NAMS CERTIFICATION FLASHCARDS
EXAM NEWEST 2026/2027 ACTUAL
EXAM TEST BANK| COMPLETE 100
REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+| NAMS
MENOPAUSE CERTIFICATION EXAM
PREP (BRAND NEW!!)
WhatmaremthemrecommendationsmformtransitioningmfrommOCPmtomMHT?m-
mCORRECTmANSWERmIndividualizationmismrequired.
Maymcontinuemcontraceptionmuntilmtypicalmagemofmmenopausem(51-
52my)mormwhenm90%mofmwomenmreachmmenopausem(55my).
CanmtransitionmfrommhormonemcontraceptionmtomHTmifmstillmsymptomatic.
Hotmflashesmmaymreappearmtransientlymbecausembirthmcontrolmhasmhighermhormonemconcentratio
nsmthanmHT.
Characterizedmbymhypergonadotropicmhypogonadismmthatmcanmbemtransient.
Affectsm1%mofmwomenmagedmyoungermthanm40myears.m-
mCORRECTmANSWERmPrimarymOvarianmInsufficiency
EtiologymofmPOI,mprematuremmenopause,mandmearlymmenopausem-
mCORRECTmANSWERmMostmcasesmaremidiopathic;mhowever,mothermetiologiesmincludemgenetic,maut
oimmune,miatrogenic,minfectious,mandmmetabolic.
Howmismovarianmreservemmeasured?m-mCORRECTmANSWERmFollicle-
stimulatingmhormonem(FSH)minmconjunctionmwithmestradiolm(daysm2-
5mofmmenstrualmcycle,mnotmtakingmhormones)
,Mostmcommonmformmeasuringmovarianmreserve.
FSHm>10mIU/Lm+mestradiolm<m60mpg/mL.
FSHm<10mIU/Lm+mestradiolm>100mpg/mL.m
AlsomAMH,mandmAFCmbutmnotmrecommendedmscreeningmtool
Whatmcharacterizesmearlymmenopausemtransition?m-
mCORRECTmANSWERmPersistentmcyclemirregularitymbym≥7md.
DeclineminminhibinmBmandmAMHmbecausemofmreductionminmfolliclesm(lowmAFC).
Diminishedmovarianmreserve.mLowermAMHmandminhibinmBmpromotesmgrowthmofmremainingmfollicul
armpool,macceleratingmfollicularmatresia.
EarlymfollicularmFSHmismvariable.
Lutealmout-of-phasem(LOOP)meventsmoccurminmaboutmoneminmfourmcycles.
Maymormmaymnotmhavemmildmvasomotormsymptomsm(VMS).
Maymhavempronouncedmpremenstrualmsyndrome.
Whatmcharacterizesmlatemmenopausemtransition?m-mCORRECTmANSWERmAmenorrheam>m60md.
Menstrualmcyclesmhavemvariablemcyclemlength.
Variablemestradiolmlevelsmwithmincreasedmprevalencemofmanovulation.
FSHmlevelsmarem≥25mIU/Lmbecausemofmfewmremainingmoocytes.
NegligiblemAMHmandmAFC.
LOOPmcyclesmoccurminmamthirdmofmwomen;mVMSmandmothermsignsmofmmenopausemlikely.
WhatmaremLutealmout-of-phasemevents?m-
mCORRECTmANSWERmSymptomsmfrommelevatedmestradiol:
Mastalgia
Migraine
,Menorrhagia
Growthmofmfibroids
Endometrialmhyperplasia
Increasedmriskmofmreproductivemcancersm(especiallymwithmlongermMT).
Pregnancymcanmoccur,mwithmincreasedmincidencemofmtwins.
Obesitymismassociatedmwithmelevatedmestradiolmconcentrationsmbecausemofmaromatizationmofmandr
ogenmtomestrogen.
Wheremaremadrenalmandrogensmproduced,mandmwhatmaremthey?m-
mCORRECTmANSWERmAdrenalmcortexmproduces:
Cortisolm(glucocorticoid).
Aldosteronem(mineralocorticoid).
Androgens,msexmsteroids:mdehydroepiandrosteronem(DHEA),mdehydroepiandrosteronemsulfatem(D
HEAS),mandrostenedione,mtestosterone.
Adrenalmmedullamproducesmandmsecretesmcatecholamines:mepinephrine,mnorepinephrine,mandmso
memdopamine.
Adrenalmandrogensmaremenzymaticallymconvertedmtomestrogensminmthemperipheralmtissues.
Althoughmcortisolmincreasesmwithmage,mandrogensmdecrease.
HowmdoesmthemHPAmaxismimpactmadrenalmandrogenmproductionmduringmMT?m-
mCORRECTmANSWERm85%mofmthoseminmthemlatemperimenopausemandmearlymmenopausemexperienc
e:
MarkedmriseminmDHEAmandmandrostenediol.
ModeratemriseminmDHEAS,mtestosterone,mandmandrostenedione.
, Adrenalmandrogenmlevelsmreturnmtompremenopausemlevelmwithinm1mtom2myearsmaftermFMP.
MarkedmriseminmcortisolmismassociatedmwithmriseminmFSHminmlatemperimenopause.
Changesminmcortisolmpatternsmassociatedmwithmmood,msleep,mandmvasomotormsymptomsm(VMS).
Whatmaremriskmfactorsmformvasomotormsymptoms?m-
mCORRECTmANSWERmObesitym(ormweightmgain).
Smokingm(tobaccomormnicotine).
Lowmsocioeconomicmposition.
Lowmeducationmattainment.
High-fatmormhigh-sugarmdiets.
Racemormethnicity.
Oophorectomy.
Medicalmcomorbiditiesm(thyroidmdisease,mdiabetesmmellitusm[DM],mobstructivemsleepmapneam[OSA
],mchronicmpainmconditions).
Highmanxietymlevels.
WhatmaremothermpossiblemreasonsmformVMSmnotmrelatedmtommenopause?m-
mCORRECTmANSWERmThyroidmdysfunction,minfections,mmalignancy,mpheochromocytoma,mandmcar
cinoidmsyndrome.
Warningmsignsmthatmtriggermevaluation:
New-onsetmVMSminmlatemmenopause.
Youngermwomenm(premenopausemormmenopausemtransition)mwithmpersistentmVMSmaccompanied
mbymnausea,mvomiting,mdiarrhea,mweightmloss,mfever,mcough,mwheezing,mpalpitations,mtachycardia,
mflushing,mormpersistentmheadache.
EXAM NEWEST 2026/2027 ACTUAL
EXAM TEST BANK| COMPLETE 100
REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+| NAMS
MENOPAUSE CERTIFICATION EXAM
PREP (BRAND NEW!!)
WhatmaremthemrecommendationsmformtransitioningmfrommOCPmtomMHT?m-
mCORRECTmANSWERmIndividualizationmismrequired.
Maymcontinuemcontraceptionmuntilmtypicalmagemofmmenopausem(51-
52my)mormwhenm90%mofmwomenmreachmmenopausem(55my).
CanmtransitionmfrommhormonemcontraceptionmtomHTmifmstillmsymptomatic.
Hotmflashesmmaymreappearmtransientlymbecausembirthmcontrolmhasmhighermhormonemconcentratio
nsmthanmHT.
Characterizedmbymhypergonadotropicmhypogonadismmthatmcanmbemtransient.
Affectsm1%mofmwomenmagedmyoungermthanm40myears.m-
mCORRECTmANSWERmPrimarymOvarianmInsufficiency
EtiologymofmPOI,mprematuremmenopause,mandmearlymmenopausem-
mCORRECTmANSWERmMostmcasesmaremidiopathic;mhowever,mothermetiologiesmincludemgenetic,maut
oimmune,miatrogenic,minfectious,mandmmetabolic.
Howmismovarianmreservemmeasured?m-mCORRECTmANSWERmFollicle-
stimulatingmhormonem(FSH)minmconjunctionmwithmestradiolm(daysm2-
5mofmmenstrualmcycle,mnotmtakingmhormones)
,Mostmcommonmformmeasuringmovarianmreserve.
FSHm>10mIU/Lm+mestradiolm<m60mpg/mL.
FSHm<10mIU/Lm+mestradiolm>100mpg/mL.m
AlsomAMH,mandmAFCmbutmnotmrecommendedmscreeningmtool
Whatmcharacterizesmearlymmenopausemtransition?m-
mCORRECTmANSWERmPersistentmcyclemirregularitymbym≥7md.
DeclineminminhibinmBmandmAMHmbecausemofmreductionminmfolliclesm(lowmAFC).
Diminishedmovarianmreserve.mLowermAMHmandminhibinmBmpromotesmgrowthmofmremainingmfollicul
armpool,macceleratingmfollicularmatresia.
EarlymfollicularmFSHmismvariable.
Lutealmout-of-phasem(LOOP)meventsmoccurminmaboutmoneminmfourmcycles.
Maymormmaymnotmhavemmildmvasomotormsymptomsm(VMS).
Maymhavempronouncedmpremenstrualmsyndrome.
Whatmcharacterizesmlatemmenopausemtransition?m-mCORRECTmANSWERmAmenorrheam>m60md.
Menstrualmcyclesmhavemvariablemcyclemlength.
Variablemestradiolmlevelsmwithmincreasedmprevalencemofmanovulation.
FSHmlevelsmarem≥25mIU/Lmbecausemofmfewmremainingmoocytes.
NegligiblemAMHmandmAFC.
LOOPmcyclesmoccurminmamthirdmofmwomen;mVMSmandmothermsignsmofmmenopausemlikely.
WhatmaremLutealmout-of-phasemevents?m-
mCORRECTmANSWERmSymptomsmfrommelevatedmestradiol:
Mastalgia
Migraine
,Menorrhagia
Growthmofmfibroids
Endometrialmhyperplasia
Increasedmriskmofmreproductivemcancersm(especiallymwithmlongermMT).
Pregnancymcanmoccur,mwithmincreasedmincidencemofmtwins.
Obesitymismassociatedmwithmelevatedmestradiolmconcentrationsmbecausemofmaromatizationmofmandr
ogenmtomestrogen.
Wheremaremadrenalmandrogensmproduced,mandmwhatmaremthey?m-
mCORRECTmANSWERmAdrenalmcortexmproduces:
Cortisolm(glucocorticoid).
Aldosteronem(mineralocorticoid).
Androgens,msexmsteroids:mdehydroepiandrosteronem(DHEA),mdehydroepiandrosteronemsulfatem(D
HEAS),mandrostenedione,mtestosterone.
Adrenalmmedullamproducesmandmsecretesmcatecholamines:mepinephrine,mnorepinephrine,mandmso
memdopamine.
Adrenalmandrogensmaremenzymaticallymconvertedmtomestrogensminmthemperipheralmtissues.
Althoughmcortisolmincreasesmwithmage,mandrogensmdecrease.
HowmdoesmthemHPAmaxismimpactmadrenalmandrogenmproductionmduringmMT?m-
mCORRECTmANSWERm85%mofmthoseminmthemlatemperimenopausemandmearlymmenopausemexperienc
e:
MarkedmriseminmDHEAmandmandrostenediol.
ModeratemriseminmDHEAS,mtestosterone,mandmandrostenedione.
, Adrenalmandrogenmlevelsmreturnmtompremenopausemlevelmwithinm1mtom2myearsmaftermFMP.
MarkedmriseminmcortisolmismassociatedmwithmriseminmFSHminmlatemperimenopause.
Changesminmcortisolmpatternsmassociatedmwithmmood,msleep,mandmvasomotormsymptomsm(VMS).
Whatmaremriskmfactorsmformvasomotormsymptoms?m-
mCORRECTmANSWERmObesitym(ormweightmgain).
Smokingm(tobaccomormnicotine).
Lowmsocioeconomicmposition.
Lowmeducationmattainment.
High-fatmormhigh-sugarmdiets.
Racemormethnicity.
Oophorectomy.
Medicalmcomorbiditiesm(thyroidmdisease,mdiabetesmmellitusm[DM],mobstructivemsleepmapneam[OSA
],mchronicmpainmconditions).
Highmanxietymlevels.
WhatmaremothermpossiblemreasonsmformVMSmnotmrelatedmtommenopause?m-
mCORRECTmANSWERmThyroidmdysfunction,minfections,mmalignancy,mpheochromocytoma,mandmcar
cinoidmsyndrome.
Warningmsignsmthatmtriggermevaluation:
New-onsetmVMSminmlatemmenopause.
Youngermwomenm(premenopausemormmenopausemtransition)mwithmpersistentmVMSmaccompanied
mbymnausea,mvomiting,mdiarrhea,mweightmloss,mfever,mcough,mwheezing,mpalpitations,mtachycardia,
mflushing,mormpersistentmheadache.
