2026 Correct Marking Scheme
1. The period of endrocrinologic, somatic, and transitory psychologic changes
that occur around the time of menopause.- ANSWER -Climacteric phase
2. LMP before age 45- ANSWER -Early menopause
3. LMP after age 54- ANSWER -Late menopause
4. Menopause that occurs before age 40- ANSWER -Primary ovarian insufficiency
5. Persistent difference of 7 days or more in the length of consecutive cycles.-
- ANSWER -Early menopause transition (stage -2)
6. 60 or more consecutive days of amenorrhea- ANSWER -Late
menopause transition (stage -1)
7. Explains why some perimenopausal women have elevated estrogen level
sometimes...In the early menopause transition, elevated FSH levels are ade-
quate 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.- ANSWER -Luteal out of phase event (LOOP)
8. 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)- ANSWER -Obese women and
estradiol levels during menopause
9. These ethnic groups have lower estradiol levels then white, black and
hispanic women.- ANSWER -Chinese and Japanese women
10. late menopause stage- ANSWER -5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms.- ANSWER -stage +2
11. early post menopause- ANSWER -2 years after FMP. FSH rises, estradiol
decreases. VMS predominate.- ANSWER -Stages +1a, +1b, +1c
12. Endocrine labs after menopause- ANSWER -Elevated FSH, LH
13. These hormones work during reproductive years to not deplete follicle
pool too quickly.- ANSWER -AMH, inhibin B
14. Menstrual cycle variable, persistent >7 day difference between difference
in length of consecutive cycles.- ANSWER -Phases during menopause
transition and PMS symptoms
15. many pitfalls, variable depending on the day of the cycle you draw the lab,
normal or low FSH is not helpful.- ANSWER -How to respond if a patient
requests FSH lab?
16. AMH- ANSWER -The potentially superior marker of menopause, a lab.
17. Adrenal androgens- ANSWER -precursor hromones produced by the
adrenal gland that are enzymatically converted to active androgens or
estrogens in periph- eral tissues.- ANSWER -DHEA (dehydroepiandrosterone)
, NAMs Menopause Certification Exam Questions With Correct Answers
2026 Correct Marking Scheme
18. Vagina, vulva, urethra, trigone of the bladder- ANSWER -Location of estrogen
receptors
, NAMs Menopause Certification Exam Questions With Correct Answers
2026 Correct Marking Scheme
19. maintain blood flow, the collagen, and HA within the epithelial surfaces.
Supports microbiome which supports acidity of vagina and protects tissue
from pathogens.- ANSWER -Effects of estrogen on tissue
20. Thinning, loss of elasticity, loss or absence or rugae.- ANSWER -Vaginal
changes with menopause
21. vagina narrows, urethra moves closer to the introitus.- ANSWER -Vagina
and urethra in menopause
22. Vaginal estrogen and urinary incontinence- ANSWER -what type does it
help with?- ANSWER --
Stress urinary incontinence
23. Minoxidil, spironolactone, finasteride, estrogen therapy- ANSWER -
Treatment for FPHL
24. -3b- ANSWER -menstrual cycles normal, FSH normal, AMH low, AFC low,
inhibin low.
-3a- ANSWER -subtle menstrual changes, variable FSH, AMH low, AFC low,
inhibin low.-
- ANSWER -Late reporoductive years -3b and -3a. What happens with menstrual
cycles, FSH, AMH, AFC, inhibin?
25. Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal
FSH level.- ANSWER -When it is appropriate to check an FSH during the cycle if
you check it? and why?
26. produced by granulosa cells
used to test damage to ovarian follicle reserve. If AMH is low, the woman has
a low ovarian reserve.
not recommended as a screening tool to predict fertility.
Peaks at around 25 years old. So before age 25, this test is not helpful.
It is influenced by exogenous hormones. Lower in hormonal contraception
users, but increases after d/cing.- ANSWER -AMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak?
27. Antral follicle count
, NAMs Menopause Certification Exam Questions With Correct Answers
2026 Correct Marking Scheme
Number of follicles that are detectable with ultrasound.
They are sensitive to FSH and considered to represent the availability pool of
follicles.- ANSWER -AFC