Science
Fed up with perimenopause or menopause? The We Do Not Care Club is here for you
Melani Sanders is over it.
She’s over meticulously applying makeup before leaving the house or, even, having to wear a bra when running errands. She’s over wasting time plucking chin hairs, searching for brain fog-induced lost reading glasses and — most of all — withholding her opinions so as not to offend others.
As a 45-year-old perimenopausal woman, Sanders is no longer searching for outside validation and is over people-pleasing.
The dedication page in her new book sums it up best: “To the a— who told me I had a “computer box booty.”
Who is this dude, and is Sanders worried about offending him?
She doesn’t care.
Author, Melani Sanders, in an outfit she typically wears in her social media videos.
(Surej Kalathil Sunman Media)
That’s Sanders’ mantra in life right now. Last year, the West Palm Beach, Fla.-based mother of three founded the We Do Not Care Club, an online “sisterhood” into the millions of perimenopausal, menopausal and post-menopausal women “who are putting the world on notice that we simply do not care much anymore.” Sanders’ social media videos feature her looking disheveled — in a bathrobe and reading glasses, for example, with additional pairs of reading glasses hanging from her lapels — while rattling off members’ comments about what they do not care about anymore.
“We do not care if we still wear skinny jeans — they stretch and they’re comfortable,” she reads, deadpan. “We do not care if the towels don’t match in our house — you got a rag and you got a towel, use it accordingly.”
Sanders’ online community of fed up women grew rapidly. She announced the club in May 2025, and it has more than 3 million members internationally; celebrity supporters include Ashley Judd, Sharon Stone and Halle Berry. It’s a welcoming, if unexpected, space where women “can finally exhale,” as Sanders puts it. The rallying cry? “We do not give a f—ing s— what anyone thinks of us anymore.”
That’s also the message of Sanders’ new book, “The Official We Do Not Care Club Handbook: A Hot-Mess Guide for Women in Perimenopause, Menopause, and Beyond Who Are Over It.” The book is part self-help book, with facts about the perimenopause and menopause transition; part memoir; part practical workbook with tools and resources; and part humor book, brimming with Sanders’ raw and authentic comedic style. (It includes a membership card for new club inductees and cutout-able patches with slogans like “lubricated and horny” or “speaking your truth.”)
We caught up with Sanders while she was in New York to promote her book and admittedly “overstimulated from all the horns,” she said. But she just. Did. Not. Care.
This interview has been edited for length and clarity.
The We Do Not Care Club came about after you had a meltdown in a supermarket parking lot. Tell us about that.
I was in the parking lot of Whole Foods. I needed Ashwagandha — that was my holy grail at the time for my perimenopause journey, and I was out of it. I got back in my car and looked at myself in the rear view mirror. I had on a sports bra that was shifted to one side. My hair was extremely unstructured. I had a hat on and socks mismatched — I was a real hot mess. Nothing added up. But in that moment, I realized that I just didn’t care much anymore. I just said, “Melanie, you have to take the pressure off, girlfriend. It’s time to stop caring so much.” I decided to press the record button and see if anyone wanted to join me in starting a club called the We Do Not Care Club. I released the video and drove home, which took about 20 minutes, and by the time I got home it had [gone viral].
You got hundreds of thousands of new followers, internationally, within 24 hours. Why do you think the post resonated so greatly at that moment?
I had to dissect that because it was kind of unreal. Like, what is it about country, old Melanie that hit record and asked about a little club that she thought maybe 20 or 30 women would want to join? Over the summer, I studied this and did more videos and I listened. It was the relatability. It was the understanding. It was just letting my guard down and just saying it out loud. Speaking my truth. Also, for many women, we have this silent pressure to get it all done. But we’re at capacity. In the book, I talk about how, once I was in perimenopause, I didn’t want to have sex with my husband. I didn’t want to see my kids — like, everyone just close the door! And that’s kind of shameful, you know? It’s not like I don’t love my family. I really do. But I can’t do it all anymore. And I just think that resonated with a lot of sisters throughout the world. It was like: Now is the time for us to just explode and I think we all did it at once.
“The Official We Do Not Care Club Handbook.”
(William Morrow)
You entered perimenopause (or “Miss Peri,” as you call it) at age 44, after a partial hysterectomy. How did your life change after that?
I did not expect it. I knew that I had fibroids and I was uncomfortable because of that. So when I had the hysterectomy, I was expecting to now be a whole person again afterwards. But I just went into this dark place. It was like you’re fighting against yourself to just be normal again. And your body is changing in so many ways. For me, that was the hot flashes, the insomnia, the depression, the rage. My joints were really, really stiff all of a sudden. It’s like, ‘wait a minute, how and why?!!’ And [I got] frozen shoulder. Frozen shoulder was how I discovered I was in perimenopause because I was not told by my doctor who performed my hysterectomy that this could happen. And I didn’t know where to turn or where to go because I was just being told everything was normal. I was so frustrated with the process, the lack of education, the lack of resources. The lack of compassion, I would even say.
Your book and social media videos are so funny. Do you have a comedy background?
I don’t, and I get asked that often. I just say what’s on my mind and sometimes, I guess, it comes out funny — but I’m not trying. The [wearing multiple pairs of] glasses: I do that because, with perimenopause, my eyesight went bad really quickly. I was out in public one day and I could not read. I was just traumatized. So every time I would see glasses, I would just put them on me because I don’t want to get stuck without them. That neck pillow, when I got frozen shoulder, I was using it a lot. Then one day when I hit record, I had the neck pillow on and I just didn’t care. And it stuck.
You’ve appeared on TV, been featured in publications, and People magazine named you creator of the year for 2025. What has this sudden fame been like for you?
It’s surreal. I have not completely processed it yet. It’s a lot to take in. I’m just an everyday woman that decided to press record and accidentally started a movement. Impostor syndrome is there from time to time. But I’m just trying my best to accept everything that’s going on — and keep just being Melani.
Has the overwhelming response from new members fueled your own resolve to be true to yourself or otherwise changed you personally?
It absolutely has. It’s the strength that the sisterhood gives me. Because I’m very scared. You know, the book is coming out. And the tour is sold out in several cities. This is all within an eight-month span. It’s a lot. But when everyone is saying they love you, and when you have a group of women that understands you and feels the way that you feel, absolutely, there’s strength in numbers. Now I don’t care about making mistakes.
You live in a very male household. What do your sons and husband think of all this?
Once I decided that I didn’t care anymore, I just expected for them to kind of allow things just to go to hell around the house — but it was quite the opposite. All three of my sons and my husband, they’re just very supportive. Because it was very sad for me. It was very hard to not want to watch movies or anything and just be by myself. But they rose to the occasion and they make sure things are done when they’re home. They really show how they love their mom during this time.
How can other men become allies to the women they love during the menopause transition?
Just either get out of our way or, you know, just kind of read the room! Because we don’t know who we are from day to day. We don’t know what’s gonna ache. We don’t know what’s going to hurt or what’s going to itch or what’s going to be dry. And if it’s an off day, then darling, it’s just an off day — and it’s OK.
What are some things that you do still care about greatly?
I care about sisterhood. Because when women bind together, it’s a game changer. We will move mountains. I just think that, in this world, there’s so much pressure, so much overstimulation. So I care about being able to live authentically. To feel free. To be OK with who you are. Within WDNC, the two things that I definitely want to convey that I care about is: that you are enough. And you are not alone. And of course I love my kids. I love my family immensely.
Where does the WDNC go from here? What’s the future?
Retreats. That is definitely a dream. To have a weekend retreat where women can come and the only thing that you need to bring is some clean underwear and some pantyliners! (You can’t have a good, hard laugh or a good sneeze or a good cough without pissing your pants.) No makeup, no nothing, just come and be free. I want three different rooms. One will be the rage room and you’ll go in there and just throw stuff around and scream and punch, whatever you want. Then a quiet room. No talking, no nothing, just silence. And the last room will be the “Let that s— go room.” That’s where we’ll put everything that we have in us, that we’re holding onto that’s keeping us from living a blissful and peaceful life, and write it down and let it go. I just want to touch sisters and let them know it is OK. We are OK. I have my s— I go through. You have your s— you go through. It’s OK. Let’s live.
The sun had barely risen over the Pacific Ocean when a small motorboat carrying a team of Indigenous artisans and Mexican biologists dropped anchor in a rocky cove near Bahías de Huatulco.
Mauro Habacuc Avendaño Luis, one of the craftsmen, was the first to wade to shore. With an agility belying his age, he struck out over the boulders exposed by low tide. Crouching on a slippery ledge pounded by surf, he reached inside a crevice between two rocks. There, lodged among the urchins, was a snail with a knobby gray shell the size of a walnut. The sight might not dazzle tourists who travel here to see humpback whales, but for Mr. Avendaño, 85, these drab little mollusks represent a way of life.
Marine snails in the genus Plicopurpura are sacred to the Mixtec people of Pinotepa de Don Luis, a small town in southwestern Oaxaca. Men like Mr. Avendaño have been sustainably “milking” them for radiant purple dye for at least 1,500 years. The color suffuses Mixtec textiles and spiritual beliefs. Called tixinda, it symbolizes fertility and death, as well as mythic ties between lunar cycles, women and the sea.
The future of these traditions — and the fate of the snails — are uncertain. The mollusks are subject to intense poaching pressure despite federal protections intended to protect them. Fishermen break them (and the other mollusks they eat) open and sell the meat to local restaurants. Tourists who comb the beaches pluck snails off the rocks and toss them aside.
A severe earthquake in 2020 thrust formerly submerged parts of their habitat above sea level, fatally tossing other mollusks in the snail’s food web to the air, and making once inaccessible places more available to poachers.
Decades ago, dense clusters of snails the size of doorknobs were easy to find, according to Mr. Avendaño. “Full of snails,” he said, sweeping a calloused, violet-stained hand across the coves. Now, most of the snails he finds are small, just over an inch, and yield only a few milliliters of dye.
new video loaded: This Parrot Has No Beak, But Is at the Top of the Pecking Order
By Meg Felling and Carl Zimmer
April 20, 2026
For months now, menopausal women across the U.S. have been unable to fill prescriptions for the estradiol patch, a long-established and safe hormone treatment. The news media has whipped up a frenzy over this scarcity, warning of a long-lasting nationwide shortage. The problem is real — but the explanations in the media coverage miss the mark. Real solutions depend on an accurate understanding of the causes.
Reporters, pharmaceutical companies and even some doctors have blamed women for causing the shortage, saying they were inspired by a “menopause moment” that has driven unprecedented demand. Such framing does a dangerous disservice to essential health advocacy.
In this narrative, there has been unprecedented demand, and it is explained in part by the Food and Drug Administration’s recent removal of the “black-box warning” from estradiol patches’ packaging. That inaccurate (and, quite frankly, terrifying) label had been required since a 2002 announcement overstated the link between certain menopause hormone treatments and breast cancer. Right-sizing and rewording the warning was long overdue. But the trouble with this narrative is that even after the black-box warning was removed, there has not been unprecedented demand.
Around 40% of menopausal women were prescribed hormone treatments in some form before the 2002 announcement. Use plummeted in its aftermath, dipping to less than 5% in 2020 and just 1.8% in 2024. According to the most recent data, the number has now settled back at the 5% mark. Unprecedented? Hardly. Modest at best.
Nor is estradiol a new or complex drug; the patch formulation has existed for decades, and generic versions are widely manufactured. There is no exotic ingredient, no rare supply chain dependency, no fluke that explains why women are suddenly being told their pharmacy is out of stock month after month.
The story is far more an indictment of the broken insurance industry: market concentration, perverse incentives and the consequences of allowing insurance companies to own the pharmacy benefit managers that effectively control drug access for the majority of users. Three companies — CVS Caremark, Express Scripts and OptumRx — manage 79% of all prescription drug claims in the United States. Those companies are wholly owned subsidiaries of three insurance behemoths: CVS Health, Cigna and UnitedHealth Group, respectively. This means that the same corporation that sells you your insurance plan also decides which drugs get covered, at what price, and whether your pharmacy can stock them. This is called vertical integration. In another era, we might have called it a cartel. The resulting problems are not unique to hormone treatments; they have affected widely used medications including blood thinners, inhalers and antibiotics. When a low-cost generic such as estradiol — a medication with no blockbuster profit margins and no patent protection — runs into friction in this system, the friction is not random. It is structural. Every decision in that chain is filtered through the same corporate profit motive. And when the drug in question is an off-patent estradiol patch that has negligible profit margins because of generic competition but requires logistical investment to keep consistently in stock? The math on “how much does this company care about ensuring access” is not complicated.
Unfortunately, there is little financial incentive to ensure smooth, consistent access. There is, however, significant financial incentive to steer patients toward branded alternatives, or simply to let supply tighten — because the companies aren’t losing much profit if sales of that product dwindle. This is not a conspiracy theory: The Federal Trade Commission noted this dynamic in a report that documented how pharmacy benefit managers’ practices inflate costs, reduce competition and harm patient access, particularly for independent pharmacies and for generic drugs.
Any claim that the estradiol patch shortage is meaningfully caused by more women now demanding hormone treatments is a distraction. It is also misogyny, pure and simple, to imply that the solution to the shortage is for women’s health advocates to dial it down and for women to temper their expectations. The scarcity of estradiol patches is the outcome of a broken system refusing to provide adequate supply.
Meanwhile, there are a few strategies to cope.
- Ask your prescriber about alternatives. Estradiol is available in multiple formulations, including gel, spray, cream, oral tablet, vaginal ring and weekly transdermal patch, which is a different product from the twice-weekly patch and may be more consistently available depending on manufacturer and region.
- Consider an online pharmacy. Many are doing a good job locating and filling these prescriptions from outside the pharmacy benefit manager system.
- Call ahead. Patch shortages are inconsistent across regions and distributors. A call to pharmacies in your area, or a broader geographic radius if you’re able, can locate stock that your regular pharmacy doesn’t have.
- Consider a compounding pharmacy. These sources can sometimes meet needs when commercially manufactured products are inaccessible. The hormones used are the same FDA-regulated bulk ingredients.
Beyond those Band-Aid solutions, more Americans need to fight for systemic change. The FTC report exists because Congress asked for it and committed to legislation that will address at least some of the problems. The FDA took action to change the labeling on estrogen in the face of citizen and medical experts’ pressure; it should do more now to demand transparency from patch manufacturers.
Most importantly, it is on all of us to call out the cracks in the current system. Instead of repeating “there’s a patch shortage” or a “surge in demand,” say that a shockingly small minority of menopausal women still even get hormonal treatments prescribed at all, and three drug companies control the vast majority of claims in this country. Those are the real problems that need real solutions.
Jennifer Weiss-Wolf, the executive director of the Birnbaum Women’s Leadership Center at New York University School of Law, is the author of the forthcoming book “When in Menopause: A User’s Manual & Citizen’s Guide.” Suzanne Gilberg, an obstetrician and gynecologist in Los Angeles, is the author of “Menopause Bootcamp.”
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