STRAW+10 High-Level Expert Questions (20)
1. Q1. According to the STRAW+10 staging system, what is the key menstrual
characteristic of the -3b (early reproductive stage)?
A. D. Amenorrhea >60 days
B. B. Persistent luteal phase progesterone
C. C. Regular cycles with subtle changes in FSH
D. A. Variable cycle length with skipped cycles
Answer: C
2. Q2. Which hormonal change best reflects transition from -2 (early menopausal
transition) to -1 (late transition) in STRAW+10?
A. C. Peak in anti-Müllerian hormone
B. A. Onset of consistent low estradiol
C. B. Onset of amenorrhea lasting >60 days
D. D. Progesterone elevation above luteal threshold
Answer: C
3. Q3. Which STRAW+10 stage is characterized by the first evidence of elevated FSH and
shorter follicular phase length?
A. B. -3b (early reproductive)
B. A. -4 (peak reproductive)
C. C. -2 (early transition)
D. D. -5 (early reproductive)
Answer: A
4. Q4. What is the clinical significance of STRAW+10 stage +1a?
A. A. Resumption of ovulatory cycles
B. B. First year after final menstrual period (FMP)
C. D. Period of full endocrine stabilization
D. C. Onset of irregular menses
Answer: B
5. Q5. Which biomarker is most reliable in distinguishing -2 (early transition) from -1 (late
transition) stages in STRAW+10?
A. D. LH surge absence
B. C. FSH and menstrual pattern
C. A. Estrone
D. B. AMH
Answer: B
6. Q6. What is the typical duration of the -1 (late menopausal transition) stage in
STRAW+10?
A. C. 1–3 years
B. B. 12 months or more
C. A. 3–6 months
D. D. Up to 10 years
Answer: A
7. Q7. In the STRAW+10 model, what menstrual pattern defines the -1 stage?
A. A. Regular menses with PMS symptoms
B. B. Menstrual cycles with increased luteal length
C. D. Monthly ovulation with shortened cycles
D. C. Amenorrhea of ≥60 days
Answer: D
8. Q8. Which reproductive marker is expected to be undetectable by STRAW+10 stage +2?
A. C. AMH
B. A. LH
C. D. Prolactin
D. B. Estradiol
Answer: A
9. Q9. Which physiological change most reliably correlates with transition to +1b in
STRAW+10?
A. A. Recurrence of folliculogenesis
B. C. VMS and continued FSH elevation
C. B. Menstrual bleeding resumes
D. D. Increase in testosterone levels
Answer: B
10. Q10. What is the definition of the final menstrual period (FMP) in STRAW+10?
A. C. Menstrual cycle with ovulation before age 51
B. D. First cycle with high FSH
C. A. Menstrual bleeding after 6 months of amenorrhea
D. B. Last bleeding episode before 12 consecutive months of amenorrhea
Answer: D
11. Q11. According to the STRAW+10 staging system, what is the key menstrual
characteristic of the -3b (early reproductive stage)?
A. A. Variable cycle length with skipped cycles
B. C. Regular cycles with subtle changes in FSH
C. D. Amenorrhea >60 days
D. B. Persistent luteal phase progesterone
Answer: B
12. Q12. Which hormonal change best reflects transition from -2 (early menopausal
transition) to -1 (late transition) in STRAW+10?
A. D. Progesterone elevation above luteal threshold
B. C. Peak in anti-Müllerian hormone
C. B. Onset of amenorrhea lasting >60 days
D. A. Onset of consistent low estradiol
Answer: D
13. Q13. Which STRAW+10 stage is characterized by the first evidence of elevated FSH and
shorter follicular phase length?
A. B. -3b (early reproductive)
B. A. -4 (peak reproductive)
C. C. -2 (early transition)
D. D. -5 (early reproductive)
Answer: B
14. Q14. What is the clinical significance of STRAW+10 stage +1a?
A. C. Onset of irregular menses
B. D. Period of full endocrine stabilization
C. B. First year after final menstrual period (FMP)
D. A. Resumption of ovulatory cycles
Answer: C
15. Q15. Which biomarker is most reliable in distinguishing -2 (early transition) from -1
(late transition) stages in STRAW+10?
A. D. LH surge absence
B. B. AMH
C. C. FSH and menstrual pattern
D. A. Estrone
Answer: D
16. Q16. What is the typical duration of the -1 (late menopausal transition) stage in
STRAW+10?
A. C. 1–3 years
B. A. 3–6 months
C. D. Up to 10 years
D. B. 12 months or more
Answer: B
17. Q17. In the STRAW+10 model, what menstrual pattern defines the -1 stage?
A. B. Menstrual cycles with increased luteal length
B. D. Monthly ovulation with shortened cycles
C. C. Amenorrhea of ≥60 days
D. A. Regular menses with PMS symptoms
Answer: B
18. Q18. Which reproductive marker is expected to be undetectable by STRAW+10 stage
+2?
A. D. Prolactin
B. B. Estradiol
C. A. LH
D. C. AMH
Answer: A
19. Q19. Which physiological change most reliably correlates with transition to +1b in
STRAW+10?
A. C. VMS and continued FSH elevation
B. D. Increase in testosterone levels
C. B. Menstrual bleeding resumes
D. A. Recurrence of folliculogenesis
Answer: C
20. Q20. What is the definition of the final menstrual period (FMP) in STRAW+10?
A. B. Last bleeding episode before 12 consecutive months of amenorrhea
B. D. First cycle with high FSH
C. C. Menstrual cycle with ovulation before age 51
D. A. Menstrual bleeding after 6 months of amenorrhea
Answer: B