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NAMS Certification Exam 2024 – Questions/Answers
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NAMS Certification Exam 2024 – Questions/AnswersEarly Menopause - ✔️ FMP before age 45
Late Menopause - ✔️ FMP after age 54
Bilateral oophorectomy prior to age 45 increases risks for: - ✔️ - All
cause mortality
- Coronary heart disease
- CVD
- Menopause symptoms
- Worsening mood symptoms
- Higher incidence of Parkinson Disease
- Associated with cognitive impairment
Early Menopause Transition (-2) - ✔️ 7 or more days persistent
difference in cycle length from previous normal cycle
- Results of increased follicular aging and depletion
- Inhibin B decreases
- FSH increases (Variable)
LOOP Cycles - ✔️ Explains elevation of Estradiol in perimenopause
- Rising FSH levels recruit 2nd follicle during luteal phase which leads to
overproduction of Estradiol
- This causes menstrual changes in future cycles
Decreased AMH in Early Menopause Transition - ✔️ More frequent
anovulatory cycles
Decreased Inhibin B in Early Menopause Transition - ✔️ - Skipped
menstrual cycles
- Mastalgia
- Migraine
- Menorrhagia (with LOOP cycles)
- Endometrial Hyperplasia
Late Menopause Transition (-1) - ✔️ 60 or more days of amenorrhea for
women aged 45 years or older
, - Women 40-44 years with recurrent episodes of amenorrhea of 60 day for
longer within a year improves prediction of entry into late menopause
transition
Late Menopause Transition (-1) Duration - ✔️ 1-3 years
Late Menopause Transition (-1) Symptoms - ✔️ VMS likely
STRAW Stage where FSH > 25 - ✔️ Late Menopause Transition (-1)
Elevated FSH symptoms in Late Menopause Transition - ✔️ - VMS
- Sleep disturbance
- Changes in weight distribution
- Increased variability in cycle length
Decreased Inhibin B in Late Menopause Transition - ✔️ - Mood changes
- Cognitive complaints
- Changes in sexual functioning
- Increased prevalence of anovulation
Decreased AMH in Late Menopause Transition - ✔️ - GSM
- Bone loss
- CVD issues
- Interval of amenorrhea > 60 days
POI - ✔️ Menopause before age 40
POI diagnosis - ✔️ - Oligomenorrhea or amenorrhea x 4 months
- FSH > 25 on two occasions at least 4 weeks apart
POI Symptoms - ✔️ - Hot flashes
- Mood changes - depression
- Insomnia
- Vaginal dryness, dyspareunia
POI Management - ✔️ HT until average of menopause
Early Menopause Risks (natural or surgical) - ✔️ - CVD
- Low bone density
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