2023 NAMS Exam Questions Verified
Solutions
By 2020, number of women over 50 - ANSWER-64 million
By 2060, number of women over 50 - ANSWER-90 million
What is the US female life expectancy - ANSWER-81.2 years
How many oocytes in the ovary at 20 weeks pregnancy - ANSWER-6-7 Million
How many oocytes left at birth - ANSWER-1-2 million
How many oocytes left at puberty - ANSWER-300,000-500,000
What is the period of change at menopause - ANSWER-Climacteric or perimenopause
What is the term for menopause that occurs before age 45 - ANSWER-Early
menopause
What is the term for menopause that occurs after age 54 - ANSWER-Late menopause
What is the timeframe within the first 8 years after FMP (and what numerical SWAN
stages correspond?) - ANSWER-Early post menopause (+1a, +1b, +1c)
What is the timeframe called after 8 years from FMP (and what numerical SWAN stage
corresponds?) - ANSWER-Late post menopause (+2)
What is the time before FMP with cycle variability (and what numerical SWAN stages
correspond?) - ANSWER-Menopause transition (-2, -1)
What is the time of 7 or more days persistent difference in cycle length (and what
numerical SWAN stage corresponds?) - ANSWER-Early menopause transition (-2)
What is the time with 60 or more days of amenorrhea at least once (and what numerical
SWAN stage corresponds?) - ANSWER-Late menopause transition (-1)
What is a retrospective determination of 12 months of amenorrhea - ANSWER-Natural
menopause
,What is the timeframe from onset of menstrual cycle irregularity to 1 year after final
menopause transition - ANSWER-Perimenopause
What is any time frame after FMP - ANSWER-Post menopause
What is the preferred term for menopause before age 40 - ANSWER-Primary ovarian
insufficiency (POI)
Preferred since this may not be a permanent state
What term for menopause before age 40 should no longer be used - ANSWER-
Premature ovarian failure
What percentage of US women experience POI - ANSWER-1%
How many total stages in STRAW - ANSWER-10 total
Reproductive has 4 (-5 to -3a)
Menopause Transition has 2 (-2 to -1)
Post Menopause has 4 (+1a to +2)
How many reproductive stages in STRAW - ANSWER-4 (-5 early reproductive, -4 Peak
reproductive, -3b and -3b late reproductive)
How many stages in menopause transition in STRAW - ANSWER-2 (-2 early transition,
-1 late transition)
How many stages in postmenopause in STRAW - ANSWER-4 (+1a, +1b and +1c early
PM, +2 late PM)
Which STRAW stage is menarche in - ANSWER--5 early reproductive
In which STRAW stage are cycles every 21 to 35 days - ANSWER--4 Peak reproductive
What differentiates STRAW stage -3b from -3a - ANSWER--3b cycles normal, FSH wnl,
AMH, AFC, inhibit B low
-3a shorter cycles, variable FSH
What effect do inhibin B and AMH have on follicles - ANSWER-They prevent too many
follicles from growing at once, so the follicle pool is not depleted too quickly
What happens to inhibin b and AMH levels during menopause transition - ANSWER-
Decreased number of follicles leads to decreased levels of both of these products.
This means more follicular atresia
What is a LOOP event - ANSWER-Luteal Out of Phase event
Explains why some perimenopausal women have elevated estrogen levels sometimes.
In early menopause, transition, elevated FSH is adequate to recruit a second follicle.
, This results in a follicular phase-like rise in estradiol during the luteal phase
Compared to normal weight women, how do the pre-menopause and post menopause
estradiol levels of obese women compare - ANSWER-Lower pre-menopause estradiol
Higher post menopause estradiol
Which ethnic groups have lower estradiol levels, compared to white/black/Hispanic
women - ANSWER-Chinese and Japanese women
Where is AMH produced - ANSWER-Granulosa cells of antral and preantral follicles
When does AMH peak - ANSWER-Around 25 yo
(so before age 25, test is not helpful)
How does birth control affect AMH - ANSWER-Lowers it
What is AFC - ANSWER-Antral follicle count
Number of follicles 2-10 mm detected with ultrasound
Do African-American women have higher or lower FSH levels - ANSWER-Higher
Do Chinese and Japanese women have higher or lower estradiol levels compared to
white women - ANSWER-Lower
What happens to SHBG at menopause - ANSWER-Decreases
(T:SHBG ratio increases by 80%)
What is the Free Androgen Index - ANSWER-T:SHBG ratio
What hormone is generally higher in obese women and why - ANSWER-Estrone
Due to aromatization of estradiol to estrone by excess adipose tissue
What 2 hormones does the postmenopausal ovary continue to produce - ANSWER-
Testosterone
Androstenedione
Surgical menopause reduces what hormone as compared to natural menopause -
ANSWER-Testosterone
(40 to 50% lower)
In menopause transition, women spend more time in what menstrual phase - ANSWER-
Luteal
What is the HPO axis theory of menopause transition - ANSWER-HPO access
becomes less sensitive to estrogen.
Even with good follicle, growth and estradiol, LH surges fail, leading to cycle irregularity.
Solutions
By 2020, number of women over 50 - ANSWER-64 million
By 2060, number of women over 50 - ANSWER-90 million
What is the US female life expectancy - ANSWER-81.2 years
How many oocytes in the ovary at 20 weeks pregnancy - ANSWER-6-7 Million
How many oocytes left at birth - ANSWER-1-2 million
How many oocytes left at puberty - ANSWER-300,000-500,000
What is the period of change at menopause - ANSWER-Climacteric or perimenopause
What is the term for menopause that occurs before age 45 - ANSWER-Early
menopause
What is the term for menopause that occurs after age 54 - ANSWER-Late menopause
What is the timeframe within the first 8 years after FMP (and what numerical SWAN
stages correspond?) - ANSWER-Early post menopause (+1a, +1b, +1c)
What is the timeframe called after 8 years from FMP (and what numerical SWAN stage
corresponds?) - ANSWER-Late post menopause (+2)
What is the time before FMP with cycle variability (and what numerical SWAN stages
correspond?) - ANSWER-Menopause transition (-2, -1)
What is the time of 7 or more days persistent difference in cycle length (and what
numerical SWAN stage corresponds?) - ANSWER-Early menopause transition (-2)
What is the time with 60 or more days of amenorrhea at least once (and what numerical
SWAN stage corresponds?) - ANSWER-Late menopause transition (-1)
What is a retrospective determination of 12 months of amenorrhea - ANSWER-Natural
menopause
,What is the timeframe from onset of menstrual cycle irregularity to 1 year after final
menopause transition - ANSWER-Perimenopause
What is any time frame after FMP - ANSWER-Post menopause
What is the preferred term for menopause before age 40 - ANSWER-Primary ovarian
insufficiency (POI)
Preferred since this may not be a permanent state
What term for menopause before age 40 should no longer be used - ANSWER-
Premature ovarian failure
What percentage of US women experience POI - ANSWER-1%
How many total stages in STRAW - ANSWER-10 total
Reproductive has 4 (-5 to -3a)
Menopause Transition has 2 (-2 to -1)
Post Menopause has 4 (+1a to +2)
How many reproductive stages in STRAW - ANSWER-4 (-5 early reproductive, -4 Peak
reproductive, -3b and -3b late reproductive)
How many stages in menopause transition in STRAW - ANSWER-2 (-2 early transition,
-1 late transition)
How many stages in postmenopause in STRAW - ANSWER-4 (+1a, +1b and +1c early
PM, +2 late PM)
Which STRAW stage is menarche in - ANSWER--5 early reproductive
In which STRAW stage are cycles every 21 to 35 days - ANSWER--4 Peak reproductive
What differentiates STRAW stage -3b from -3a - ANSWER--3b cycles normal, FSH wnl,
AMH, AFC, inhibit B low
-3a shorter cycles, variable FSH
What effect do inhibin B and AMH have on follicles - ANSWER-They prevent too many
follicles from growing at once, so the follicle pool is not depleted too quickly
What happens to inhibin b and AMH levels during menopause transition - ANSWER-
Decreased number of follicles leads to decreased levels of both of these products.
This means more follicular atresia
What is a LOOP event - ANSWER-Luteal Out of Phase event
Explains why some perimenopausal women have elevated estrogen levels sometimes.
In early menopause, transition, elevated FSH is adequate to recruit a second follicle.
, This results in a follicular phase-like rise in estradiol during the luteal phase
Compared to normal weight women, how do the pre-menopause and post menopause
estradiol levels of obese women compare - ANSWER-Lower pre-menopause estradiol
Higher post menopause estradiol
Which ethnic groups have lower estradiol levels, compared to white/black/Hispanic
women - ANSWER-Chinese and Japanese women
Where is AMH produced - ANSWER-Granulosa cells of antral and preantral follicles
When does AMH peak - ANSWER-Around 25 yo
(so before age 25, test is not helpful)
How does birth control affect AMH - ANSWER-Lowers it
What is AFC - ANSWER-Antral follicle count
Number of follicles 2-10 mm detected with ultrasound
Do African-American women have higher or lower FSH levels - ANSWER-Higher
Do Chinese and Japanese women have higher or lower estradiol levels compared to
white women - ANSWER-Lower
What happens to SHBG at menopause - ANSWER-Decreases
(T:SHBG ratio increases by 80%)
What is the Free Androgen Index - ANSWER-T:SHBG ratio
What hormone is generally higher in obese women and why - ANSWER-Estrone
Due to aromatization of estradiol to estrone by excess adipose tissue
What 2 hormones does the postmenopausal ovary continue to produce - ANSWER-
Testosterone
Androstenedione
Surgical menopause reduces what hormone as compared to natural menopause -
ANSWER-Testosterone
(40 to 50% lower)
In menopause transition, women spend more time in what menstrual phase - ANSWER-
Luteal
What is the HPO axis theory of menopause transition - ANSWER-HPO access
becomes less sensitive to estrogen.
Even with good follicle, growth and estradiol, LH surges fail, leading to cycle irregularity.
