Latest Version Of NAMs Menopause Certification
Exam 2025-2026 Prep Test Bank with a Review of 300
Most Recent Exam Questions and Correct Answers with
Rationales/ NAMS Menopause Certified Practitioner
Climacteric phase - Answer--The period of endocrinologic, somatic, and transitory
psychologic changes that occur around the time of menopause.
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 levels sometimes.
Obese women and estradiol levels during menopause - Answer--Obese women are
more likely to have anovulatory cycles with high estradiol levels.
Chinese and Japanese women - Answer--These ethnic groups have lower estradiol
levels than white, black, and Hispanic women.
Stage +2 - Answer--Late menopause stage: 5-8 years after FMP. Somatic aging
predominates.
Stages +1a, +1b, +1c - Answer--Early post menopause: 2 years after FMP. FSH
rises, estradiol decreases.
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.
The potentially superior marker of menopause, a lab. - Answer--AMH.
DHEA (dehydroepiandrosterone) - 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 - 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.
Vaginal changes with menopause - Answer--Thinning, loss of elasticity, loss or
absence of 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 reproductive years -3b and -3a - 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? -
Answer--Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal
FSH level.
AFC - Answer--Antral follicle count. Number of follicles that are detectable with
ultrasound.
, Late menopause transition (-1) FSH level on random draw - Answer--25 or higher.
Black women have higher or lower FSH levels? - Answer--Higher.
Chinese and Japanese women have higher or lower estradiol levels compared to
white, black and Hispanic women? - Answer--Lower.
Menopause transition-changes in SHBG and testosterone? - Answer--SHBG
decreases. Testosterone/SHBG ratio increases by 80%.
Testosterone/SHBG ratio is called what? - Answer--The free androgen index.
What stage are VMS more likely? - Answer--+1b (generally last 2 years).
What hormone is generally higher in obese women? - Answer--Estrone-via
aromatization.
The postmenopausal ovary continues to produce what two hormones? -
Answer--Testosterone and androstenedione.
Surgical menopause causes women to have lower levels of what hormone? -
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? - Answer--Inhibin and AMH decrease.
In the menopause transition, women spend more time in what phase? -
Answer--Luteal-more PMS symptoms, more frequent menstrual periods.
HPO axis theory and the menopause transition - 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? -
Answer--Progesterone.
What region of the adrenal gland secretes the androgens? - Answer--Zona
reticularis.
What are considered the 'adrenal androgens'? - Answer--DHEA, DHEAS,
Androstenedione.
Exam 2025-2026 Prep Test Bank with a Review of 300
Most Recent Exam Questions and Correct Answers with
Rationales/ NAMS Menopause Certified Practitioner
Climacteric phase - Answer--The period of endocrinologic, somatic, and transitory
psychologic changes that occur around the time of menopause.
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 levels sometimes.
Obese women and estradiol levels during menopause - Answer--Obese women are
more likely to have anovulatory cycles with high estradiol levels.
Chinese and Japanese women - Answer--These ethnic groups have lower estradiol
levels than white, black, and Hispanic women.
Stage +2 - Answer--Late menopause stage: 5-8 years after FMP. Somatic aging
predominates.
Stages +1a, +1b, +1c - Answer--Early post menopause: 2 years after FMP. FSH
rises, estradiol decreases.
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.
The potentially superior marker of menopause, a lab. - Answer--AMH.
DHEA (dehydroepiandrosterone) - 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 - 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.
Vaginal changes with menopause - Answer--Thinning, loss of elasticity, loss or
absence of 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 reproductive years -3b and -3a - 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? -
Answer--Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal
FSH level.
AFC - Answer--Antral follicle count. Number of follicles that are detectable with
ultrasound.
, Late menopause transition (-1) FSH level on random draw - Answer--25 or higher.
Black women have higher or lower FSH levels? - Answer--Higher.
Chinese and Japanese women have higher or lower estradiol levels compared to
white, black and Hispanic women? - Answer--Lower.
Menopause transition-changes in SHBG and testosterone? - Answer--SHBG
decreases. Testosterone/SHBG ratio increases by 80%.
Testosterone/SHBG ratio is called what? - Answer--The free androgen index.
What stage are VMS more likely? - Answer--+1b (generally last 2 years).
What hormone is generally higher in obese women? - Answer--Estrone-via
aromatization.
The postmenopausal ovary continues to produce what two hormones? -
Answer--Testosterone and androstenedione.
Surgical menopause causes women to have lower levels of what hormone? -
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? - Answer--Inhibin and AMH decrease.
In the menopause transition, women spend more time in what phase? -
Answer--Luteal-more PMS symptoms, more frequent menstrual periods.
HPO axis theory and the menopause transition - 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? -
Answer--Progesterone.
What region of the adrenal gland secretes the androgens? - Answer--Zona
reticularis.
What are considered the 'adrenal androgens'? - Answer--DHEA, DHEAS,
Androstenedione.
