NAMs Menopause Certification Exam Verified Questions
And Correct Answers 2026
Climacteric phase - Correct Answer>>The period of
endrocrinologic, 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
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 - Correct
Answer>>Obese women are more likely to have anovulatory
cycles with high estradiol levels. They are also more likely to
have lower premenopause yet higher postmenopause estradiol
,levels compared with women of normal weight. (why they are
at higher risk of endometrial cancer)
Chinese and Japanese women - Correct Answer>>These ethnic
groups have lower estradiol levels then white, black and
hispanic women.
stage +2 - Correct Answer>>late menopause stage: 5-8 years
after FMP. Somatic aging predominates. Increased
genitourinary symptoms.
Stages +1a, +1b, +1c - Correct Answer>>early post menopause:
2 years after FMP. FSH rises, estradiol decreases. VMS
predominate.
Elevated FSH, LH - Correct Answer>>Endocrine labs after
menopause
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 shortenes, follicular phase
compresses, women spend more time in luteal phase.. meaning
more premenstrual symptoms and more frequent menstrual
periods.
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, normal or low FSH is not helpful.
The potentially superior marker of menopause, a lab. - Correct
Answer>>AMH
, DHEA (dehydroepiandrosterone) - Correct Answer>>Adrenal
androgens: precursor hromones 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.
Supports microbiome and protects tissue from pathogens.
Vaginal changes with menopause - Correct Answer>>Thinning,
loss of elasticity, loss or absence or 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 reporoductive years -3b and -3a. What happens with
menstrual cycles, FSH, AMH, AFC, inhibin? - 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? and why? - Correct Answer>>Cycle day #3. Elevated
estradiol can suppress FSH giving a falsely normal FSH level.
And Correct Answers 2026
Climacteric phase - Correct Answer>>The period of
endrocrinologic, 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
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 - Correct
Answer>>Obese women are more likely to have anovulatory
cycles with high estradiol levels. They are also more likely to
have lower premenopause yet higher postmenopause estradiol
,levels compared with women of normal weight. (why they are
at higher risk of endometrial cancer)
Chinese and Japanese women - Correct Answer>>These ethnic
groups have lower estradiol levels then white, black and
hispanic women.
stage +2 - Correct Answer>>late menopause stage: 5-8 years
after FMP. Somatic aging predominates. Increased
genitourinary symptoms.
Stages +1a, +1b, +1c - Correct Answer>>early post menopause:
2 years after FMP. FSH rises, estradiol decreases. VMS
predominate.
Elevated FSH, LH - Correct Answer>>Endocrine labs after
menopause
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 shortenes, follicular phase
compresses, women spend more time in luteal phase.. meaning
more premenstrual symptoms and more frequent menstrual
periods.
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, normal or low FSH is not helpful.
The potentially superior marker of menopause, a lab. - Correct
Answer>>AMH
, DHEA (dehydroepiandrosterone) - Correct Answer>>Adrenal
androgens: precursor hromones 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.
Supports microbiome and protects tissue from pathogens.
Vaginal changes with menopause - Correct Answer>>Thinning,
loss of elasticity, loss or absence or 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 reporoductive years -3b and -3a. What happens with
menstrual cycles, FSH, AMH, AFC, inhibin? - 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? and why? - Correct Answer>>Cycle day #3. Elevated
estradiol can suppress FSH giving a falsely normal FSH level.
