Women's Health
Perimenopause Care at Nova Wellness
Perimenopause is the transition before menopause when hormones begin shifting, cycles become less predictable, and symptoms that once felt unfamiliar suddenly become part of daily life. Sleep changes. Mood changes. Energy changes. Weight changes. And many women are told everything is “normal” while they no longer feel like themselves. At Nova Wellness, perimenopause is treated as the complex physiologic transition it is — not something to simply push through or ignore. Care is focused on understanding the hormonal, metabolic, neurologic, and lifestyle changes happening beneath the surface so treatment can be personalized, proactive, and effective.
What Perimenopause Actually Is
Perimenopause is not menopause itself. It is the transition leading up to menopause, often lasting several years, during which estrogen and progesterone levels begin fluctuating and ovulation becomes less consistent.
Because these hormonal shifts affect nearly every system in the body, symptoms often extend far beyond menstrual changes alone. Sleep, mood, cognition, metabolism, body composition, libido, skin, cardiovascular health, and stress resilience can all be affected during this phase. For many women, the changes are subtle at first. For others, they become disruptive enough to impact relationships, performance, energy, and overall quality of life.
Common Symptoms of Perimenopause
Perimenopause can present differently for every woman, but common symptoms may include:
- Sleep disruption or waking during the night
- Anxiety, irritability, or mood changes
- Brain fog and difficulty concentrating
- Irregular or changing menstrual cycles
- Weight gain or shifts in body composition
- Fatigue and reduced resilience to stress
- Low libido or painful intimacy
- Hair, skin, and joint changes
- Hot flashes, palpitations, or temperature dysregulation
These symptoms are not imagined, exaggerated, or simply “part of getting older.” They are physiologic responses to changing hormone patterns and deserve proper evaluation and treatment.
Led By
Dr. Jennifer Knight
Dr. Knight is an internist certified in integrative medicine by the American Board of Integrative Medicine, a graduate of the Andrew Weil Center for Integrative Medicine fellowship, and a Menopause Society Certified Practitioner. She leads women's health at Nova, including perimenopause, menopause, and hormone therapy, along with functional and integrative medicine.
Why Perimenopause Is Often Missed
Hormone levels fluctuate significantly during perimenopause, which means standard lab work may still appear “normal” even when symptoms are very real. Short appointments and limited testing often leave women with incomplete answers or symptom-based prescriptions that fail to address the larger hormonal and metabolic picture.
At Nova Wellness, care goes beyond a single lab value. Evaluations consider symptoms, cycle history, sleep, metabolism, thyroid function, inflammation, stress physiology, and overall health patterns to better understand what may be contributing to how you feel.
The Nova Wellness Approach to Perimenopause
Every treatment plan is personalized based on symptoms, health history, lifestyle, and laboratory findings. The goal is not simply symptom relief, but helping women feel strong, stable, energized, and supported through this transition.
- Hormone OptimizationBioidentical hormone therapy may be considered when clinically appropriate and carefully monitored over time.
- Sleep & Nervous System SupportSleep quality, stress physiology, and nervous system regulation are addressed as foundational parts of hormonal health.
- Metabolic & Body Composition SupportNutrition, strength training, insulin sensitivity, and metabolic health are integrated into treatment planning.
- Nutrient Repletion & RecoveryVitamin deficiencies, inflammation, and recovery capacity are evaluated and corrected where needed.
- Mood & Cognitive SupportTreatment plans may also address focus, mood stability, anxiety, brain fog, and emotional resilience.
Nova Wellness’s women’s health program is led by Dr. Jennifer Knight, a Menopause Society Certified Practitioner (MSCP), with additional cardiovascular and metabolic support from Dr. Chris Di Giorgio and the broader clinical team.
Who This Program Is For
Perimenopause care at Nova Wellness may be appropriate for:
- Women in their late 30s, 40s, and 50s experiencing unexplained symptoms
- Women struggling with sleep, mood, weight, or cognitive changes
- Patients told their labs are “normal” despite ongoing symptoms
- High-performing women noticing changes in energy or resilience
- Women seeking a more proactive, personalized approach to hormonal health
What to Expect
I
Discovery Call
A brief consultation to discuss symptoms, goals, and determine fit.
II
Comprehensive Evaluation
A detailed review of symptoms, cycle history, hormones, sleep, lifestyle, metabolism, and overall health.
III
Advanced Testing
Testing may include hormone panels, thyroid markers, metabolic labs, inflammatory markers, and nutrient evaluation.
IV
Personalized Prevention Plan
Your plan may include hormone therapy, nutrition support, sleep optimization, supplementation, metabolic support, and lifestyle interventions.
V
Ongoing Monitoring
Care evolves over time through follow-up visits, lab monitoring, and treatment adjustments as your body changes.
Before Your Visit
Frequently Asked Questions
How do I know if I’m in perimenopause?
Symptoms often provide the earliest clues. Changes in sleep, mood, cycles, energy, cognition, libido, or body composition during your late 30s or 40s may all suggest hormonal transition.
Is hormone therapy safe during perimenopause?
For many women, appropriately prescribed and monitored hormone therapy can be both safe and effective. Treatment decisions are individualized based on symptoms, medical history, and risk factors.
Will everyone need hormones?
No. Hormones are one tool among many. Some women benefit significantly from hormone therapy, while others improve through sleep optimization, nutrition, metabolic support, stress regulation, and lifestyle interventions.
How long does perimenopause last?
Perimenopause can last anywhere from several years to over a decade. The goal is not simply to “wait it out,” but to support health, function, and quality of life throughout the transition.
Is weight gain during perimenopause normal?
Hormonal changes can affect insulin sensitivity, fat distribution, muscle maintenance, and metabolism, making body composition changes more common during this phase.
Perimenopause Is a Transition — Not Something You Have to “Just Deal With”
If your symptoms feel real but your answers have felt incomplete, Nova Wellness offers a more comprehensive approach to understanding and supporting your health through perimenopause and beyond.
Start Here
Request a Consultation
We started Nova because the appointments we were trained to give were too short for the questions our patients were asking. That is why a first visit here is 90 minutes, and why the two of us work from the same plan. We both see patients in Roseland, and we would be glad to meet you.