NAMS MENOPAUSE CERTIFICATION FINAL
PAPER EXAM PREP QUESTIONS AND
CORRECT ANSWERS TEST BANK FULLY
UPDATED PASS READY RESOURCE
●● Early menopause.
Answer: LMP before age 45
●● Late menopause.
Answer: LMP after age 54
●● Primary ovarian insufficiency.
Answer: Menopause that occurs before age 40
●● Early menopause transition (stage -2).
Answer: Persistent difference of 7 days or more in the length of
consecutive cycles.
●● Late menopause transition (stage -1).
Answer: 60 or more consecutive days of amenorrhea
●● Luteal out of phase event (LOOP).
,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.
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.
Answer: These ethnic groups have lower estradiol levels then white,
black and hispanic women.
●● stage +2.
Answer: late menopause stage: 5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms.
●● Stages +1a, +1b, +1c.
Answer: early post menopause: 2 years after FMP. FSH rises, estradiol
decreases. VMS predominate.
,●● Elevated FSH, LH.
Answer: Endocrine labs after menopause
●● AMH, inhibin B.
Answer: These hormones work during reproductive years to not deplete
follicle pool too quickly.
●● Phases during menopause transition and PMS symptoms.
Answer: Menstrual cycle variable, persistent >7 day difference between
difference in length of consecutive cycles.
●● How to respond if a patient requests FSH lab?.
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..
Answer: AMH
●● DHEA (dehydroepiandrosterone).
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.
Answer: Vagina, vulva, urethra, trigone of the bladder
●● Effects of estrogen on tissue.
Answer: 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.
Answer: Thinning, loss of elasticity, loss or absence or rugae.
●● Vagina and urethra in menopause.
Answer: vagina narrows, urethra moves closer to the introitus.
●● Stress urinary incontinence.
Answer: Vaginal estrogen and urinary incontinence: what type does it
help with?
●● Treatment for FPHL.
Answer: Minoxidil, spironolactone, finasteride, estrogen therapy
●● Late reporoductive years -3b and -3a. What happens with menstrual
cycles, FSH, AMH, AFC, inhibin?.
PAPER EXAM PREP QUESTIONS AND
CORRECT ANSWERS TEST BANK FULLY
UPDATED PASS READY RESOURCE
●● Early menopause.
Answer: LMP before age 45
●● Late menopause.
Answer: LMP after age 54
●● Primary ovarian insufficiency.
Answer: Menopause that occurs before age 40
●● Early menopause transition (stage -2).
Answer: Persistent difference of 7 days or more in the length of
consecutive cycles.
●● Late menopause transition (stage -1).
Answer: 60 or more consecutive days of amenorrhea
●● Luteal out of phase event (LOOP).
,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.
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.
Answer: These ethnic groups have lower estradiol levels then white,
black and hispanic women.
●● stage +2.
Answer: late menopause stage: 5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms.
●● Stages +1a, +1b, +1c.
Answer: early post menopause: 2 years after FMP. FSH rises, estradiol
decreases. VMS predominate.
,●● Elevated FSH, LH.
Answer: Endocrine labs after menopause
●● AMH, inhibin B.
Answer: These hormones work during reproductive years to not deplete
follicle pool too quickly.
●● Phases during menopause transition and PMS symptoms.
Answer: Menstrual cycle variable, persistent >7 day difference between
difference in length of consecutive cycles.
●● How to respond if a patient requests FSH lab?.
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..
Answer: AMH
●● DHEA (dehydroepiandrosterone).
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.
Answer: Vagina, vulva, urethra, trigone of the bladder
●● Effects of estrogen on tissue.
Answer: 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.
Answer: Thinning, loss of elasticity, loss or absence or rugae.
●● Vagina and urethra in menopause.
Answer: vagina narrows, urethra moves closer to the introitus.
●● Stress urinary incontinence.
Answer: Vaginal estrogen and urinary incontinence: what type does it
help with?
●● Treatment for FPHL.
Answer: Minoxidil, spironolactone, finasteride, estrogen therapy
●● Late reporoductive years -3b and -3a. What happens with menstrual
cycles, FSH, AMH, AFC, inhibin?.
