For billions of women, menopause is a biological milestone—a
transition often discussed with doctors, friends, and family, and managed with
medical support. But in Afghanistan, a nation grappling with decades of
conflict, deeply entrenched patriarchal norms, and a collapsed healthcare
system, this natural life stage is not a topic of conversation. It is a silent
passage, endured in private and shaped by a unique interplay of cultural
stigma, religious interpretation, and immense hardship.
To understand menopause in Afghanistan is to understand the
cultural value placed on a woman's body, which is primarily seen through the
lens of fertility and honor. Here, the cessation of menstruation is a profound,
yet unspoken, shift in a woman's identity and social standing.
A Culture of Silence and Taboo
In Afghan society, matters of women's health, particularly
reproductive health, are intensely private. Menstruation itself is a taboo
subject, shrouded in euphemism and rarely discussed openly, even between
mothers and daughters. It is little surprise, then, that its permanent
end—menopause—is met with an even deeper silence.
There is often no shared vocabulary for the experience
beyond clinical terms that are inaccessible to most. The Arabic-derived
term ya's (يأس), meaning "despair" or
"hopelessness," is sometimes used to describe this period, revealing
a deeply negative cultural perception. This framing casts menopause not as a
natural transition but as an ending—the loss of a woman’s primary purpose.
Women experiencing symptoms like hot flashes, insomnia, anxiety, or mood swings
often have no framework to understand them. These physical and emotional
struggles are frequently misinterpreted as signs of general aging, illness, or
even spiritual distress, rather than a specific, manageable hormonal shift.
The End of Fertility: A Double-Edged Sword
A woman's status in traditional Afghan culture is
inextricably linked to her ability to bear children. A large family is a source
of pride, social security, and influence. Consequently, the end of fertility can
be perceived as a significant loss of value and purpose. A woman may feel she
has become "useless" to her husband and family, contributing to
feelings of depression and isolation.
However, this transition carries a complex duality. While a
woman may lose the status associated with childbearing, she often gains a
different kind of freedom and respect. Once she is post-menopausal, she is no
longer viewed as a sexual being in the same way. This perceived
"asexuality" can grant her a new social mobility. She may be able to
engage more freely with men outside her immediate family, take on a more
public-facing role within her community, and command respect as a matriarch and
wise elder. Freed from the restrictions associated with menstruation—which can
limit participation in certain religious rituals—she may also experience a
deeper, more consistent spiritual life.
The Overwhelming Shadow of Healthcare Collapse
The cultural silence surrounding menopause is tragically
compounded by a near-total lack of medical support. Decades of war and the
current rule of the Taliban have decimated Afghanistan's healthcare
infrastructure. For women, access is even more limited due to restrictions on
their movement, education, and ability to see male doctors.
Specialized care for non-life-threatening conditions like
menopause is virtually non-existent. Hormone Replacement Therapy (HRT),
counseling, and even basic informational pamphlets are luxuries beyond reach
for all but a tiny, privileged elite. Afghan women are left to endure often
debilitating symptoms entirely on their own, with no medical recourse or
understanding of what is happening to their bodies.
A Matter of Priority
In a country where daily survival is the primary concern,
menopause inevitably falls to the bottom of the list of priorities. When a
woman is worried about feeding her children, ensuring their safety, or
navigating the severe restrictions on her freedom, hot flashes and mood swings
are just another hardship to be borne in a life full of them. The physical and
emotional toll of menopause is subsumed by the greater struggles of existence.
This context makes the Western concept of "managing" menopause seem
like an impossible and distant luxury.
Conclusion: Resilience in the Face of Neglect
The experience of menopause in Afghanistan is a stark
illustration of how a universal biological process is profoundly reshaped by
culture, conflict, and systemic neglect. It is not a medical event to be
managed but a silent social and personal passage to be endured. For Afghan
women, it marks the end of one identity and the quiet beginning of another,
fraught with the potential for both loss of status and newfound respect.
Their story is one of incredible resilience, but it is also
a powerful reminder of the hidden health crises that affect half the population
in societies where women's voices are silenced and their needs are ignored.
