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How Women's Brains Can Get Their Mojo Back After Midlife

Women might be surprised to learn they're in for an Upgrade. Find out what that means.

By Margie Zable Fisher

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After reading "The Upgrade: How the Female Brain Gets Stronger and Better in Midlife and Beyond" by Louann Brizendine, M.D., I felt the excitement that made me want to play pickleball doubles with a female partner against two males and say to my partner: "We're going to win. Girl power!"
That's right. Girl power. But not just any girl power. Over 50 girl power. When was the last time you felt that way?

A older woman putting on lipstick in her car's rear view mirror. Next Avenue
"You can't help getting older, but you can take control of what your life looks like as you get older. We can get older and get better. Don't give up."  |  Credit: Getty

If it's been a while, I have good news. You can feel it, too. You can feel it even if you think you've been going downhill as you've gotten older.

"The cultural assumption is that after 40 or 50, it's all over, ladies."

"The cultural assumption is that after 40 or 50, it's all over, ladies," says Brizendine. "Your natural thought is that you're no longer relevant to the culture because you're not fertile anymore, right? But once you get through those miserable years during the transition, so many things are so much better."

The bottom line is that you're not going through a downgrade as you age. You're going through an upgrade. And Brizendine can prove it. After receiving her degree in neurobiology at UC Berkeley, Brizendine graduated from Yale School of Medicine and did her internship and residency at Harvard Medical School. She founded the Women's Mood and Hormone Clinic at UC San Francisco and is a practicing psychiatrist.

The brain expert and author of "The Female Brain" and "The Male Brain," who is 70, identifies critical times in a woman's life based on hormonal changes. She also changed the terms for these periods to better explain them.

This book is about women, but it also has some critical learnings for men. Brizendine says she's heard from many men who buy and read the books to understand better and support women going through these changes.

The Hormonal War Zone

Brizendine describes "The Upgrade" in her book as "the wisdom phase that emerges after spending decades in the hormonal war zone."

The bottom line is that you're not going through a downgrade as you age. You're going through an upgrade.

But what is the hormonal war zone? Our hormonal war zone, says Brizendine, starts at puberty and ends at menopause. During these roughly 35 years, a combination of ovarian hormones, adrenal hormones and brain and nervous system chemicals have constantly changed and affected our bodies and behaviors. Brizendine defines and explains all of these terms as if she were conversing with you, not like you're reading a science textbook.

Ovarian hormones prepare and sustain the body for pregnancy and have other functions.These hormones include estrogen (controls brain energy, inflammation, mood, mental ability and affectionate behavior), progesterone (makes you want to be comfortable and cozy, as well as creating the "brain fog" during pregnancy), and testosterone (drives libido, muscle stimulation and zest for life).

Adrenal hormones include adrenaline (which provides bursts of energy to respond to danger), cortisol (which regulates your body's stress, emotional reactions and metabolism), and DHEA (which counteracts cortisol, decreases depression, increases sex drive and causes acne and body odor).

Finally, brain and nervous system chemicals include follicle-stimulating hormone (FSH), which triggers the creation of follicles in the ovary to get the best eggs ready for fertilization; luteinizing hormone (LH), which brings the egg to release; oxytocin, which moves together with estrogen and leads to a bonding effect, and GABA (gamma-aminobutyric acid) which acts as the body's natural Valium.

All of these hormones have a profound effect on the brain. Says Brizendine, "Waves of LH, FSH, estrogen, oxytocin and testosterone temporarily reorganize brain networks and stimulate qualities like memory, language and affection, peaking around ovulation."


The Transition

Between 45 and 55, women begin "The Transition," formerly known as perimenopause, which is "the developmental phase of a woman's life when the brain and body enter unfamiliar territory as the reproductive-­phase circuits are finishing their job," says Brizendine. 

This is often a time when our hormones feel totally out of whack. It's also a good time for women to consider Hormone Therapy (HT), she says, and not just for hot flashes. If you're nervous about trying HT, you're not alone.

"The transition marks a change in our relationships and societal roles."

"The Women's Health Initiative study in 2002 set women back for many years by saying hormone therapy could lead to an increased risk of breast cancer and heart disease," says Brizendine. "Those findings were later found to be untrue, but doctors today are still wary about prescription hormone therapy."

Yet, for many women going through the transition, HT's estrogen and progesterone "can soften the wildness of the waves by calming the brain's spiky demands for a dwindling supply in the ovaries," says Brizendine.

Plus, every tissue and organ in the body uses hormones. "Estrogen helps with vascular health, and the brain has estrogen receptors all over it," says Brizendine. HT can help neutralize the glitchy, brain fog symptoms that may occur during perimenopause and beyond.

While hormones are the show's star, many other psychological growth phases occur during the transition, including shifting identities and moving toward authenticity. "The transition marks a change in our relationships and societal roles," says Brizendine.  

The Upgrade

This is when women are "emerging into the most powerful identity phase," says Brizendine, previously known as menopause or postmenopause. It may be the understatement of the year, but I like the term Upgrade vs menopause, don't you? Here's why Brizendine changed it:

"'Perimenopause' and 'menopause' are fossil words created by men at pharmaceutical companies," Brizendine writes. "These words arose as men studied how to maintain elasticity and fullness in the parts of our bodies they, as cisgender men, like to interact with, i.e., breasts and vaginas. I don't believe they encompass the full scope of the Upgrade, and so I decline to use them, other than in this note explaining my reasons."

"'Perimenopause' and 'menopause' are fossil words created by men at pharmaceutical companies."

The Upgrade can take over a decade and continue for the rest of a woman's life. During this phase, the female brain can make changes accessible to its wiring during the reproductive stage. Ultimately, the Upgrade is "about realizing you have a choice about your path in the second half of life," says Brizendine.

Benefits You Can Expect During the Upgrade

In the book, Brizendine shares these positives you can enjoy during the Upgrade:

● Directness. Brizendine explains that younger women's brains use estrogen to get along with others for reproductive purposes biologically. During the Upgrade, new hormonal influences motivate us to speak up.

● Focus. During the Upgrade, our brains can only hold one thought. Instead of dealing with the anxiety of multitasking, we can become more engaged, focused and thorough in our actions.

 Validation from within. Since our fertility hormones are no longer driving our need for external approval, we are more confident in our wisdom and experience.

● The return of fearlessness. Our hormones are no longer driving us to please others, so we can often find the courage to try new things during the Upgrade.

● Freedom. Without the "urges, obsessions and delusions that your fertility hormones created around relationships and intimacy," your brain is free "to explore and expand intellectually and emotionally."

The 3 Necessary Ingredients

Brizendine (or anyone) can't wave a magic wand and make everything wonderful during the Upgrade. You'll have to put in a little work. Luckily, she has a formula. "You can sleep, eat and exercise your way to an Upgrade," she says. Here's how:

1. Sleep

"Sleep is important for every life function," says Brizendine, "especially for brain function." As your brain is getting used to the hormonal changes during the Upgrade, it needs sleep to reset and recharge. 

However, sleep can be more difficult as you age. "As women age, their nighttime sleep can be less steady because of drops in estrogen and hot flashes, among other things," says Brizendine. Sleep interruptions contribute to short-term memory loss.

Brizendine doesn't recommend using prescription and over-the-counter sleep aids. They contain chemicals that block the brain's ability to lay down memory pathways, she writes, which can lead to forgetfulness, confusion, falls and even the feeling that you have dementia. 

Instead, she recommends a series of actions that help you sleep better. These include getting direct sunlight, vigorous exercise before 3 p.m., limiting yourself to one cup of something caffeinated in the morning at the most, eliminating alcohol at night, eating protein and nonstarchy vegetables at night, finishing dinner by 6 p.m., and shutting off tech at least 30 minutes before you go to sleep. 

Keep your bedroom between 66 and 68 degrees, which is optimal for sleeping. You can use blankets. I shared my favorite line with my husband: "If your spouse complains, tell him to man up and get a heating pad." Brizendine also suggests a short nap (20 minutes) before 4 p.m. if you've gotten under six hours of sleep.

"Drink a shot of joy every day by moving to music, walking in nature, jumping into a pool. Do something playful and something challenging or new every day."

2. Food and Drink

Unhealthy foods we could get away with eating when we were younger have a more significant effect on our microbiome during the Upgrade, says Brizendine. The microbiome includes the cells and bacteria in our intestines that are essential to keeping our immune systems healthy.

That means that sugar and processed food cause more inflammation, drive higher weight gain and decrease brain function during this phase. What should you eat to optimize your Upgrade experience?

2023 study found that the Mediterranean diet was associated with a lower incidence of brain decline in older adults. Brizendine recommends following the plan, which includes lean proteins, leafy greens and a small amount of healthy fats. 

She follows the Mediterranean diet, with a particular emphasis on eating a good amount of protein. Protein is crucial for muscle building and strength, and Brizendine aims for 100 grams of protein each day and a minimum of 80 grams daily. She also suggests eating foods high in fiber. Fiber encourages the brain's regeneration, which can help protect it from Parkinson's and Alzheimer's diseases. 

Be careful with your wine consumption, Brizendine says. Stick to only one glass of wine per day. Otherwise, alcohol becomes an inflammatory to the brain and can even lead to permanent brain damage.   

Timing your eating and drinking is essential, too. Brizendine suggests allowing 12 to 16 hours between dinner and breakfast. "It stresses the metabolism in a good way, just like building muscles in the gym," she says. "Giving the GI tract a rest during these hours helps the microbiome flourish."

3. Movement

"Sarcopenia means the wasting away of muscles, and starting at age 35, our muscles start to break down," says Brizendine. "We need to counteract it by stimulating muscles through exercise and eating protein."

Strong muscles are essential to prevent falls, maintain balance and more, says Brizendine. But beyond building muscles, exercise has wide-ranging effects on your body. Studies have shown that moderate aerobic exercise, for 30 to 60 minutes three times a week, increases the diversity of microbes in your intestines, she says, and reduces your gut's inflammation in only six weeks.

Even after just one exercise session, your mood is improved as your brain releases neurotransmitters, including endorphin, dopamine, noradrenaline and serotonin. That single workout can also improve your reaction time and your ability to focus for at least two hours afterward, says Brizendine. If you need a place to start, here's Brizendine's prescription:

"Drink a shot of joy every day by moving to music, walking in nature, jumping into a pool. Do something playful and something challenging or new every day. Take up space. When you go to the gym, occupy the weight room. Like the warrior stance, it tells the brain that you are powerful. Just don't let exuberance override your better judgment about how much you can lift."

Ready for an Upgrade?

Brizendine offers these parting words: "You can't help getting older, but you can take control of what your life looks like as you get older. We can get older and get better. Don't give up."

Photograph of Margie Zable Fisher
Margie Zable Fisher is a freelance writer and the founder of The 50-Year-Old Mermaid, where she and other 50+ women share their learnings and experiences on living their best lives after 50. Her website is Read More
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