NAMS Certification Knowledge Check with complete solutions |Latest 2024/2025
NAMS Certification Knowledge Check with complete solutions. Summarize the physiology of natural menopause and describe the recommendation for or against laboratory confirmation of menopause ️ Menopause is defined as the point in time at which menstruation has ceased for a full year. In the peri-menopausal period leading up to this time, i tis common for cycles to become erratic due to normal physiologic changes to the hypothalamic-pituitary-ovarian axis. The developing ovarian follicles are less responsive to FSH and the ovaries produce less estradiol, progesterone, and androgens. Normally, high levels of estrogen and progesterone serve as a negative feedback loop on the hypothalamus, keeping production of gonadotropin-releasing hormone (GnRH) low. However, as estrogen and progesterone levels decrease, this eliminates the usual negative feedback effect and thus GnRH is high and FSH/LH from the anterior pituitary is thus high. During this transition, hormone levels can fluctuate wildly from day to day, which makes measuring hormones during this time difficult to interpret and is not recommended in most cases. Due to the established risk for breast cancer, estrogen-progesterone therapy for menopausal symptoms should be limited to _________ years of use. ️ 3-5 years The addition of progesterone to estrogen hormone therapy was developed to lower the risk of.... ️ endometrial hyperplasia and cancer Describe the 3 type of estrogens and where they are produced. ️ E1 = estrone, the weakest estrogen, primary estrogen present in postmenopausal females, children, and males. In the post-menopausal period, 5% is produced by the ovaries by 95% is produced by adipose-conversion of androstenedione secreted by the adrenals E2 = estradiol, most potent estrogen, main estrogen produced during the female reproductive years by the ovaries E3 = estriol, secreted by the placenta, present in non-pregnant females only in small amounts as a by-product of estradiol and estrone
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