Between Culture and Care:
When Culture Speaks Louder Than Medicine

By Nasim Jozan | Women's Health

Women’s health is shaped not only by biology, but also by culture, beliefs, and social expectations. From a midwifery perspective, these factors are often reflected in how women describe their bodies, their concerns, and their experiences within healthcare systems. In many contexts, gaps in awareness and cultural misconceptions can influence both access to care and the quality of women’s health experiences.

One example is virginity testing. This practice involves examining the hymen with the intention of determining sexual activity. From a medical and midwifery point of view, this approach is not reliable. The hymen varies significantly between individuals and can be influenced by multiple factors unrelated to sexual activity (“Virginity Testing”).

Even though there is no scientific basis for it, such practices may still exist in some settings due to cultural beliefs and social expectations. In practice, women may feel unable to refuse such examinations. This raises important concerns around autonomy, dignity, privacy, and human rights—principles that are central to respectful women-centered care.

Health organizations, including the World Health Organization, have clearly stated that virginity testing has no medical value and may cause harm. In clinical and community settings, it can also have emotional consequences. Women may experience feelings of shame, discomfort, or fear, and in some cases this may affect their willingness to seek healthcare in the future.

MENOPAUSE AS A NATURAL TRANSITION

Another important stage in women’s life course is menopause. In midwifery and primary care practice, menopause is understood as a natural biological transition, typically occurring between the ages of 45 and 55, marking the end of menstrual cycles. Although it is a normal physiological process, many women experience it without sufficient prior education or preparation (UNFPA).

Symptoms may include hot flashes, sleep disturbances, mood changes, anxiety, and fatigue. However, the experience of menopause varies widely between individuals. Some women describe only mild changes, while for others it may have a more noticeable impact on daily life and wellbeing.

In many care settings, women often share that limited information and lack of open discussion about menopause can leave them feeling unprepared or uncertain when these changes begin. Beyond its biological dimensions, menopause is also shaped by social perceptions of aging and femininity, which influence how women interpret their own experiences.

In some cultural contexts, natural biological transitions such as menopause may even be referenced in public discourse in ways that carry dismissive or symbolic meanings. This reflects broader societal attitudes toward aging in women and highlights the importance of more respectful and informed language around this life stage.

SUPPORTING WOMEN THROUGH CULTURAL AND SOCIAL CHANGE

Healthcare providers, including midwives and primary care professionals, play an important role in supporting women through these transitions. Often, this involves not only providing information, but also listening, reassurance, and creating a space where women feel their experiences are understood and validated.

Across both virginity testing and menopause, a shared pattern becomes visible: cultural beliefs and levels of awareness strongly shape how women experience healthcare. These influences extend beyond physical health and also affect emotional wellbeing and the level of trust between women and health systems.

Addressing these challenges requires a broader and more connected approach. Education systems can play an important role in building early understanding of health, bodily autonomy, and respect. At the same time, change is not limited to formal education; awareness within families and communities also shapes how beliefs are formed and passed on.

When both women and men have access to accurate information, it becomes easier to challenge misconceptions and support healthier attitudes toward women’s health. Involving all members of society, including boys and young men, in health education can contribute to more balanced understanding and shared responsibility in creating respectful cultural norms.

Ultimately, from a midwifery perspective, women’s health cannot be separated from the cultural and social environments in which it exists. Supporting women requires both accurate knowledge and a sensitive understanding of how culture shapes lived experience.