Culture is a rather amorphous concept yet has a huge impact on our attitudes to diet, lifestyle, religion, sexuality and, via its influence on society, attitudes to education and health care. The midlife is a time of emotional and hormonal upheaval for any woman so defining the effects on culture on her response is challenging. Much depends on the value she places on her fertility and sexuality together with her own goals and aspirations, yet these are also influenced by culture. Very few traditional cultures survive in isolation for comparison. Shifting populations mean counter influences and transitional societies can be ambivalent. Emigrants and refugees transplanted into a different environment may struggle with the concept of acculturation. In time, all cultures evolve regardless. Finally, there may be biological and hormonal differences between races. This article seeks to place these different forces into context.