NAMs Menopause Certification Exam| Complete Solution Guide, A+ Rated| Latest Update 2024

NAMs Menopause Certification Exam| Complete Solution Guide, A+ Rated| Latest Update 2024
Climacteric phase
The period of endrocrinologic, somatic, and transitory psychologic changes that
occur around the time of menopause.
Early menopause
LMP before age 45
Late menopause
LMP after age 54
Primary ovarian insufficiency
Menopause that occurs before age 40
Early menopause transition (stage -2)
Persistent difference of 7 days or more in the length of consecutive cycles.
Late menopause transition (stage -1)
60 or more consecutive days of amenorrhea
Luteal out of phase event (LOOP)
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
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)
Chinese and Japanese women
These ethnic groups have lower estradiol levels then white, black and hispanic
women.
stage +2
late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased
genitourinary symptoms.
Stages +1a, +1b, +1c
early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS
predominate.
Elevated FSH, LH
Endocrine labs after menopause
AMH, inhibin B
These hormones work during reproductive years to not deplete follicle pool too
quickly.
Phases during menopause transition and PMS symptoms
Menstrual cycle variable, persistent >7 day difference between difference in length
of consecutive cycles.
How to respond if a patient requests FSH lab?
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.
AMH
DHEA (dehydroepiandrosterone)
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
Vagina, vulva, urethra, trigone of the bladder
Effects of estrogen on tissue
maintain blood flow, the collagen, and HA within the epithelial surfaces. Supports
microbiome which supports acidity of vagina and protects tissue from pathogens.
Vaginal changes with menopause
Thinning, loss of elasticity, loss or absence or rugae.