What are the key topics to focus on when studying for the North American Menopause Society (NAMS) certification test?

From the Guidelines

To prepare for the Menopause Society test in June, focus on core topics including hormone therapy options, non-hormonal treatments, and menopause physiology, with a particular emphasis on the latest guidelines and recommendations from reputable sources such as the American Heart Association/American Stroke Association 1. When studying for the exam, it is essential to prioritize the most recent and highest-quality evidence, which in this case is the 2024 guideline for the primary prevention of stroke from the American Heart Association/American Stroke Association 1. This guideline provides critical information on the assessment of contraindications to menopausal hormone therapy use, including history of breast cancer, liver disease, and thrombophilic disorders. Some key areas to focus on include:

• Hormone therapy regimens, including estrogen types and progestogens, and their dosing protocols for both systemic and local applications
• Non-hormonal medications like SSRIs/SNRIs, gabapentinoids, and clonidine for vasomotor symptoms
• Genitourinary syndrome management, including moisturizers, lubricants, and vaginal estrogen options
• Cardiovascular, bone, and cognitive health considerations in menopause, including osteoporosis prevention strategies
• The timing hypothesis for hormone therapy initiation and contraindications for hormone use
• Menopause stages, diagnostic criteria, including FSH levels, and special populations like premature ovarian insufficiency and surgical menopause It is also crucial to understand the benefits and harms of hormone therapy, as outlined in the USPSTF recommendation statement 1, which found that the chronic disease prevention benefits of combined estrogen and progestin do not outweigh the harms in most postmenopausal women. However, the most recent guideline from the American Heart Association/American Stroke Association 1 should take precedence in guiding study focus.

From the Research

Menopause Society Test Study Focus

To prepare for the menopause society test, it's essential to focus on the following key areas:

• Hormone replacement therapy (HRT) and its role in managing menopausal symptoms 2, 3, 4, 5
• Types of HRT, including systemic estrogen, combined estrogen/progestogen therapy, and bioidentical estrogens 2, 4, 5
• Risks and benefits associated with HRT, such as increased risk of stroke, cardiovascular disease, breast cancer, and venous thromboembolism 2, 3, 4, 5
• Nonhormonal treatment options for menopausal symptoms, including selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and gabapentin 3, 4, 6
• Management of genitourinary syndrome of menopause (GSM), including vaginal estrogen, nonhormonal vaginal moisturizers, and ospemifene 3, 4, 6

Key Concepts to Study

Some key concepts to study for the menopause society test include:

• Vasomotor symptoms, such as hot flashes and night sweats, and their treatment options 2, 3, 4, 6
• Genitourinary symptoms, such as vaginal atrophy and dryness, and their treatment options 2, 3, 4, 6
• The role of estrogen and progestogen in HRT, including the importance of combining estrogen with progestogen in women with an intact uterus 2, 3, 4, 5
• The different formulations of HRT, including oral, transdermal, and intravaginal formulations 2, 4, 5
• The importance of individualized treatment plans and shared decision-making in managing menopausal symptoms 6, 5

Treatment Options to Focus On

Some key treatment options to focus on for the menopause society test include:

• Systemic estrogen therapy, including conjugated equine estrogens (CEE) and bioidentical estrogens 2, 4, 5
• Combined estrogen/progestogen therapy, including CEE with medroxyprogesterone acetate (MPA) 2, 3, 4
• Nonhormonal medications, such as selective serotonin reuptake inhibitors and gabapentin, for vasomotor symptoms 3, 4, 6
• Vaginal estrogen and nonhormonal vaginal moisturizers for genitourinary syndrome of menopause (GSM) 3, 4, 6
• Ospemifene and intravaginal dehydroepiandrosterone for vaginal dryness and dyspareunia associated with menopause 3, 6