NAMS Menopause Certification Exam
Practice Questions with correct Answers.
Which 2 nonpharmacologic treatments are HIGHLY recommended by the
North American Menopause Society (NAMS) to treat VMS? ✔️ Cognitive
behavioral therapy, clinical hypnosis
What other nonpharmacologic options are used to treat VMS? ✔️
Temperature control (colder pillow)
Yoga/relaxation therapy
Avoid spicy foods, chocolate, caffeine
Exercise
Acupuncture
Paced respiration (slowed down breathing)
What are vasomotor symptoms? ✔️ Hot flushes and night sweats
What are the non-VMS of menopause? ✔️ Dyspareunia, vaginal dryness,
mood changes, sleep disturbances, concentration and memory issues,
arthralgia
If patient has a uterus, you must give them ✔️ estrogen + progestin
combo
If patient does NOT have a uterus, you can give them ✔️ estrogen alone
What are the 3 main differences in estrogen of transdermal estrogens? ✔️
Lower VTE risk
No impact on triglycerides
Potential lower stroke risk, so lower blood clot risk
What are the 2 main differences in estrogen of oral estrogens? ✔️
Increases triglycerides
, Potential for decreased libido
What is the Women's Health Initiative (WHI)? ✔️ Clinical study started in
1991. Studied the use of conjugated equine estrogens (CEE) and
medroxyprogesterone acetate (MPA) in women with and without a uterus
What was the most important "shocking" result from the WHI? ✔️
Estrogen + progestin combo resulted in an increased risk of breast cancer
What was the problem with how the WHI ended? ✔️ There was some bias
in the study, since it stopped early. Upon further investigation 18 years
later, increased mortality was not associated with hormone therapy.
Women would have less side effects over time
When is it considered safe to start menopause hormone therapy (MHT) in
women? ✔️ Likely safe to start in patients with no contraindications who
are within 10 years of menopause, and/or <60 years old according to
NAMS (North American Menopause Society)
Is tobacco use a contraindication to MHT? ✔️ Tobacco use is NOT a
contraindication to hormone therapy, but transdermal therapy may be
preferred
What is the 1st line treatment to help with VMS of menopause after trying
nonpharmacologic therapies? ✔️ Systemic hormone therapy (HT), since it
provides optimal relief of hot flushes
What symptoms should be present for a woman to be on HT? ✔️ VMS
If patients have vaginal symptoms only, only use what kind of products?
✔️ Vaginal products
What are the 2 most common estrogens used in HT? ✔️ Estradiol and
Conjugated equine estrogens (CEE)
Practice Questions with correct Answers.
Which 2 nonpharmacologic treatments are HIGHLY recommended by the
North American Menopause Society (NAMS) to treat VMS? ✔️ Cognitive
behavioral therapy, clinical hypnosis
What other nonpharmacologic options are used to treat VMS? ✔️
Temperature control (colder pillow)
Yoga/relaxation therapy
Avoid spicy foods, chocolate, caffeine
Exercise
Acupuncture
Paced respiration (slowed down breathing)
What are vasomotor symptoms? ✔️ Hot flushes and night sweats
What are the non-VMS of menopause? ✔️ Dyspareunia, vaginal dryness,
mood changes, sleep disturbances, concentration and memory issues,
arthralgia
If patient has a uterus, you must give them ✔️ estrogen + progestin
combo
If patient does NOT have a uterus, you can give them ✔️ estrogen alone
What are the 3 main differences in estrogen of transdermal estrogens? ✔️
Lower VTE risk
No impact on triglycerides
Potential lower stroke risk, so lower blood clot risk
What are the 2 main differences in estrogen of oral estrogens? ✔️
Increases triglycerides
, Potential for decreased libido
What is the Women's Health Initiative (WHI)? ✔️ Clinical study started in
1991. Studied the use of conjugated equine estrogens (CEE) and
medroxyprogesterone acetate (MPA) in women with and without a uterus
What was the most important "shocking" result from the WHI? ✔️
Estrogen + progestin combo resulted in an increased risk of breast cancer
What was the problem with how the WHI ended? ✔️ There was some bias
in the study, since it stopped early. Upon further investigation 18 years
later, increased mortality was not associated with hormone therapy.
Women would have less side effects over time
When is it considered safe to start menopause hormone therapy (MHT) in
women? ✔️ Likely safe to start in patients with no contraindications who
are within 10 years of menopause, and/or <60 years old according to
NAMS (North American Menopause Society)
Is tobacco use a contraindication to MHT? ✔️ Tobacco use is NOT a
contraindication to hormone therapy, but transdermal therapy may be
preferred
What is the 1st line treatment to help with VMS of menopause after trying
nonpharmacologic therapies? ✔️ Systemic hormone therapy (HT), since it
provides optimal relief of hot flushes
What symptoms should be present for a woman to be on HT? ✔️ VMS
If patients have vaginal symptoms only, only use what kind of products?
✔️ Vaginal products
What are the 2 most common estrogens used in HT? ✔️ Estradiol and
Conjugated equine estrogens (CEE)
