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NAMs Menopause Certification Exam Study Guide with Complete Solutions
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NAMs Menopause Certification Exam Study Guide with Complete Solutions Climacteric phase - Answer-The period of endrocrinologic, somatic, and transitory psychologic changes that occur around the time of menopause. Early menopause - Answer-LMP before age 45 Late menopause - Answer-LMP after age ...

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  • October 6, 2024
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EMILLYCHARLOTTE 2024/2025 ACADEMIC YAER ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED
FIRST PUBLISH SEPTEMBER 2024




NAMs Menopause Certification Exam
Study Guide with Complete Solutions

Climacteric phase - Answer✔✔-The period of endrocrinologic, somatic, and transitory psychologic

changes that occur around the time of menopause.


Early menopause - Answer✔✔-LMP before age 45


Late menopause - Answer✔✔-LMP after age 54


Primary ovarian insufficiency - Answer✔✔-Menopause that occurs before age 40


Early menopause transition (stage -2) - Answer✔✔-Persistent difference of 7 days or more in the length

of consecutive cycles.


Late menopause transition (stage -1) - Answer✔✔-60 or more consecutive days of amenorrhea


Luteal out of phase event (LOOP) - Answer✔✔-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.


Obese women and estradiol levels during menopause - Answer✔✔-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)


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Chinese and Japanese women - Answer✔✔-These ethnic groups have lower estradiol levels then white,

black and hispanic women.


stage +2 - Answer✔✔-late menopause stage: 5-8 years after FMP. Somatic aging predominates.

Increased genitourinary symptoms.


Stages +1a, +1b, +1c - Answer✔✔-early post menopause: 2 years after FMP. FSH rises, estradiol

decreases. VMS predominate.


Elevated FSH, LH - Answer✔✔-Endocrine labs after menopause


AMH, inhibin B - Answer✔✔-These hormones work during reproductive years to not deplete follicle pool

too quickly.


Phases during menopause transition and PMS symptoms - Answer✔✔-Menstrual cycle variable,

persistent >7 day difference between difference in length of consecutive cycles.


How to respond if a patient requests FSH lab? - Answer✔✔-many pitfalls, variable depending on the day

of the cycle you draw the lab, normal or low FSH is not helpful.


The potentially superior marker of menopause, a lab. - Answer✔✔-AMH


DHEA (dehydroepiandrosterone) - Answer✔✔-Adrenal androgens: precursor hromones produced by the

adrenal gland that are enzymatically converted to active androgens or estrogens in peripheral tissues.


Location of estrogen receptors - Answer✔✔-Vagina, vulva, urethra, trigone of the bladder


Effects of estrogen on tissue - Answer✔✔-maintain blood flow, the collagen, and HA within the epithelial

surfaces. Supports microbiome which supports acidity of vagina and protects tissue from pathogens.


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Vaginal changes with menopause - Answer✔✔-Thinning, loss of elasticity, loss or absence or rugae.


Vagina and urethra in menopause - Answer✔✔-vagina narrows, urethra moves closer to the introitus.


Stress urinary incontinence - Answer✔✔-Vaginal estrogen and urinary incontinence: what type does it

help with?


Treatment for FPHL - Answer✔✔-Minoxidil, spironolactone, finasteride, estrogen therapy


Late reporoductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH, AFC, inhibin? -

Answer✔✔--3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low.




-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low.


When it is appropriate to check an FSH during the cycle if you check it? and why? - Answer✔✔-Cycle day

#3. Elevated estradiol can suppress FSH giving a falsely normal FSH level.


AMH


produced by...


used to test...


Is it a screening tool for fertility?


When does it peak? - Answer✔✔-produced by granulosa cells




used to test damage to ovarian follicle reserve. If AMH is low, the woman has a low ovarian reserve.



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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.


AFC - Answer✔✔-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.


Late menopause transition (-1) FSH level on random draw - Answer✔✔-25 or higher


Black women have higher or lower FSH levels? - Answer✔✔-Higher


Chinese and Japanese women have higher or lower estradiol levels compared to white, black and

hispanic women? - Answer✔✔-lower


Menopause transition-changes in SHBG and testosterone? ratio? - Answer✔✔-SHBG decreases


Testosterone/SHBG ratio increases by 80%.


Testosterone/SHGB ratio is called what? - Answer✔✔-The free androgen index


What stage are VMS more likely? - Answer✔✔-+1b (generally last 2 years)


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