NAMS Menopause Certification Exam Prep Guide
1.
2. Climacteric phase The period of endrocrinologic, somatic, and transitory psychologic
changes that occur around the time of menopause.
3. Perimenopause What defines the phase?
Menopause Transition,
5. Luteal out of phase event (LOOP)
Early
List the STRAW Stage
What defines the phase?
4. Perimenopause
6. Describe the E2 level during the life of a
Menopause Transition,
pa- tient with obesity.
Late
List the STRAW Stage
, NAMS Menopause Certification Exam Prep Guide
7. In comparison to other STRAW Stage: (Stage -2)
ethnicities, Chinese and Persistent ditterence of 7 days or more in the length of consecutive
Japanese women have cycles.
E2 levels?
8. STRAW Stage +2, de-
scribe the timeline as STRAW Stage: (Stage -1)
60 or more consecutive days of amenorrhea
Explains why some perimenopausal women have elevated estrogen
level sometimes...In the early menopause transition, elevated FSH lev-
els 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.
They are also more likely to have lower premenopause/peri-
menopausal estradiol levels compared to patients with average BMIs.
However, the level is the highest in postmenopausal patients with
obesity.
These ethnic groups have lower estradiol levels than white, black and
hispanic women.
Postmenopause, Late. (Remaining Lifespan) 5-8 years after FMP. So-
matic aging predominates. Increased genitourinary symptoms.
, NAMS Menopause Certification Exam Prep Guide
well as the predominant
symptoms.
9. Stages +1a, +1b, +1c, de- Postmenopause, Early. 2 years after FMP.
scribe the timeline as +1a/b (2yrs) FSH variable where as the AMH and InhB are low. The AFC
well as the supportive are very low. VMS predominate.
criteria and the symp- 1c (3-6yrs) FSH levels stabilize. The other measures continue as previ-
toms. ous.
10. Elevated FSH, LH Endocrine labs after menopause
11. AMH, Inhibin B These hormones work during reproductive years to not deplete follicle
pool too quickly.
12. Describe the phases dur- Menstrual cycle shortens. Due to unrestrained FSH, follicular phase
ing the early menopause compresses. More premenstrual symptoms due to the longer luteal
transition and what hap- phase. Cycle irregularity and skipped cycles because of ovulatory fail-
pens with PMS symp- ure and increased atresia.
toms
13. How to respond if a pa- many pitfalls, variable depending on the day of the cycle you draw the
tient requests FSH lab? lab, normal or low FSH is not helpful.
14. What lab is potentially AMH
the superior marker of
time to menopause?
15. DHEA (dehy- Adrenal androgens: precursor hromones produced by the adrenal
droepiandrosterone) gland that are enzymatically converted to active androgens or estro-
gens in peripheral tissues.
16. Location of GU estrogen Vagina, vulva, urethra, trigone of the bladder
receptors (4)
, NAMS Menopause Certification Exam Prep Guide
1.
2. Climacteric phase The period of endrocrinologic, somatic, and transitory psychologic
changes that occur around the time of menopause.
3. Perimenopause What defines the phase?
Menopause Transition,
5. Luteal out of phase event (LOOP)
Early
List the STRAW Stage
What defines the phase?
4. Perimenopause
6. Describe the E2 level during the life of a
Menopause Transition,
pa- tient with obesity.
Late
List the STRAW Stage
, NAMS Menopause Certification Exam Prep Guide
7. In comparison to other STRAW Stage: (Stage -2)
ethnicities, Chinese and Persistent ditterence of 7 days or more in the length of consecutive
Japanese women have cycles.
E2 levels?
8. STRAW Stage +2, de-
scribe the timeline as STRAW Stage: (Stage -1)
60 or more consecutive days of amenorrhea
Explains why some perimenopausal women have elevated estrogen
level sometimes...In the early menopause transition, elevated FSH lev-
els 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.
They are also more likely to have lower premenopause/peri-
menopausal estradiol levels compared to patients with average BMIs.
However, the level is the highest in postmenopausal patients with
obesity.
These ethnic groups have lower estradiol levels than white, black and
hispanic women.
Postmenopause, Late. (Remaining Lifespan) 5-8 years after FMP. So-
matic aging predominates. Increased genitourinary symptoms.
, NAMS Menopause Certification Exam Prep Guide
well as the predominant
symptoms.
9. Stages +1a, +1b, +1c, de- Postmenopause, Early. 2 years after FMP.
scribe the timeline as +1a/b (2yrs) FSH variable where as the AMH and InhB are low. The AFC
well as the supportive are very low. VMS predominate.
criteria and the symp- 1c (3-6yrs) FSH levels stabilize. The other measures continue as previ-
toms. ous.
10. Elevated FSH, LH Endocrine labs after menopause
11. AMH, Inhibin B These hormones work during reproductive years to not deplete follicle
pool too quickly.
12. Describe the phases dur- Menstrual cycle shortens. Due to unrestrained FSH, follicular phase
ing the early menopause compresses. More premenstrual symptoms due to the longer luteal
transition and what hap- phase. Cycle irregularity and skipped cycles because of ovulatory fail-
pens with PMS symp- ure and increased atresia.
toms
13. How to respond if a pa- many pitfalls, variable depending on the day of the cycle you draw the
tient requests FSH lab? lab, normal or low FSH is not helpful.
14. What lab is potentially AMH
the superior marker of
time to menopause?
15. DHEA (dehy- Adrenal androgens: precursor hromones produced by the adrenal
droepiandrosterone) gland that are enzymatically converted to active androgens or estro-
gens in peripheral tissues.
16. Location of GU estrogen Vagina, vulva, urethra, trigone of the bladder
receptors (4)
, NAMS Menopause Certification Exam Prep Guide
