Study Points

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- Review the course material online or in print.
- Complete the course evaluation.
- Review your Transcript to view and print your Certificate of Completion. Your date of completion will be the date (Pacific Time) the course was electronically submitted for credit, with no exceptions. Partial credit is not available.

Up to what percentage of adults experience hot flashes during perimenopause?
- 25%
- 45%
- 85%
- 95%
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All of the following are potential non-vasomotor symptoms of menopause, EXCEPT:
- Depression
- Insomnia
- Incontinence
- Increased libido
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What changes in bone mass typically occur in the first five years after menopause?
- On average, a person loses up to 10% of bone mass.
- Most people maintain bone mass density during this period.
- Bone mass initially increases by up to 5%, but later decreases to premenopausal levels.
- None of the above
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Which of the following statements regarding bioidentical hormones is FALSE?
- Natural hormones used in compounded products must be converted to the active form in a laboratory.
- Compounded bioidentical hormone replacement therapy is a "natural alternative" to traditional hormone replacement therapy.
- The term bioidentical simply indicates that the hormone has the same chemical and molecular structure as the endogenous hormone.
- Due to a lack of oversight, these compounded products carry a risk of under- or overdosing, lack of sterility, and the presence of impurities.
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At what age does the recommended dietary allowance (RDA) for calcium for women start to increase to account for hormonal changes associated with menopause?
- 31 years
- 45 years
- 51 years
- 65 years
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How would you describe to a colleague the evidence regarding the cardiovascular disease (CVD) risks of calcium supplementation in postmenopausal adults?
- Taking calcium with vitamin D can increase the risk of CVD.
- The risk of CVD is indirectly proportional to the dose of calcium.
- Calcium supplements may be associated with a small increased risk of CVD, although research is conflicting.
- The Women's Health Initiative study attributed the risk of CVD to hormone replacement therapy, not calcium supplements.
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An otherwise healthy 65-year-old adult tells you that she is looking for a calcium and vitamin D supplement, as she has recently gone through menopause and a friend recommended both supplements. How would you respond?
- The recommended daily intake of calcium and vitamin D can often be met through the diet. If the diet provides adequate amounts of these nutrients, supplements are not necessary.
- It is often helpful to take calcium supplements to ensure adequate intake of this nutrient in the diet. Consider taking calcium 500 mg three times daily; vitamin D supplements are not necessary.
- The recommended daily intake of calcium and vitamin D can often be met through the diet. In fact, vitamin D supplements may cause serious health issues when taken long-term and should be avoided.
- It is often helpful to take calcium and vitamin D supplements to ensure adequate intake of these nutrients. To reduce the number of pills needed, consider taking calcium 1,000 mg and vitamin D 20 mcg as a single dose daily.
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What is the recommended daily allowance (RDA) of magnesium for those 31 years of age and older?
- 32 mg
- 100 mg
- 320 mg
- 800 mg
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Which lifestyle recommendation should be considered for most postmenopausal adults?
- Adequate daily protein intake of about 1 gram/kg, or about 20–25 grams of protein per meal, may help combat age-related muscle loss.
- Consumption of about 500 mg (about five cups of coffee) daily can limit calcium losses and reduce the severity of vasomotor symptoms.
- Moderate alcohol intake (two drinks per day) has been found to reduce the frequency of vasomotor symptoms.
- Proton pump inhibitors (PPIs) should be avoided in order to reduce the risk for calcium deficiency, which can impact bone health.
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For the management of menopause-associated hot flashes,
- the risk of serious injury outweighs any potential benefits.
- evidence supporting the use of acupoint modalities is unclear.
- acupuncture has been definitively shown to reduce hot flashes but not other menopause symptoms.
- moxibustion and acustimulation are the modalities with the greatest evidence supporting efficacy.
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The practice of mindfulness has shown consistent benefit across multiple clinical trials for the short-term management of which health concern related to menopause?
- Depression
- Hot flashes
- Sleep quality
- Vaginal dryness
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Which complementary modality has been shown to reduce various symptoms of menopause while also providing muscle-strengthening and balancing exercises?
- Acupuncture
- Mindfulness
- Moxibustion
- Yoga
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Which statement best defines phytoestrogens?
- Chemicals found naturally in plants that, when purified, have similar potency to endogenous estrogen
- Plant hormones that are bioidentical to human estrogen and can be used as an alternative to hormone replacement therapy
- Plant constituents that, while not structurally related to estrogen, demonstrate weak activity at human estrogen receptors
- A class of plant chemicals, including isoflavones, lignans, and coumestans, that can increase the production of estrogen in humans
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What can be said about the association between long-term soy intake and hormone-sensitive conditions?
- Observational research suggests that the long-term use of soy can increase the risk of breast cancer, although it is unclear if it is associated with endometrial cancer.
- The available clinical and population research suggests that soy does not increase the risk of estrogen-related health issues.
- Most research indicates that soy has no clinically relevant activity at estrogen receptors and is not expected to cause long-term hormone-related health issues.
- Although population research has raised concerns that soy may increase the risk of endometrial cancer, clinical studies show that soy increases the risk of breast, not endometrial, cancer.
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Soy may antagonize the effects of
- tamoxifen.
- antidiabetes medications.
- antidepressant medications.
- antihypertensive medications.
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Compared with placebo, multiple clinical studies show that taking S-equol modestly reduces menopause-associated
- fatigue.
- insomnia.
- hot flashes.
- vaginal dryness.
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Which of the following statements regarding black cohosh is TRUE?
- Black cohosh extracts bind to estrogen receptors or upregulate estrogen-dependent genes.
- At least one black cohosh product seems to be comparable to certain forms of hormone replacement therapy.
- Research on the use of black cohosh for vasomotor symptoms of menopause has primarily evaluated generic extracts.
- Clinically, black cohosh appears to affect levels of hormones such as estradiol, luteinizing hormone (LH), or follicle-stimulating hormone (FSH).
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Chasteberry is generally well-tolerated, although it has been reported to cause
- diarrhea.
- headache.
- skin irritation.
- All of the above
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The most common adverse effect reported with Panax ginseng is
- insomnia.
- vaginal bleeding.
- cognitive dysfunction.
- prolongation of the QT interval.
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Which herb can modify the activity of various cytochrome P450 (CYP) enzymes, resulting in significant interactions with many prescription medications?
- Black cohosh
- Equol
- Soy
- St. John's wort
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Back to Course Home
Participation Instructions
- Review the course material online or in print.
- Complete the course evaluation.
- Review your Transcript to view and print your Certificate of Completion. Your date of completion will be the date (Pacific Time) the course was electronically submitted for credit, with no exceptions. Partial credit is not available.

Complete Your CE

Complementary Therapies for Menopause

Study Points

Up to what percentage of adults experience hot flashes during perimenopause?

All of the following are potential non-vasomotor symptoms of menopause, EXCEPT:

What changes in bone mass typically occur in the first five years after menopause?

Which of the following statements regarding bioidentical hormones is FALSE?

At what age does the recommended dietary allowance (RDA) for calcium for women start to increase to account for hormonal changes associated with menopause?

How would you describe to a colleague the evidence regarding the cardiovascular disease (CVD) risks of calcium supplementation in postmenopausal adults?

An otherwise healthy 65-year-old adult tells you that she is looking for a calcium and vitamin D supplement, as she has recently gone through menopause and a friend recommended both supplements. How would you respond?

What is the recommended daily allowance (RDA) of magnesium for those 31 years of age and older?

Which lifestyle recommendation should be considered for most postmenopausal adults?

For the management of menopause-associated hot flashes,

The practice of mindfulness has shown consistent benefit across multiple clinical trials for the short-term management of which health concern related to menopause?

Which complementary modality has been shown to reduce various symptoms of menopause while also providing muscle-strengthening and balancing exercises?

Which statement best defines phytoestrogens?

What can be said about the association between long-term soy intake and hormone-sensitive conditions?

Soy may antagonize the effects of

Compared with placebo, multiple clinical studies show that taking S-equol modestly reduces menopause-associated

Which of the following statements regarding black cohosh is TRUE?

Chasteberry is generally well-tolerated, although it has been reported to cause

The most common adverse effect reported with Panax ginseng is

Which herb can modify the activity of various cytochrome P450 (CYP) enzymes, resulting in significant interactions with many prescription medications?