NAMS Menopause Certification Exam (NCMP) |
questions and answers | 2025/2026
1. Which ovarian change marks the start of the menopausal transition (perimenopause)?
A. Sudden cessation of menses
B. Complete absence of follicular development
C. Changes in menstrual cycle length (increasing variability)
D. Ovulatory cycles every 28 days
2. The clinical definition of menopause is:
A. One year after the last menstrual period
B. 12 consecutive months of amenorrhea (no menses) without another cause
C. 6 months of irregular bleeding followed by amenorrhea
D. The date of the last natural ovulation
3. The most common symptom of menopause reported worldwide is:
A. Dyspareunia
B. Vasomotor symptoms (hot flashes, night sweats)
C. Urinary incontinence
D. Weight gain
4. Which hormone level typically rises during the menopausal transition?
A. Estradiol
B. Inhibin B
, C. Follicle-stimulating hormone (FSH)
D. Progesterone
5. Regarding menopausal hormone therapy (HT), professional guidelines state that HT is:
A. Contraindicated in all women over 50
B. The most effective treatment for vasomotor symptoms
C. Effective only when given orally
D. First-line for all women regardless of risk factors
6. For symptomatic women younger than 60 and within 10 years of menopause onset, HT:
A. Is always unsafe
B. Has benefits that often outweigh risks when individualized
C. Must be avoided if the woman has mild hypertension
D. Should only be used transdermally
7. Which route of estrogen administration may carry a lower risk of venous
thromboembolism (VTE) compared with oral estrogen?
A. Vaginal ring only
B. Transdermal (patch/gel)
C. High-dose oral tablets
D. Intramuscular injections
8. A woman with an intact uterus starting systemic estrogen therapy should also receive:
A. Progesterone only if bleeding occurs
B. A progestogen (or cyclic progesterone) to protect the endometrium
C. No additional therapy — estrogen alone is sufficient
D. High-dose estrogen to prevent bleeding
, 9. Which progestogen formulation is commonly used to protect the endometrium in women
receiving systemic estrogen?
A. Testosterone
B. Tamoxifen
C. Medroxyprogesterone acetate (or micronized progesterone)
D. Clomiphene
10. For a woman with a history of estrogen receptor–positive breast cancer, guideline-
recommended menopausal management typically:
A. Recommends systemic HT as first-line for VMS
B. Encourages unopposed estrogen use
C. Suggests avoiding systemic HT and considering nonhormone options
D. Recommends high-dose estrogen for short term only
11. Which FDA-approved nonhormone medication is indicated for hot flashes (vasomotor
symptoms)?
A. Fluoxetine 20 mg daily
B. Paroxetine mesylate 7.5 mg daily
C. Gabapentin 300 mg daily
D. Clonidine patch
12. Which neurokinin-3 receptor antagonist has FDA approval for vasomotor symptoms?
A. Paroxetine
B. Elinzanetant
C. Fezolinetant
D. MLE4901
questions and answers | 2025/2026
1. Which ovarian change marks the start of the menopausal transition (perimenopause)?
A. Sudden cessation of menses
B. Complete absence of follicular development
C. Changes in menstrual cycle length (increasing variability)
D. Ovulatory cycles every 28 days
2. The clinical definition of menopause is:
A. One year after the last menstrual period
B. 12 consecutive months of amenorrhea (no menses) without another cause
C. 6 months of irregular bleeding followed by amenorrhea
D. The date of the last natural ovulation
3. The most common symptom of menopause reported worldwide is:
A. Dyspareunia
B. Vasomotor symptoms (hot flashes, night sweats)
C. Urinary incontinence
D. Weight gain
4. Which hormone level typically rises during the menopausal transition?
A. Estradiol
B. Inhibin B
, C. Follicle-stimulating hormone (FSH)
D. Progesterone
5. Regarding menopausal hormone therapy (HT), professional guidelines state that HT is:
A. Contraindicated in all women over 50
B. The most effective treatment for vasomotor symptoms
C. Effective only when given orally
D. First-line for all women regardless of risk factors
6. For symptomatic women younger than 60 and within 10 years of menopause onset, HT:
A. Is always unsafe
B. Has benefits that often outweigh risks when individualized
C. Must be avoided if the woman has mild hypertension
D. Should only be used transdermally
7. Which route of estrogen administration may carry a lower risk of venous
thromboembolism (VTE) compared with oral estrogen?
A. Vaginal ring only
B. Transdermal (patch/gel)
C. High-dose oral tablets
D. Intramuscular injections
8. A woman with an intact uterus starting systemic estrogen therapy should also receive:
A. Progesterone only if bleeding occurs
B. A progestogen (or cyclic progesterone) to protect the endometrium
C. No additional therapy — estrogen alone is sufficient
D. High-dose estrogen to prevent bleeding
, 9. Which progestogen formulation is commonly used to protect the endometrium in women
receiving systemic estrogen?
A. Testosterone
B. Tamoxifen
C. Medroxyprogesterone acetate (or micronized progesterone)
D. Clomiphene
10. For a woman with a history of estrogen receptor–positive breast cancer, guideline-
recommended menopausal management typically:
A. Recommends systemic HT as first-line for VMS
B. Encourages unopposed estrogen use
C. Suggests avoiding systemic HT and considering nonhormone options
D. Recommends high-dose estrogen for short term only
11. Which FDA-approved nonhormone medication is indicated for hot flashes (vasomotor
symptoms)?
A. Fluoxetine 20 mg daily
B. Paroxetine mesylate 7.5 mg daily
C. Gabapentin 300 mg daily
D. Clonidine patch
12. Which neurokinin-3 receptor antagonist has FDA approval for vasomotor symptoms?
A. Paroxetine
B. Elinzanetant
C. Fezolinetant
D. MLE4901
