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NAMs Menopause Certification
Exam With 100% Correct
Questions and Answers | Graded
A+
Climacteric phase - Correct Answer-The period of endocrinologic, somatic, and
transitory psychologic changes that occur around the time of menopause.
Early menopause - Correct Answer-LMP before age 45.
Late menopause - Correct Answer-LMP after age 54.
Primary ovarian insufficiency - Correct Answer-Menopause that occurs before age 40.
Early menopause transition (stage -2) - Correct Answer-Persistent difference of 7 days
or more in the length of consecutive cycles.
Late menopause transition (stage -1) - Correct Answer-60 or more consecutive days of
amenorrhea.
Luteal out of phase event (LOOP) - Correct Answer-Explains why some
perimenopausal women have elevated estrogen levels sometimes.
Obese women and estradiol levels during menopause - Correct Answer-Obese women
are more likely to have anovulatory cycles with high estradiol levels.
Chinese and Japanese women - Correct Answer-These ethnic groups have lower
estradiol levels than white, black, and Hispanic women.
Stage +2 - Correct Answer-Late menopause stage: 5-8 years after FMP. Somatic aging
predominates.
Stages +1a, +1b, +1c - Correct Answer-Early post menopause: 2 years after FMP. FSH
rises, estradiol decreases.
Elevated FSH, LH - Correct Answer-Endocrine labs after menopause.
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AMH, inhibin B - Correct Answer-These hormones work during reproductive years to
not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms - Correct Answer-Menstrual
cycle variable, persistent >7 day difference between difference in length of consecutive
cycles.
How to respond if a patient requests FSH lab? - Correct Answer-Many pitfalls, variable
depending on the day of the cycle you draw the lab.
The potentially superior marker of menopause, a lab. - Correct Answer-AMH.
DHEA (dehydroepiandrosterone) - Correct Answer-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 - Correct Answer-Vagina, vulva, urethra, trigone of the
bladder.
Effects of estrogen on tissue - Correct Answer-Maintain blood flow, the collagen, and
HA within the epithelial surfaces.
Vaginal changes with menopause - Correct Answer-Thinning, loss of elasticity, loss or
absence of rugae.
Vagina and urethra in menopause - Correct Answer-Vagina narrows, urethra moves
closer to the introitus.
Stress urinary incontinence - Correct Answer-Vaginal estrogen and urinary
incontinence: what type does it help with?
Treatment for FPHL - Correct Answer-Minoxidil, spironolactone, finasteride, estrogen
therapy.
Late reproductive years -3b and -3a - Correct Answer--3b: menstrual cycles normal, FSH
normal, AMH low, AFC low, inhibin low. -3a: subtle menstrual changes, variable FSH,
AMH low, AFC low, inhibin low.
When it is appropriate to check an FSH during the cycle if you check it? - Correct
Answer-Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH
level.
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AFC - Correct Answer-Antral follicle count. Number of follicles that are detectable with
ultrasound.
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? - Correct Answer-SHBG
decreases. Testosterone/SHBG ratio increases by 80%.
Testosterone/SHBG 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.
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.
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.
3|Page
NAMs Menopause Certification
Exam With 100% Correct
Questions and Answers | Graded
A+
Climacteric phase - Correct Answer-The period of endocrinologic, somatic, and
transitory psychologic changes that occur around the time of menopause.
Early menopause - Correct Answer-LMP before age 45.
Late menopause - Correct Answer-LMP after age 54.
Primary ovarian insufficiency - Correct Answer-Menopause that occurs before age 40.
Early menopause transition (stage -2) - Correct Answer-Persistent difference of 7 days
or more in the length of consecutive cycles.
Late menopause transition (stage -1) - Correct Answer-60 or more consecutive days of
amenorrhea.
Luteal out of phase event (LOOP) - Correct Answer-Explains why some
perimenopausal women have elevated estrogen levels sometimes.
Obese women and estradiol levels during menopause - Correct Answer-Obese women
are more likely to have anovulatory cycles with high estradiol levels.
Chinese and Japanese women - Correct Answer-These ethnic groups have lower
estradiol levels than white, black, and Hispanic women.
Stage +2 - Correct Answer-Late menopause stage: 5-8 years after FMP. Somatic aging
predominates.
Stages +1a, +1b, +1c - Correct Answer-Early post menopause: 2 years after FMP. FSH
rises, estradiol decreases.
Elevated FSH, LH - Correct Answer-Endocrine labs after menopause.
1|Page
, Page |2
AMH, inhibin B - Correct Answer-These hormones work during reproductive years to
not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms - Correct Answer-Menstrual
cycle variable, persistent >7 day difference between difference in length of consecutive
cycles.
How to respond if a patient requests FSH lab? - Correct Answer-Many pitfalls, variable
depending on the day of the cycle you draw the lab.
The potentially superior marker of menopause, a lab. - Correct Answer-AMH.
DHEA (dehydroepiandrosterone) - Correct Answer-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 - Correct Answer-Vagina, vulva, urethra, trigone of the
bladder.
Effects of estrogen on tissue - Correct Answer-Maintain blood flow, the collagen, and
HA within the epithelial surfaces.
Vaginal changes with menopause - Correct Answer-Thinning, loss of elasticity, loss or
absence of rugae.
Vagina and urethra in menopause - Correct Answer-Vagina narrows, urethra moves
closer to the introitus.
Stress urinary incontinence - Correct Answer-Vaginal estrogen and urinary
incontinence: what type does it help with?
Treatment for FPHL - Correct Answer-Minoxidil, spironolactone, finasteride, estrogen
therapy.
Late reproductive years -3b and -3a - Correct Answer--3b: menstrual cycles normal, FSH
normal, AMH low, AFC low, inhibin low. -3a: subtle menstrual changes, variable FSH,
AMH low, AFC low, inhibin low.
When it is appropriate to check an FSH during the cycle if you check it? - Correct
Answer-Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH
level.
2|Page
, Page |3
AFC - Correct Answer-Antral follicle count. Number of follicles that are detectable with
ultrasound.
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? - Correct Answer-SHBG
decreases. Testosterone/SHBG ratio increases by 80%.
Testosterone/SHBG 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.
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.
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.
3|Page
