Treatment for FPHL -- ANSWER--Minoxidil, spironolactone,
finasteride, estrogen therapy
Late reporoductive years -3b and -3a. What happens with menstrual
cycles, FSH, AMH, AFC, inhibin? -- 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? -- ANSWER--Cycle day #3. Elevated estradiol can
suppress FSH giving a falsely normal FSH level.
AMH
produced by...
used to test...
