NAMS MENOPAUSE CERTIFICATION
EXAM ACTUAL EXAM COMPLETE 350
QUESTIONS WITH DETAILED CORRECT
ANSWERS// (100% CORRECT ANSWERS-
GRADED A+)
Climacteric phase -CORRECTANSWER the period of endocrinologic, somatic, and
transitory psychologic changes that occur around the time of menopause.
Early menopause -CORRECTANSWER LMP before age 45
Late menopause -CORRECTANSWER LMP after age 54
Primary ovarian insufficiency -CORRECTANSWER Menopause that occurs before
age 40
Early menopause transition (stage -2) -CORRECTANSWER Persistent difference of 7
days or more in the length of consecutive cycles.
Late menopause transition (stage -1) -CORRECTANSWER 60 or more consecutive
days of amenorrhea
,Luteal out of phase event (LOOP) -CORRECTANSWER 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.
Obese women and estradiol levels during menopause -CORRECTANSWER Obese
women are more likely to have anovulatory cycles with high estradiol levels. They are
also more likely to have lower premenopausal yet higher post menopause estradiol
levels compared with women of normal weight. (why they are at higher risk of
endometrial cancer)
Chinese and Japanese women -CORRECTANSWER These ethnic groups have
lower estradiol levels then white, black and Hispanic women.
stage +2 -CORRECTANSWER late menopause stage: 5-8 years after FMP. Somatic
aging predominates. Increased genitourinary symptoms.
Stages +1a, +1b, +1c -CORRECTANSWER early post menopause: 2 years after
FMP. FSH rises, estradiol decreases. VMS predominates.
Elevated FSH, LH -CORRECTANSWER Endocrine labs after menopause
,AMH, inhibin B -CORRECTANSWER These hormones work during reproductive
years to not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms -CORRECTANSWER
Menstrual cycle variable, persistent >7-day difference between difference in length of
consecutive cycles.
How to respond if a patient requests FSH lab? -CORRECTANSWER many pitfalls,
variable depending on the day of the cycle you draw the lab, normal or low FSH is not
helpful.
The potentially superior marker of menopause, a lab. -CORRECTANSWER AMH
DHEA (dehydroepiandrosterone) -CORRECTANSWER Adrenal androgens: precursor
hormones produced by the adrenal gland that are enzymatically converted to active
androgens or estrogens in peripheral tissues.
Location of estrogen receptors -CORRECTANSWER Vagina, vulva, urethra, trigone
of the bladder
, Effects of estrogen on tissue -CORRECTANSWER maintain blood flow, the collagen,
and HA within the epithelial surfaces. Supports microbiome which supports acidity of
vagina and protects tissue from pathogens.
Vaginal changes with menopause -CORRECTANSWER Thinning, loss of elasticity,
loss or absence or rugae.
Vagina and urethra in menopause -CORRECTANSWER vagina narrows, urethra
moves closer to the introitus.
Stress urinary incontinence -CORRECTANSWER Vaginal estrogen and urinary
incontinence: what type does it help with?
Treatment for FPHL -CORRECTANSWER Minoxidil, spironolactone, finasteride,
estrogen therapy
Late reproductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH,
AFC, inhibin? -CORRECTANSWER -3b: menstrual cycles normal, FSH normal, AMH
low, AFC low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
EXAM ACTUAL EXAM COMPLETE 350
QUESTIONS WITH DETAILED CORRECT
ANSWERS// (100% CORRECT ANSWERS-
GRADED A+)
Climacteric phase -CORRECTANSWER the period of endocrinologic, somatic, and
transitory psychologic changes that occur around the time of menopause.
Early menopause -CORRECTANSWER LMP before age 45
Late menopause -CORRECTANSWER LMP after age 54
Primary ovarian insufficiency -CORRECTANSWER Menopause that occurs before
age 40
Early menopause transition (stage -2) -CORRECTANSWER Persistent difference of 7
days or more in the length of consecutive cycles.
Late menopause transition (stage -1) -CORRECTANSWER 60 or more consecutive
days of amenorrhea
,Luteal out of phase event (LOOP) -CORRECTANSWER 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.
Obese women and estradiol levels during menopause -CORRECTANSWER Obese
women are more likely to have anovulatory cycles with high estradiol levels. They are
also more likely to have lower premenopausal yet higher post menopause estradiol
levels compared with women of normal weight. (why they are at higher risk of
endometrial cancer)
Chinese and Japanese women -CORRECTANSWER These ethnic groups have
lower estradiol levels then white, black and Hispanic women.
stage +2 -CORRECTANSWER late menopause stage: 5-8 years after FMP. Somatic
aging predominates. Increased genitourinary symptoms.
Stages +1a, +1b, +1c -CORRECTANSWER early post menopause: 2 years after
FMP. FSH rises, estradiol decreases. VMS predominates.
Elevated FSH, LH -CORRECTANSWER Endocrine labs after menopause
,AMH, inhibin B -CORRECTANSWER These hormones work during reproductive
years to not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms -CORRECTANSWER
Menstrual cycle variable, persistent >7-day difference between difference in length of
consecutive cycles.
How to respond if a patient requests FSH lab? -CORRECTANSWER many pitfalls,
variable depending on the day of the cycle you draw the lab, normal or low FSH is not
helpful.
The potentially superior marker of menopause, a lab. -CORRECTANSWER AMH
DHEA (dehydroepiandrosterone) -CORRECTANSWER Adrenal androgens: precursor
hormones produced by the adrenal gland that are enzymatically converted to active
androgens or estrogens in peripheral tissues.
Location of estrogen receptors -CORRECTANSWER Vagina, vulva, urethra, trigone
of the bladder
, Effects of estrogen on tissue -CORRECTANSWER maintain blood flow, the collagen,
and HA within the epithelial surfaces. Supports microbiome which supports acidity of
vagina and protects tissue from pathogens.
Vaginal changes with menopause -CORRECTANSWER Thinning, loss of elasticity,
loss or absence or rugae.
Vagina and urethra in menopause -CORRECTANSWER vagina narrows, urethra
moves closer to the introitus.
Stress urinary incontinence -CORRECTANSWER Vaginal estrogen and urinary
incontinence: what type does it help with?
Treatment for FPHL -CORRECTANSWER Minoxidil, spironolactone, finasteride,
estrogen therapy
Late reproductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH,
AFC, inhibin? -CORRECTANSWER -3b: menstrual cycles normal, FSH normal, AMH
low, AFC low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
