Perimenopause Specialist Columbus, Ohio
Proactively Addressing Irregular Periods, Mood Swings & Brain Fog
Perimenopause can start years before anyone tells you it has. The missed period, the 2 a.m. wake-up, the mood swings that came out of nowhere. But these aren’t things you have to quietly push through until menopause makes it “official.” More women than ever are getting ahead of these symptoms instead of waiting them out, and our perimenopause specialists in Columbus, Ohio, are here to help you do exactly that.
Clinical Insights About Treating Perimenopause
- What It Is: Perimenopause is the transitional phase leading up to menopause, marked by fluctuating (not just declining) estrogen and progesterone, that typically lasts several years before periods stop entirely.
- Who Treatment Is For: You may be a candidate if you’re noticing new, hormone-driven symptoms anywhere from your mid-30s through your mid-40s, especially with a family history of early onset or certain underlying conditions.
- How Donaldson Does It Differently: Rather than waiting for menopause to “confirm” what you’re feeling, we use hormone testing to proactively identify perimenopause and build a lifestyle-first treatment plan early, escalating to hormone therapy only when it’s medically indicated.
Perimenopause Is Not Menopause. The Differences Matter Clinically.
Perimenopause and menopause sometimes get used interchangeably, or at least very close together. But they are two different stages and require two meaningfully different approaches to care.
Perimenopause is the transitional phase leading up to menopause, where hormone levels fluctuate unpredictably and symptoms begin to appear. Menopause is the destination, officially diagnosed once you’ve gone 12 consecutive months without a period.
Perimenopause Is Defined by Inconsistency
Estrogen and progesterone rise and fall in unpredictable patterns. This is why it feels like your symptoms can come and go, change in intensity or seem to contradict themselves month to month. Treating it effectively means both addressing the symptoms afflicting you and tracking that fluctuation.
Most patients enter perimenopause between 40 and 44, though it can begin as early as your mid-30s. If you’re noticing changes now and assuming menopause is still years away, you’re not wrong. You’re also not imagining things. Perimenopause is real; it is measurable and the symptoms can be treated at the root cause.
Courtney Gilbert, PA-C
Your Experienced Perimenopause Specialist
Courtney leads perimenopause and hormone health treatment at our Columbus, Ohio functional medicine practice. Her background in urogynecology gives her a foundational understanding of how subtle hormonal shifts show up in the body well before menopause is officially on the table, which makes her uniquely equipped to catch perimenopause early instead of waiting for symptoms to escalate.
Her approach blends clinical precision with an openness to discuss symptoms patients are often embarrassed to bring up themselves. This welcoming transparency helps women ask the questions that have gone unanswered, understand what is happening and make informed, confident decisions about their health.
OUR PROVIDERS
Your Collaborative Perimenopause Care Team
Marguerite Weston, MD, IFMCP
Director of Functional Medicine
Dr. Weston oversees the clinical strategy behind the team’s perimenopause treatment plans, drawing on two decades of experience in functional and primary care to ensure hormone fluctuations are treated at the root rather than chased symptom by symptom.
Dr. Weston oversees the clinical strategy behind the team’s perimenopause treatment plans, drawing on two decades of experience in functional and primary care to ensure hormone fluctuations are treated at the root rather than chased symptom by symptom.
Tricia Granchi, MSN, FNP-C
Functional Medicine Expert
Tricia brings a functional movement and strength lens to perimenopause care, helping patients manage the joint discomfort, muscle loss and energy shifts that hormonal fluctuation can bring well before menopause begins — with less reliance on prescriptions for relief.
Tricia brings a functional movement and strength lens to perimenopause care, helping patients manage the joint discomfort, muscle loss and energy shifts that hormonal fluctuation can bring well before menopause begins — with less reliance on prescriptions for relief.
Colleen Bush, RDN, LDN, IFNCP
Registered Functional Dietitian
Perimenopause symptoms often show up in the gut before anywhere else. Colleen specializes in connecting the two. Many patients work with both Colleen and Courtney together to ease digestive symptoms and find lasting comfort throughout the transition.
Perimenopause symptoms often show up in the gut before anywhere else. Colleen specializes in connecting the two. Many patients work with both Colleen and Courtney together to ease digestive symptoms and find lasting comfort throughout the transition.
Hormone Testing & Treatment
The Benefits of Catching Natural Shifts Early
If you’re reading this, you’re likely far ahead of the game already.
The earlier perimenopause is identified, the more treatment options you have and the fewer symptoms that need to be addressed at once. Our credentialed practitioners start with advanced hormone testing (often the DUTCH Test) to understand exactly where your estrogen, progesterone and related hormones stand, rather than guessing based on symptoms alone.
Our First Treatment Is Often Lifestyle & Nutrition
You probably don’t want yet another prescription. We don’t want to stick you with one, either. Sleep hygiene, movement, alcohol and caffeine reduction and dietary support all play a meaningful role in easing perimenopause symptoms, and for many patients these changes provide real, measurable relief.
When HRT Becomes a Viable Tool in Our Toolbox
Lifestyle changes, alone, can do a lot, but they may not be enough to offer the support you need to address your symptoms adequately. Hormone replacement therapy (HRT) — including bioidentical hormone replacement therapy (BHRT) — is one of the most effective tools available.
We do not default to it. We build toward it only when it’s the right next step for you.
FAQs About Perimenopause Treatments
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The clearest signal is a change in your menstrual cycle, paired with signature symptoms like mood swings, sleep disruption and/or hot flashes that were not part of your normal pattern before.
Most patients notice these changes between their late 30s and mid-40s, though timing varies. It is worth bringing this conversation to your care provider if your cycle or your symptoms feel different than they used to.
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Perimenopause is the transitional phase where hormone levels fluctuate and symptoms begin, while menopause is officially diagnosed after 12 consecutive months without a period.
They share some symptoms, but perimenopause is defined by unpredictability and menopause by a settled hormonal baseline. Also, many of our patients describe menopause symptoms as more intense and difficult to manage, often stating that they were able to handle the discomfort years earlier but now need assistance.
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Yes. Age alone shouldn’t rule out a perimenopause diagnosis. While most patients enter perimenopause between 40 and 44, it can begin as early as your mid-30s, especially if you have a family history of early onset or certain underlying health conditions.
These conditions often include autoimmune disorders like Hashimoto’s disease and Addison’s disease, along with chronic infections that can damage the ovaries (like mumps, HIV/AIDS & pelvic tuberculosis) and neurological conditions, such as epilepsy.
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No. Testing is not always required to start a treatment plan, especially if a patient has been diligently tracking their period and symptoms. However, it does give us a much clearer picture than symptoms alone.
Because perimenopause hormone levels fluctuate rather than decline steadily, testing helps confirm what’s happening and rules out other causes, like thyroid issues, that can mimic perimenopause symptoms.
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Often, yes. Addressing sleep, mood and hormonal fluctuation as they appear, rather than waiting until they’re disruptive, tends to make the transition through menopause more manageable. Early treatment also gives us more time to identify what’s actually working for your body.
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Yes, and it’s typically where we start. Sleep hygiene, movement, dietary changes and reduced alcohol and caffeine intake can meaningfully ease perimenopause symptoms for many patients. Hormone therapy remains an option when you’re ready for it and if natural approaches aren’t providing enough relief.
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We do not, and that is by design. Insurance often limits access to the advanced testing, treatments and time with patients that actually help achieve the greatest therapeutic outcomes. We offer flexible payment options to help lower the barrier of access to desired healthcare.
Every patient deserves to receive real value for their investment in care.
Your Perimenopause Experience Is Different Than Your Mother's.
And you don’t have to wait for things to get worse, or for menopause to make it “official.” Our providers are located in Columbus, Dublin, and Lewis Center, Ohio, and proudly serve patients throughout the state. Are you ready for real answers?
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