NAMS MENOPAUSE CERTIFICATION
EXAM 2025/2026 QUESTIONS AND
CORRECT ANSWERS
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
Number of follicles that are detectable with ultrasound.
,They are sensitive to FSH and considered to represent the
availability poo of follicles.
Late menopause transition (-1) FSH level on random draw
Correct Answer 25 or higher
Black women have higher or lower FSH levels? Correct
Answer Higher
Chinese and Japanese women have higher or lower
estradiol levels compared to white, black and hispanic
women? Correct Answer lower
Menopause transition-changes in SHBG and
testosterone? ratio? Correct Answer SHBG decreases
Testosterone/SHBG ratio increases by 80%.
Testosterone/SHGB ratio is called what? Correct Answer
The free androgen index
What stage are VMS more likely? Correct Answer +1b
(generally last 2 years)
What hormone is generally higher in obese women?
Correct Answer Estrone-via aromatization.
The postmenopausal ovary continues to produce what two
hormones? Correct Answer testosterone and
androstenedione
, Surgical menopause causes women to have lower levels
of what hormone? Correct Answer testosterone. 40-50%
lower than in women w/ intact ovaries.
Driving piece of menopause is ovarian follicles depleting.
What does this do to the inhibin B and AMH? Correct
Answer inhibin and AMH decrease
therefore, follicle growth is not restrained, this allows for
the growth of the remaining, diminished follicle pool.
In the menopause transition, women spend more time in
what phase? Correct Answer Luteal-more PMS
symptoms, more frequent menstrual periods.
HPO axis theory and the menopause transition Correct
Answer It is felt that the HPO axis may become less
sensitive to estrogen, so even with good follicle growth
and estradiol secretion, LH surges can fail which can lead
to more cycle irregularity.
In the first year after the FMP, there is no production of
what hormone? Correct Answer progesterone
What region of the adrenal gland secretes the androgens?
Correct Answer zona reticularis
what are considered the 'adrenal androgens'? Correct
Answer DHEA, DHEAS, Androstenedione.
EXAM 2025/2026 QUESTIONS AND
CORRECT ANSWERS
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
Number of follicles that are detectable with ultrasound.
,They are sensitive to FSH and considered to represent the
availability poo of follicles.
Late menopause transition (-1) FSH level on random draw
Correct Answer 25 or higher
Black women have higher or lower FSH levels? Correct
Answer Higher
Chinese and Japanese women have higher or lower
estradiol levels compared to white, black and hispanic
women? Correct Answer lower
Menopause transition-changes in SHBG and
testosterone? ratio? Correct Answer SHBG decreases
Testosterone/SHBG ratio increases by 80%.
Testosterone/SHGB ratio is called what? Correct Answer
The free androgen index
What stage are VMS more likely? Correct Answer +1b
(generally last 2 years)
What hormone is generally higher in obese women?
Correct Answer Estrone-via aromatization.
The postmenopausal ovary continues to produce what two
hormones? Correct Answer testosterone and
androstenedione
, Surgical menopause causes women to have lower levels
of what hormone? Correct Answer testosterone. 40-50%
lower than in women w/ intact ovaries.
Driving piece of menopause is ovarian follicles depleting.
What does this do to the inhibin B and AMH? Correct
Answer inhibin and AMH decrease
therefore, follicle growth is not restrained, this allows for
the growth of the remaining, diminished follicle pool.
In the menopause transition, women spend more time in
what phase? Correct Answer Luteal-more PMS
symptoms, more frequent menstrual periods.
HPO axis theory and the menopause transition Correct
Answer It is felt that the HPO axis may become less
sensitive to estrogen, so even with good follicle growth
and estradiol secretion, LH surges can fail which can lead
to more cycle irregularity.
In the first year after the FMP, there is no production of
what hormone? Correct Answer progesterone
What region of the adrenal gland secretes the androgens?
Correct Answer zona reticularis
what are considered the 'adrenal androgens'? Correct
Answer DHEA, DHEAS, Androstenedione.
