NAMS MENOPAUSE CERTIFICATION
EXAM 2026 NEWEST EXAM QUESTIONS
WITH DETAILED VERIFIED ANSWERS
(100% CORRECT ANSWERS) /A+ STUDY
MATERIAL
What hormone is generally higher in obese women? - CORRECT ANSWER ✔✔-
Estrone-via aromatization.
The postmenopausal ovary continues to produce what two hormones? - CORRECT
ANSWER ✔✔- testosterone and androstenedione
Surgical menopause causes women to have lower levels of what hormone? -
CORRECT 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? - CORRECT ANSWER ✔✔- inhibin and AMH decrease
therefore, follicle growth is not restrained, this allows for the growth of the
remaining, diminished follicle pool.
In the menopause transition, women spend more time in what phase? - CORRECT
ANSWER ✔✔- Luteal-more PMS symptoms, more frequent menstrual periods.
1|Page
,HPO axis theory and the menopause transition - CORRECT ANSWER ✔✔- It is
felt that the HPO axis may become less sensitive to estrogen, so even with good
follicle growth and estradiol secretion, LH surges can fail which can lead to more
cycle irregularity.
In the first year after the FMP, there is no production of what hormone? -
CORRECT ANSWER ✔✔- progesterone
What region of the adrenal gland secretes the androgens? - CORRECT ANSWER
✔✔- zona reticularis
what are considered the 'adrenal androgens'? - CORRECT ANSWER ✔✔- DHEA,
DHEAS, Androstenedione.
Aldosterone secretion from the zona reticularis in the adrenal gland is regulated by
3 main factors. - CORRECT ANSWER ✔✔- Angiotensin II, potassium
concentration, adrenocorticotropic hormone secreted by the anterior pituitary.
What part of the pituitary gland secretes adrenocorticotropic hormone? -
CORRECT ANSWER ✔✔- Anterior pituitary. The posterior only secretes
vasopressin and oxytosin.
Cortisol and HRT - CORRECT ANSWER ✔✔- Most serum cortisol circulates
bound to cortisol binding globulin.
Oral estrogen increases the cortisol binding globulin, which increases total cortisol
concentration.
2|Page
,Oral tamoxifen acts similarly.
Transdermal does not increase it, so it has a minimal effect on serum cortisol
concentration.
Do cortisol levels associate with VMS severity? - CORRECT ANSWER ✔✔- No,
cortisol levels have NOT been associated with more severe VMS.
Climacteric phase - CORRECT ANSWER ✔✔- The period of endrocrinologic,
somatic, and transitory psychologic changes that occur around the time of
menopause.
Early menopause - CORRECT ANSWER ✔✔- LMP before age 45
Late menopause - CORRECT ANSWER ✔✔- LMP after age 54
Primary ovarian insufficiency - CORRECT ANSWER ✔✔- Menopause that
occurs before age 40
Early menopause transition (stage -2) - CORRECT ANSWER ✔✔- Persistent
difference of 7 days or more in the length of consecutive cycles.
Late menopause transition (stage -1) - CORRECT ANSWER ✔✔- 60 or more
consecutive days of amenorrhea
Luteal out of phase event (LOOP) - CORRECT ANSWER ✔✔- Explains why
some perimenopausal women have elevated estrogen level sometimes...In the early
3|Page
, 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 - CORRECT 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 - CORRECT ANSWER ✔✔- These ethnic groups
have lower estradiol levels then white, black and hispanic women.
stage +2 - CORRECT ANSWER ✔✔- late menopause stage: 5-8 years after FMP.
Somatic aging predominates. Increased genitourinary symptoms.
Stages +1a, +1b, +1c - CORRECT ANSWER ✔✔- early post menopause: 2 years
after FMP. FSH rises, estradiol decreases. VMS predominate.
Elevated FSH, LH - CORRECT ANSWER ✔✔- Endocrine labs after menopause
AMH, inhibin B - CORRECT ANSWER ✔✔- These hormones work during
reproductive years to not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms - CORRECT ANSWER
✔✔- Menstrual cycle variable, persistent >7 day difference between difference in
length of consecutive cycles.
4|Page
EXAM 2026 NEWEST EXAM QUESTIONS
WITH DETAILED VERIFIED ANSWERS
(100% CORRECT ANSWERS) /A+ STUDY
MATERIAL
What hormone is generally higher in obese women? - CORRECT ANSWER ✔✔-
Estrone-via aromatization.
The postmenopausal ovary continues to produce what two hormones? - CORRECT
ANSWER ✔✔- testosterone and androstenedione
Surgical menopause causes women to have lower levels of what hormone? -
CORRECT 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? - CORRECT ANSWER ✔✔- inhibin and AMH decrease
therefore, follicle growth is not restrained, this allows for the growth of the
remaining, diminished follicle pool.
In the menopause transition, women spend more time in what phase? - CORRECT
ANSWER ✔✔- Luteal-more PMS symptoms, more frequent menstrual periods.
1|Page
,HPO axis theory and the menopause transition - CORRECT ANSWER ✔✔- It is
felt that the HPO axis may become less sensitive to estrogen, so even with good
follicle growth and estradiol secretion, LH surges can fail which can lead to more
cycle irregularity.
In the first year after the FMP, there is no production of what hormone? -
CORRECT ANSWER ✔✔- progesterone
What region of the adrenal gland secretes the androgens? - CORRECT ANSWER
✔✔- zona reticularis
what are considered the 'adrenal androgens'? - CORRECT ANSWER ✔✔- DHEA,
DHEAS, Androstenedione.
Aldosterone secretion from the zona reticularis in the adrenal gland is regulated by
3 main factors. - CORRECT ANSWER ✔✔- Angiotensin II, potassium
concentration, adrenocorticotropic hormone secreted by the anterior pituitary.
What part of the pituitary gland secretes adrenocorticotropic hormone? -
CORRECT ANSWER ✔✔- Anterior pituitary. The posterior only secretes
vasopressin and oxytosin.
Cortisol and HRT - CORRECT ANSWER ✔✔- Most serum cortisol circulates
bound to cortisol binding globulin.
Oral estrogen increases the cortisol binding globulin, which increases total cortisol
concentration.
2|Page
,Oral tamoxifen acts similarly.
Transdermal does not increase it, so it has a minimal effect on serum cortisol
concentration.
Do cortisol levels associate with VMS severity? - CORRECT ANSWER ✔✔- No,
cortisol levels have NOT been associated with more severe VMS.
Climacteric phase - CORRECT ANSWER ✔✔- The period of endrocrinologic,
somatic, and transitory psychologic changes that occur around the time of
menopause.
Early menopause - CORRECT ANSWER ✔✔- LMP before age 45
Late menopause - CORRECT ANSWER ✔✔- LMP after age 54
Primary ovarian insufficiency - CORRECT ANSWER ✔✔- Menopause that
occurs before age 40
Early menopause transition (stage -2) - CORRECT ANSWER ✔✔- Persistent
difference of 7 days or more in the length of consecutive cycles.
Late menopause transition (stage -1) - CORRECT ANSWER ✔✔- 60 or more
consecutive days of amenorrhea
Luteal out of phase event (LOOP) - CORRECT ANSWER ✔✔- Explains why
some perimenopausal women have elevated estrogen level sometimes...In the early
3|Page
, 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 - CORRECT 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 - CORRECT ANSWER ✔✔- These ethnic groups
have lower estradiol levels then white, black and hispanic women.
stage +2 - CORRECT ANSWER ✔✔- late menopause stage: 5-8 years after FMP.
Somatic aging predominates. Increased genitourinary symptoms.
Stages +1a, +1b, +1c - CORRECT ANSWER ✔✔- early post menopause: 2 years
after FMP. FSH rises, estradiol decreases. VMS predominate.
Elevated FSH, LH - CORRECT ANSWER ✔✔- Endocrine labs after menopause
AMH, inhibin B - CORRECT ANSWER ✔✔- These hormones work during
reproductive years to not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms - CORRECT ANSWER
✔✔- Menstrual cycle variable, persistent >7 day difference between difference in
length of consecutive cycles.
4|Page
