NAMs Menopause Certification Exam
Questions And Answers Updated 2024/2025
The period of endrocrinologic, somatic, and transitory psychologic changes that occur
around the time of menopause. - answer✔Climacteric phase
LMP before age 45 - answer✔Early menopause
LMP after age 54 - answer✔Late menopause
Menopause that occurs before age 40 - answer✔Primary ovarian insufficiency
Persistent difference of 7 days or more in the length of consecutive cycles. - answer✔Early
menopause transition (stage -2)
60 or more consecutive days of amenorrhea - answer✔Late menopause transition (stage -
1)
Explains why some perimenopausal women have elevated estrogen level sometimes...In
the early 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. - answer✔Luteal out of phase
event (LOOP)
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) - answer✔Obese women and estradiol levels during menopause
These ethnic groups have lower estradiol levels then white, black and hispanic women. -
answer✔Chinese and Japanese women
late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased
genitourinary symptoms. - answer✔stage +2
ALL RIGHTS RESERVED.
early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS
predominate. - answer✔Stages +1a, +1b, +1c
Endocrine labs after menopause - answer✔Elevated FSH, LH
These hormones work during reproductive years to not deplete follicle pool too quickly. -
answer✔AMH, inhibin B
Menstrual cycle variable, persistent >7 day difference between difference in length of
consecutive cycles. - answer✔Phases during menopause transition and PMS symptoms
many pitfalls, variable depending on the day of the cycle you draw the lab, normal or low
FSH is not helpful. - answer✔How to respond if a patient requests FSH lab?
AMH - answer✔The potentially superior marker of menopause, a lab.
Adrenal androgens: precursor hromones produced by the adrenal gland that are
enzymatically converted to active androgens or estrogens in peripheral tissues. -
answer✔DHEA (dehydroepiandrosterone)
Vagina, vulva, urethra, trigone of the bladder - answer✔Location of estrogen receptors
maintain blood flow, the collagen, and HA within the epithelial surfaces. Supports
microbiome which supports acidity of vagina and protects tissue from pathogens. -
answer✔Effects of estrogen on tissue
Thinning, loss of elasticity, loss or absence or rugae. - answer✔Vaginal changes with
menopause
vagina narrows, urethra moves closer to the introitus. - answer✔Vagina and urethra in
menopause
Vaginal estrogen and urinary incontinence: what type does it help with? - answer✔Stress
urinary incontinence
ALL RIGHTS RESERVED.
Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH level. -
answer✔When it is appropriate to check an FSH during the cycle if you check it? and why?
produced by granulosa cells
used to test damage to ovarian follicle reserve. If AMH is low, the woman has a low ovarian
reserve.
not recommended as a screening tool to predict fertility.
Peaks at around 25 years old. So before age 25, this test is not helpful.
It is influenced by exogenous hormones. Lower in hormonal contraception users, but
increases after d/cing. - answer✔AMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak?
Antral follicle count
Number of follicles that are detectable with ultrasound.
They are sensitive to FSH and considered to represent the availability pool of follicles. -
answer✔AFC
25 or higher - answer✔Late menopause transition (-1) FSH level on random draw
Higher - answer✔Black women have higher or lower FSH levels?
lower - answer✔Chinese and Japanese women have higher or lower estradiol levels
compared to white, black and hispanic women?
SHBG decreases
Testosterone/SHBG ratio increases by 80%. - answer✔Menopause transition-changes in
SHBG and testosterone? ratio?
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