NAMS Menopause Certification Exam 2025/2026 –Actual
Exam 250 Questions with Correct Answers and Expert
Explanations | LATEST UPDATE 2025/2026 | GRADED
A+.
Menopause that occurs before age 40 -CORRECTANSWER Primary ovarian
insufficiency
Persistent difference of 7 days or more in the length of consecutive cycles. -
CORRECTANSWER Early menopause transition (stage -2)
The period of endrocrinologic, somatic, and transitory psychologic changes that occur around
the time of menopause. -CORRECTANSWER Climacteric phase
LMP before age 45 -CORRECTANSWER Early menopause
LMP after age 54 -CORRECTANSWER Late menopause
60 or more consecutive days of amenorrhea -CORRECTANSWER Late menopause
transition (stage -1)
,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)
CORRECTANSWER Obese women and estradiol levels during menopause
early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS predominate.
CORRECTANSWER Stages +1a, +1b, +1c
Endocrine labs after menopause -CORRECTANSWER Elevated FSH, LH
These hormones work during reproductive years to not deplete follicle pool too quickly. -
CORRECTANSWER AMH, inhibin B
Menstrual cycle variable, persistent >7 day difference between difference in length of
consecutive cycles. -CORRECTANSWER Phases during menopause transition and
PMS symptoms
many pitfalls, variable depending on the day of the cycle you draw the lab, normal or low FSH is
not helpful. -CORRECTANSWER How to respond if a patient requests FSH lab?
AMH -CORRECTANSWER The potentially superior marker of menopause, a lab.
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. -
CORRECTANSWER Luteal out of phase event (LOOP)
These ethnic groups have lower estradiol levels then white, black and hispanic women.
-CORRECTANSWER Chinese and Japanese women
late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased genitourinary
symptoms. -CORRECTANSWER stage +2
Adrenal androgens: precursor hromones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues. -
CORRECTANSWER DHEA (dehydroepiandrosterone)
Vagina, vulva, urethra, trigone of the bladder -CORRECTANSWER Location of estrogen
receptors
maintain blood flow, the collagen, and HA within the epithelial surfaces. Supports microbiome
which supports acidity of vagina and protects tissue from pathogens. CORRECTANSWER
Effects of estrogen on tissue
, Thinning, loss of elasticity, loss or absence or rugae. -CORRECTANSWER Vaginal changes
with menopause
Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH level.
CORRECTANSWER When it is appropriate to check an FSH during the cycle if you check it?
and why?
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.
Vaginal estrogen and urinary incontinence: what type does it help with? -
CORRECTANSWER Stress urinary incontinence
It is influenced by exogenous hormones. Lower in hormonal contraception users, but increases
after d/cing. -CORRECTANSWER AMH produced by... used to test...
Is it a screening tool for fertility?
When does it peak?
Antral follicle count
Exam 250 Questions with Correct Answers and Expert
Explanations | LATEST UPDATE 2025/2026 | GRADED
A+.
Menopause that occurs before age 40 -CORRECTANSWER Primary ovarian
insufficiency
Persistent difference of 7 days or more in the length of consecutive cycles. -
CORRECTANSWER Early menopause transition (stage -2)
The period of endrocrinologic, somatic, and transitory psychologic changes that occur around
the time of menopause. -CORRECTANSWER Climacteric phase
LMP before age 45 -CORRECTANSWER Early menopause
LMP after age 54 -CORRECTANSWER Late menopause
60 or more consecutive days of amenorrhea -CORRECTANSWER Late menopause
transition (stage -1)
,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)
CORRECTANSWER Obese women and estradiol levels during menopause
early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS predominate.
CORRECTANSWER Stages +1a, +1b, +1c
Endocrine labs after menopause -CORRECTANSWER Elevated FSH, LH
These hormones work during reproductive years to not deplete follicle pool too quickly. -
CORRECTANSWER AMH, inhibin B
Menstrual cycle variable, persistent >7 day difference between difference in length of
consecutive cycles. -CORRECTANSWER Phases during menopause transition and
PMS symptoms
many pitfalls, variable depending on the day of the cycle you draw the lab, normal or low FSH is
not helpful. -CORRECTANSWER How to respond if a patient requests FSH lab?
AMH -CORRECTANSWER The potentially superior marker of menopause, a lab.
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. -
CORRECTANSWER Luteal out of phase event (LOOP)
These ethnic groups have lower estradiol levels then white, black and hispanic women.
-CORRECTANSWER Chinese and Japanese women
late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased genitourinary
symptoms. -CORRECTANSWER stage +2
Adrenal androgens: precursor hromones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues. -
CORRECTANSWER DHEA (dehydroepiandrosterone)
Vagina, vulva, urethra, trigone of the bladder -CORRECTANSWER Location of estrogen
receptors
maintain blood flow, the collagen, and HA within the epithelial surfaces. Supports microbiome
which supports acidity of vagina and protects tissue from pathogens. CORRECTANSWER
Effects of estrogen on tissue
, Thinning, loss of elasticity, loss or absence or rugae. -CORRECTANSWER Vaginal changes
with menopause
Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH level.
CORRECTANSWER When it is appropriate to check an FSH during the cycle if you check it?
and why?
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.
Vaginal estrogen and urinary incontinence: what type does it help with? -
CORRECTANSWER Stress urinary incontinence
It is influenced by exogenous hormones. Lower in hormonal contraception users, but increases
after d/cing. -CORRECTANSWER AMH produced by... used to test...
Is it a screening tool for fertility?
When does it peak?
Antral follicle count
