2024 - NAMS Menopause Certification Exam Study Set
Jeremiah
Terms in this set (200)
secondary causes of osteoporosis Hyperthyroidism, hyperparathyroidism, hypercalciuria, certain drugs (eg: tamoxifen,
steroids, PPIs), calcium/vitamin D deficiency, RA, celiac disease, malabsorptive diseases
which 3 common drugs? such as Crohn disease, and ulcerative colitis
Median age of menopause in US women 52.54 y
POI Intermittent ovarian function & insufficient estrogen levels occurring at age <40 y
which STRAW stage? -5
menarche / early reproductive
which STRAW stage? -4
peak reproductive
which STRAW stage? -3
late reproductive
which STRAW stage? -2 to -1 & +1a
perimenopause
which STRAW stage? FMP = 0
12 months after = +1a
FMP &
12 months after final menstrual period
+1a (most likely)
which STRAW stage?
-1 (likely)
VMS most likely
aka perimenopause/menopause transition
which STRAW stage? +1a to +1c
early post menopause
which STRAW stage? +2
2024 - NAMS Menopause Certification Exam Study Set
late postmenopause
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, 8/30/24, 6:02 PM
which STRAW stage? -1
amenorrhea >60 days aka late menopause transition
which STRAW stage? -2
variable cycle lengths of >7 days differences aka early menopause transition
menopause transition: -2 and -1, prior to FMP
difference between menopause transition vs
perimenopause per STRAW criteria?
perimenopause: -2 to +1a, includes 12 mo of amenorrhea following FMP
which STRAW stage? -3b
initial drop in AMH/AFC/inhibin, cycles still aka late reproductive
regular, FSH normal
which STRAW stage? -3a
cycles shorter, first increase in FSH aka late reproductive
levels spike with ovulation, marker of ovarian inhibin B
reserve
Produced by granulosa cells of activated AMH
follicles, most reflective of true ovarian
reserve; provides the best single prediction
of time to menopause
what day of cycle to draw FSH to predict day 3
ovarian response/reserve?
normal day 3 FSH? < 10
FSH value for menopause? >25
# of ultrasound detected follicles 2-10 mm in AFC (antral follicle count)
size
normal AFC >12
- FSH elevation recruits follicles for the subsequent cycle before the current cycle is
over
- Excess estradiol production as new follicles start growing
Luteal-Out-Of-Phase (LOOP) event
- Increase chance of TWINS
- Very short follicular phase
- More time spent in luteal phase (more PMS/PMDD sx)
—Mastalgia
—Worsening migraine
symptoms of LOOP event —Growing fibroids
—Risk of endometrial hyperplasia
- longer time in luteal phase (worsening PMDD in peri)
pre: lower, more anovulatory cycles
premenopausal vs postmenopausal estradiol
levels in obesity
post: higher
FSH spikes --> fast growth of remaining follicles (twins more likely) --> shorter follicular
consequence of inhibin B and AMH drop in
phase --> follicle atresia --> LOOP cycles --> pronounced PMS sx from longer luteal
early menopause transition?
phase --> cycle irregularity by >7 days
dec ovarian reserve causes the drop in what inhibin B and AMH
2 hormones?
2024 - NAMS Menopause Certification Exam Study Set
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