There’s a Reason We Give Less F**cks As We Age
That growing sense of “I don’t care anymore” isn’t random. It’s rooted in real neurological changes that come with perimenopause and midlife.
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At the Los Angeles Times Festival of Books, a crowd gathered for a live taping of the “Live + Well” podcast as host Melissa Magsaysay sat down with two grounded voices in women’s health and psychology: Mindy Pelz and Deepika Chopra.
What followed was a useful corrective to the noise surrounding both the menopause boom and the wellness industry’s fixation on quick fixes.
What Actually Happens to Your Brain During Menopause
The short version: as women move through perimenopause, the neurons responsible for people-pleasing and fixing everyone else’s problems are literally pruned away. What replaces them is something women are rarely given permission to prioritize… themselves.
For decades, the story around menopause has been one of loss. Of hormones, of youth, of relevance. Women get handed patches, supplements, and a cultural script that treats one of the most significant biological transitions of their lives as something to get through as quickly as possible.
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Dr. Pelz flips this. When you look at the neuroscience of what happens to a woman’s brain as she goes through menopause, it rewires itself. The neurons tied to people-pleasing begin to fall away, making space for independent thinking. To explain why, she points to what evolutionary biologists call the Grandmother Hypothesis. In hunter-gatherer societies, the energy once devoted to reproduction didn’t disappear when fertility declined. It was redirected toward cognition, leadership, and community roles. Menopause, in that framing, isn’t an ending. It’s a redeployment.
Dr. Chopra adds another layer: happiness tends to follow a U-shaped curve across a lifetime, dipping in midlife before rising again. The peak, notably, comes later than most people expect.
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The mechanism behind all of this comes down to the amygdala and estradiol, a form of estrogen that begins declining in perimenopause. Women tend to have more oxytocin receptor sites in the amygdala, which helps explain why stress often triggers a need for connection.
For decades, that wiring has reinforced emotional attunement and, often, self-sacrifice. As estradiol declines, those neural pathways begin to shift. The people-pleasing reflex doesn’t just fade psychologically. It changes biologically.
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What fills that space is something many women haven’t fully accessed before: their own internal authority. Priorities sharpen. Tolerance narrows. Relationships come into focus in new ways. This is also why so many women describe a sudden sense of indifference or clarity. It’s not apathy. It’s neurological recalibration.
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Dr. Pelz is clear that this isn’t an argument against hormone replacement therapy. She uses it herself and acknowledges that it can be helpful. The issue, she says, is how narrowly the conversation is framed.
Too often, menopause is treated as something to fix rather than something to understand. She points to broader patterns. The majority of autoimmune conditions occur in women, something she connects to long-term emotional suppression. The emotional intensity many women feel during perimenopause isn’t random. It may be signaling what’s no longer working.
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And for women in partnerships, Dr. Pelz says one of the most practical challenges is communication at this time. As needs change, relationships often need to be renegotiated in real time. Dr. Pelz describes approaching this directly, not as conflict, but as translation. Naming what has changed, setting new expectations, and allowing relationships to evolve rather than fracture.
She and her husband even refer to different phases of their relationship as versions, a framework that allows for change without blame. The takeaway is less about managing menopause and more about recognizing what it makes possible.
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What to Actually Do
Both doctors were asked for practical starting points. Start the morning with one thing to look forward to. Dr. Chopra is deliberate about this practice, and noted it doesn’t need to be significant. Her example was peeling a clementine. The brain is a forward-moving organ. Give it somewhere to go. And end the night with a to-done list, not a to-do list. Dr. Chopra is specific about this. Write down what you handled today, not what’s left undone. The brain already fixates on the incomplete... it doesn’t need a list for that.
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What it needs is intentional attention to what you’ve actually done. She frames it as a self-efficacy practice, not a gratitude exercise. There’s a difference. Put joy on your calendar as a non-negotiable. Dr. Pelz, now 56, described looking at her day through the lens of what’s going to make her happy. Surfing. A phone call with a friend. Something that’s hers. “When do we get to put joy first?” she asked. For her, that shift from scheduling around everyone else’s needs to scheduling around her own has been one of the more concrete expressions of what menopause made possible.
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When asked about what to do when anxiety or rage shows up, they suggest asking what it’s pointing to. Both doctors pushed back on the reflex to immediately medicate or suppress difficult emotions during this transition. The neuroscience Dr. Pelz outlined suggests those feelings are informational.
‘Age Like a Girl ‘by Dr. Mindy Pelz is available at Amazon, Barnes & Noble, and Hay House. ‘The Power of Real Optimism’ by Dr. Deepika Chopra is available at Amazon, Barnes & Noble, and Simon & Schuster.
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