Copyright Š2016 - 2017 Student document publication meant for private circulation only. All rights reserved. Masters of design, Graphic Design, 2013 - 2016 National Institute of Design, Ahmedabad, India. No part of this document will be reproduced or transmitted in any form or by any means including photocopying, xerography, photography and videography recording without written permission from the publisher, Pooja Vasu and National Institute of Design. All the illustrations and photographs in this document are Copyright Š2016 - 2017 by respective people and organizations. Edited and designed by : Pooja Vasu pooja.octaves@gmail.com Processed at : National Institute of Design, Paldi,Ahmedabad 380007 Gujrat,India. www.nid.edu Printed Digitally in Ahmedabad, India October2016
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Originality Statement I hereby declare that this submission is my own work and it contains no full or substantial copy of previously published material, or it does not even contain substantial proportions of material which have been accepted for the award of any other degree or ďŹ nal graduation of any other educational institution, except where due acknowledgement is made in this graduation project. Moreover I also declare that none of the concepts are borrowed or copied without due acknowledgement. I further declare that the intellectual content of this graduation project is the product of my own work, except to the extent that assistance from others in the project’s design and conception or in style, presentation and linguistic expression is acknowledged. This graduation project (or part of it) was not and will not be submitted as assessed work in any other academic course. Student Name in Full: Pooja Vasu Signature: __________________________________________________________________ Date:_______________________________________________________________________
COPYRIGHT STATEMENT I hereby grant the National Institute of Design the right to archive and to make available my graduation project/thesis/dissertation in whole or in part in the Institutes Knowledge Management Centre in all forms of media, now or hereafter known, subject to the provisions of the Copyright Act. I have either used no substantial portions of copyright material in my document or I have obtained permission to use copyright material. Student Name in Full: Pooja Vasu Signature:___________________________________________________________________ Date:_______________________________________________________________________
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Second Innings Narrativizing Menopause
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Synopsis Menopause is not a sudden process. The period of transition of a woman is mostly 4 -5 years before the actual onset of menopause. This transition phase is called Peri-menopause. This transition not only takes a toll on the physical body but also on the mental health. There is a gap in communication during these various stages of Menopause that lead to misconceptions. There is no counseling available at the early stage. The rapid diffusion of hundreds of web resources has created a gap between information quality and the user expectations. The awareness of ‘Menopause’ in general is very low amongst women. They need to be aware of the changes that occur in their body so that they’re well prepared to deal with the symptoms and not panic. This project would be dedicated to promoting the health and quality of life in all women during midlife and beyond through an understanding of menopause and healthy ageing.
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Acknowledgement Project Guide Since 2004, Shilpa Das has been looking after Science and Liberal Arts Studies at NID. She has cumulative work experience of 22 years in the education, publishing, and voluntary sectors.
Dr. Shilpa Das Coordinator, Inter Disciplinary Design Studies, NID Co-Head, Ph.D - Research Programm, NID
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At NID, Shilpa teaches Comparative Aesthetics, Semiotics and Communication, Indian Art and Culture, Narrative Theory, Identity and Subjectivity, Cultural Studies and Craft Documentation. At present, her research interest lies in Disability Studies. She has been involved in various outreach and consultancy projects, notably, a project on strategic behaviour change with respect to persons with disabilities for Handicap International and Department of Health and Family Welfare for the Government of Gujarat, Ananya, a book on Indian women for the Ministry of Women and Child Development and Sanchar Shakti, a book on information communication technology and women’s empowerment for the Department of Telecommunications, Government of India. For the last four years, she has, along with a colleague,collaboratedwith faculty members from Konstfack University, Swedento conduct think-tanks on future forecasting.
Shilpa speaks frequently on subjects as diverse as Indian and Western aesthetics, socio cultural stigma faced by women with disabilities in India,representation of people with disabilities in Indian literature and Indian philosophy. She has lectured at CEPT, Ahmedabad, IIT Bombay, Marist College in NewYork, Utkal University, Bhubaneshwar, and H.L. Collegeof Commerce, Ahmedabad. She has published widely inacademic and popular journals, books, and magazines.She has been editorial consultant to Collins Cobuild Dictionaries, UK, and is on the Board of Advisors toPool, a design magazine. Shilpa is the Co-editor of two prominent publications brought out by the Research and Publications department of NID—The Trellis, a research based publication and a magazine called D/signed. Currently, Shilpa is pursuing a PhD in Social Sciencefrom the Tata Institute of Social Sciences, Mumbai.
Project Co-Guide
Rupesh Vyas Ex faculty, NID
Rupesh Vyas is a Senior Faculty in Communication Design, Activity Chairperson Online Programmes at NID. In recent past he has been Head of Information Technology and Coordinator of Graphic Design. He is taking lead role in developing Information and Interaction Design as emerging domain under Communication Design and IT Integrated Design Disciplines at NID. He is a Board Member of International Institute of Information Design (IIID) which is based in Vienna, Austria. He has Masters degree in Visualization and Under-Graduation in Applied Arts (Graphic Design) from M. S. University of Baroda. He has 17 years of experience in Communication Design education, research and professional projects. Prior to joining NID in 2002 he was a lecturer at Faculty of Fine Arts, M. S. University of Baroda. He has wide areas of academic and professional interests which includes Visual Identity design, Static and Dynamic Graphic Application, Documentation of Visual Culture of India, Colour in Analogous and Digital medium, Way Finding Systems, Information Graphics, Complex Information Systems and Visual Diagraming. He has special interest in strategic design innovations with socially relevant issues and exploring newer ways of information, interactions and interfaces in governance, social sector and public domain.
He has contributed significantly to some of the major consultancy project having National importance like Information Design for Census of India 2011 Data Collection and Digitization processes and Multipurpose National Identity Card for Citizens of India from Ministry of Home Affairs, Government of India, Smart Card based Indian Union Driver’s License, Standardizing Visual Design for National level implementation, by Ministry of Road Transport and National Informatics Center, Government of India. He was key planner and Chair for “Vision Plus 2010” conference (www.iidi.in) in India hosted at NID. “Vision Plus” is an internationally recognised series of conferences, dedicated to all aspects of Information Design, initiated by IIID, which invited national and international Scholars and experts from 14 countries, covered a wide range of engageing issues in the domains of Communities, Healthcare, and Mobility.
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Acknowledgement OoWomaniya Team
Sneh Bhavsar
Krutika Katrat
Varun Varunesh
Co-Founder & CEO (Chief Executive Officer) He has studied Information Systems Management from University of London and has worked as Information Systems Professional, Business Analyst and Process Manager for 10 years in the field of Information Technology
Co-Founder & CAO (Chief Acquisition Officer) She has pursued her M.TECH (Integrated) in Biotechnology from Pune. She has worked as a research trainee in a DBT/DST project at ACTREC, Tata Memorial Centre, in the field of cancer biology and structural biochemistry before taking a plunge into entrepreneurship.
Co-Founder & CAO (Chief Acquisition Officer) He is a postgraduate from Central University of Hyderabad. He worked in Morgan Stanley before joining the core team of OoWomaniya.com as the tech lead. His core skills include machine learning, algorithm design, web development, web architecture management etc.
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Research Dr. Darshna Thakkar Obstetrics & Gynecologist Dr. Nita Thakre MD, Gynecologist & Urogynecologist practicing at Welcare clinic, SAL hospital and CIMS hospital Sonal Deshpande Psychological Counsellor Dr Ranjana Harish Professor& Head Department of English, School of Languages &Director, Reaney Canadian Study Centre, Gujarat University Dr Anu Vij Gynecologist/Obstetrician, Member of IMA Dr Gauri Amonkar Radiologist Dr Kaushal Agarwal Obstetrics & Gynecologist Dr Meena Srikanth Obstetrics & Gynecologist
Video & Editing Jayashri Vasu Officer - BOI, a mother and my inspiration for this project
Titu Milli M Des 2013, Graphic Design
Abhishek Vasu Sheetal Vanwari Madhuvanti Maddur Omana Menon Preetha Choudhary Margie Sastry Prapti Iyengar Himanshu Desai Kinjal’s Mom Aarti Abraham Girish Shah Reema Shah Smita Zanzarakiya Natubhai Zanzarakiya Kaaki Shreya Bhagthariya Dr Aakash Doshi Eeshan Joshi Aarti Nair Krina Patel Aayush Amol Mehrotra Kinjal Zanzarakiya Rohit Asokan Rhea Matthews
Sivaranjini M Des 2013, Film & Video Communication Design
Shridhar Sudhir M Des 2014, Film & Video Communication Design
Technical Assistance Kushagraha M Des 2016, Graphic Design
Special thanks to Swapnil Vibhute Jason VM Nandana Chakraborty Gagan Narhe Dinesh Borana Paul Joshua Aravind Sivan Shreya Kanoi
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Content Introduction
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1.1 About NID
18-19
1.2 About the Sponsor
Initial Research
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Design Process
2.1 What is Menopause
30-33
3.1 Methodology
20-21
2.2 Sign & Symptoms
34-35
3.2 User Study
1.3 How it all started
22-23
2.3 Myths & Misconceptions
36-37
- Women
54-63
1.4 Why Menopause
24-25
2.4 Women’s Health Scenario
38-41
- Doctors
64-71
1.5 Project Proposal
26-27
2.5 Indian Women & Menopause
42-47
- Husbands & Children
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3.3 User Persona Study
76-79
3.4 Insights from the Research
80-87
3.5 Why Communication Design?
88-89
3.6 OoWomaniya Context
90-93
3.7 Redefined Brief
94-95
Design Structure
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Design Development
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Conclusion
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114-115
6.1 Deliver
166-167
5.2 Film Development
116-131
6.2 References
168-169
106-108
5.3 Branding
132-139
4.4 Proposed Design Concept
109-110
5.4 Data Visualization
140-157
4.5 Final Design Structure
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5.5 Website Design
158-163
5.6 Wayforward
164-165
4.1 Design Structure
98-99
5.1 Deliver
4.2 Precedent Study
100-105
4.3 Design Direction
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Introduction 1.1 About NID
18-19
1.2 About the Sponsor
20-21
1.3 How it all started
22-23
1.4 Why Menopause
24-25
1.5 Project Proposal
26-27
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PC: Vikas Bansal
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1.1 About NID The establishment of NID was a result of several forces, both global and local. The late 1950s saw a confluence of these forces, and this time would be a significant one for Indian culture and education. Based on the recommendations made in the India Report, the Government of India with the assistance of the Ford Foundation and the Sarabhai family established the National Institute of Industrial Design, as it was originally called as an autonomous all-India body in September 1961 at Ahmedabad. Gautam Sarabhai and his sister Gira were played a major role in the establishment and early years of NID. Gautam Sarabhai sidestepped the accepted wisdom and conventional method of education . He revived the philosophy of the Bauhaus design movement which was learning by doing. This unique curriculum and revolutionary educational philosophy remain part of NID to the present day. Today the National Institute of Design is internationally acclaimed as one of the finest educational and research institutions for Industrial, Communication, Textile and IT Integrated (Experiential) Design. It is an autonomous institution under the aegis of the Ministry of Commerce and Industry, Government of India. NID has been declared ‘Institution of National Importance’ by the Act of Parliament, by virtue of the National Institute of Design Act 2014.
The mandate for NID is to offer world-class design education and to promote design awareness and application towards raising the quality of life by and through Education to create design professionals of excellence to help meet India’s diverse design needs. To train design trainers for other design and design related institutions and positions in the 21st century as global leaders in Design Education and Research by recognising the changes in economic and business environment nationally and globally. Ensuring the expansion in the number of quality design professionals and faculty, through existing and new institutional mechanisms. Becoming a repository of design knowledge, experience and information on products, systems, materials, design and production processes related to traditional as well as modern technologies. Encourageing the design of products and systems of everyday use in a spirit of restless search for indigenous design solutions by focusing on affordable design for the masses. To undertake fundamental and applied research to create cutting edge knowledge in the areas of design especially those concerned with user understanding and trends.
To help place designers in key sectors of national need for benchmarking of standards of design education and practice, and encourageing ‘thinking global and acting local’.
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1.2 About the Sponsor Organization name: Impetus Wellness Pvt. Ltd. OoWomaniya.com (A flagship platform of Impetus Wellness Pvt. Ltd) – a venture striving towards Gender Inclusivity via Women’s Health Services, Awareness and Preventive Care
OoWomaniya Perspective and Vision OoWomaniya was incepted with a conscious attention towards understanding WOMEN’s issues in daily lives. Workshops, field study, interviews and the literature study helped us understanding and defining the focus on women’s health issues and it further narrowed down to emotional and intimate health issues. OoWomaniya.com is an online consultation platform for women to take advice, ask questions and take counseling sessions using web and mobile application. They are reaching out to the urban women aged between 15 to 35 years and who have easy access to the Internet (Web and mobile platforms). Here’s the detailed perspective for providing these services: 1. OoWomaniya is and will remain focused on Women’s issues and primarily health and wellness of entire female gender. 2. They are sensitive towards women’s emotional wellness and endorse the science of strong connection between mental and physical health. 3. The vision is to provide women a dedicated, non-judgmental and safe platform to talk about their issues, problems or to simple share and aim to create multiple mediums for women to be able to access expert advice in a cost-effective way. 4. They want to provide the users with alternative ways of preventive care
Educating women about their health and wellness issues, awareness and preventive care.
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It’s our duty to urge our mothers to take care of their health
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1.3 How it all started It all started with a girl who couldn’t understand what was happening with her mom. The calm and loving person she knew her entire life had suddenly changed into someone she couldn’t recognise. Everything about her mom was different. To add to this confusion, there were a lot of physiological changes that her mom was undergoing. Little did she know that her life was going to change soon. A visit to the family doctor confirmed that her mom was experiencing all peri-menopause and menopausal symptoms. Menopause was just one the words she had come across while reading some article in scroll or medium. It didn’t occur to her that it would be a part of her life from here onwards. Internet was not of much a use because more than comforting, it just kept on adding to her fears. Would her mom ever be the same again? Why did she have to undergo Mammography, PAP smear and all the other possible scary sounding tests when she had no apparent problem? Why were her parents, who never had any major disagreement over any issue in their entire life were yelling at each other suddenly since past few years. When she dug deep into the topic, she realised that nothing much has been spoken about it. There was very little awareness about it, including in case of her mom.
It reminded her of her own puberty. How she had all the support she could expect from her mom. She had to never google menstruation or periods to know what was happening to her. Her mom had answers to all her questions She never complained during her PMS days. May because she knew how it felt, beacuse she had gone throught the same experiences in the past. It just felt strange that the mother was also clueless about what she, herself was going through now. She knew that the journey was going to be interesting, stressful and full of surprises. The fact that generally almost no one in the family is aware about what Menopause is, was very surprising. There was a need to address this issue and susbsequently promoting Healthy ageing amongst menopausal women.
Menopause is not an easy transition for some women
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1.4 Why Menopause? The “mysteries” of a woman’s body - puberty, menstruation, pregnancy, lactation and menopause are seen as times of power and growth. A woman’s body goes through a lot of physiological changes throughout her lifetime. These changes are more prominent during certain years in her life.
Menopause is not a sudden process. The period of transition of a woman is mostly 4 -5 years beforethe actual onset of menopause. This transition phase is called Peri-menopause. Like mentioned earlier, this transition not only takes a toll on the physical body but also on the mental health.
Puberty is marked as the most important stage in her life which is basically the onset of Menstruation. The next few years are the most fertile years where the body is again subjected to many ups and downs with respect to the hormonal changes, the main markers being Pregnancy and lactation which completely depends on her own personal decisions. But every woman has to go through two major phases in her life where in everything she knows about her own body changes drastically- Puberty and Menopause. These changes not only take a toll on her physical body but also the mental health. Puberty occurs somewhere between the age of 10-17 and Menopause generally after 45 years of age. Adapting to these changes mentally and physically becomes very crucial and difficult at times.
There is a gap in communication during these various stages of Menopause that lead to misconceptions. There is no counseling available at the early stage. The rapid diffusion of hundreds of web resources has created a gap between information quality and the user expectations. The awareness of ‘Menopause’ in general is very low amongst women. They need to be aware of the changes that occur in their body so that they’re well prepared to deal with the symptoms and not panic.
The changes that occur during the Puberty are often not a conscious one. But on the other hand, Menopause is an opportunity for a conscious change, not a disease to be treated. The change of life. The end of fertility, beginning of freedom. Whatever people call it, menopause is a unique and personal experience for every woman. As you stand at the brink of it, it can appear that only darkness, danger and delay lie beyond. As a third of a woman’s life will be in her post-menopausal period, it is essential that she understands and manages this period, makes some adjustments and enjoys optimum health.
Menopause always occurs at the age when the individual’s mother became menopausal.
Some of the myths plaguing our thinking concerning menopause include: Menopause is the beginning of a downhill coursein life. Menopause is a time of diminished productivity and contribution to society.
This project aims at providing accurate information necessary at every stage to help them take a proper decision and not assume the worst.
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02
Synthesis
Analysis
Understanding the brief. Information collection Final Output
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Concept with design exploration
04 Vaidation of ideas.
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1.5 Project Proposal Understanding Menopause and encourageing Healthy ageing amongst women
Scope of Work: Understanding the need for communication with respect to the social context of the topic. The attempt in this project to come up with a communication means exclusive for this issue, under a distinguished flagship platform. Learning the different medical terms related to the issue and creating a more effective way to communicate the related complexities in a simpler way. Understand the different models in medical industry: institutional practice, services and patient engagement. Rethinking care systems and it’s consumers. Getting a deeper insight into the patient psychology. Working closely with the concerned medical staff and coming up with effective tools. Considering different stakeholders including medical educators, management of hospitals, companies providing healthcare applications and policy makers. To make women understand the reasons and the effects of Menopause on their body. This project would be dedicated to promoting the health and quality of life of all women during midlife and beyond through an understanding of menopause and healthy ageing. To come up with the most authentic and verified source on anything related to Menopause to all the stakeholders: from Healthcare providers to public.
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02
Initial Research 2.1 What is Menopause
30-33
2.2 Sign & Symptoms
34-35
2.3 Myths & Misconceptions
36-37
2.4 Women’s Health Scenario
38-41
2.5 Indian Women & Menopause
42-47
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Menopausal Age
20
30
40
50 Age in years
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2.1 What is Menopause? Menopause is a natural physiological condition which all women experience during their lifetime as part of the ageing process. Menopause is stoppage of menstruation as a result of stoppage of ovarian activity and marks the end of reproductive period of a woman’s life.
Estrogen, a female sex hormone, protects women from various diseases like breast cancer, heart diseases and weight gain. But in menopause, loss of estrogen occurs. Hence, women in menopause must take good and holistic care of their health.
A woman can be said to be in her menopause if she has not had her periods constantly for a time of 12 months.
What is estrogen?
How Menopause occurs? A female is born with a fixed number of eggs in her two ovaries. These eggs participate in ovulation each month starting from the time of the puberty. But as the woman moves towards older age, these eggs exhaust, estrogen hormone level quickly drops in the ovaries, ovulation stops and as a result of which she stops getting her periods. Reproduction or conceiving a child, naturally, for a menopausal woman is not possible. Ideally, menopause can happen in a woman’s life between 48 – 52 years of age while normally women have also been found to be getting into their menopause phase between ages of 45 – 48 years.
The ovaries are the main source of female hormones or estrogen, which controls the development of female body characteristics such as the breasts, body shape, and body hair. The hormones also regulate the menstrual cycle and pregnancy. Estrogens also protect the bone. As part of the ageing process the ovaries begin to produce less estrogen and progesterone. This decrease signals the beginning of the end of a woman’s reproductive years. Eventually the menstrual periods stop and it is no longer possible for a woman to become pregnant.
What is a menopausal transition or climacteric? The menopausal transition starts with infrequent periods and ends with the final menstrual period. The transition can begin as early as the 30s and last even into the 60s. This span of time is also referred to as the change of life or the climacteric. ‘Experiencing Menopause’ is experiencing a transition in life for a woman. No more periods, no more childbearing, no more milk producing capability, are some of the changes that immediately hit a woman along with changes in physical appearance and a dry vagina.
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Climacteric can be divided into three phases:
Pre-Menopause stage During this phase there is little disruption of ovarian function and the menstrual cycle remains regular. Some symptoms may begin to occur in this phase.
Peri-Menopause stage This represents declining ovarian function with menstrual irregularities and symptoms commonly start or become troublesome during this time Menopause is not a sudden process. The period of transition of a woman is mostly 4 -5 years before the actual onset of menopause. This transition phase is called Perimenopause. During perimenopause, periods may become irregular. The periods during perimenopause, may last longer, sometimes one may get heavy menstrual flow or sometimes the woman may get no periods at all
Post-Menopause stage This is when there have been no menses for 12 months, the post menopause phase is entered.
source: http://www.hormone.org
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What is the effect of this “transition� period before menopause? This transition can be the most traumatic and at times psychologically depressing but there are two sides to it: on one side there is sadness and gloom of losing youth but on the other side there is liberation and freedom from the monthly routine and a new found status of wisdom and maturity.
How does it affect a woman? The symptoms of menopause are caused by changes in estrogen and progesterone levels. As the ovaries become less functional, they produce less estrogen / progesterone and the body subsequently reacts. Some women experience no symptoms, while others experience mild to ever symptoms. This variation is normal. A gradual decrease of estrogen allows the body to slowly adjust to the hormone change, but in some women a sudden decrease in estrogen level occurs, causing severe symptoms. This result is often seen when menopause is caused by surgical removal of ovaries (Surgical Menopause). Menopausal symptoms are part of a natural biological process experienced by all women as their child-bearing years come to an end.
Does menopause cause complications? After menopause there are chronic conditions that tend to appear in women. Declining estrogen levels increase the risk of cardiovascular disease. To combat this potential problem, women should stop smoking, maintain their blood pressure in normal limits, exercise regularly, and eat a diet rich in fruits, vegetables, and whole grains and low in saturated fats. Bone density decreases at a rapid rate after menopause and some women develop osteoporosis. In this condition brittle or weak bones break easily, especially those in the hip, wrist, and spine. Adequate amounts of calcium at dosage of 1500 mg a day as well as 400-800 mg of Vitamin D will help to decrease this risk. Strength training and walking or jogging are extremely important ways to decrease the risk of fractures. Menopause manifests at different times and in different ways for individual women. Some are lucky enough to get through the experience with no significant problems but for others, menopause disrupts both their lives and their interpersonal relationships. There are a number of signs and symptoms to indicate the onset of menopause beginning with irregular menstrual periods. The irregularity may be apparent with increased or decreased frequency or in the amount of flow present. As ovulation begins to get erratic, a woman is less likely to get pregnant. The possibility of conception is almost nil after menstrual periods have been absent for a year.
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Menopause Signs and symptoms source: http://www.naturalremedies.org/
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2.2 Signs and Symptoms Often the first symptom of impending menopause is a change in bleeding patterns. Periods may become lighter or heavier, longer or shorter, the time between periods may increase and there may be occasional missed periods. These changes may occur gradually in some women, yet are more abrupt in others. There are also a wide range of physical and psychological signs and symptoms associated with menopause. In some women they are very mild while in others they are more severe. They may last for only a few months, or may continue for several years. The average length of time for menopausal symptoms to be experienced is three to five years.
Psychological signs and symptoms may include Anxiety Reduced interest in sex Irritability and mood swings Difficulty concentrating Loss of confidence Forgetfulness Difficulty sleeping
Physical signs and symptoms may include
Depression
Hot flushes (occurring in approximately 60% of women)
Diagnosis
Sweats (often at night) Tiredness Headaches Joint and bone pain Palpitations Unusual skin sensations Vaginal dryness, incontinence and infections of the urinary tract and vagina may occur due to the thinning of the vagina and bladder walls
There is no one test to diagnose menopause. Symptoms may indicate that menopause is imminent but menopause can only be confirmed retrospectively after periods have been absent for one year. Blood tests may be taken at this time as the levels of hormones produced by the pituitary gland - follicle stimulating hormone (FSH) and luteinizing hormone (LH) - may be higher if menopause has occurred. A change in bleeding patterns, particularly where periods become heavier, and an absence of periods (amenorrhoea) can indicate various medical conditions. It is therefore advisable to consult a doctor before assuming that the changes are menopausal symptoms. Also, if bleeding occurs after periods have been absent for a year, a doctor should be consulted, as this is not considered normal.
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There are so many myths and misconceptions about the menopause, it’s no wonder that women can get confused
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2.3 Myths and Misconceptions Perhaps the biggest myth about menopause is that it’s the beginning of the end. That may have been true in the sixth century, when the average age of menopause coincided with or often surpassed life expectancy, but today women are living longer and healthier lives than ever before. The average woman can now expect to live about one-third of her adult life after menopause, which typically begins around age 51. And for many women, those years are a time of growth and opportunity.
After menopause, your body doesn’t produce hormones
It is not the miserable experience it’s often made out to be. Some of the common myths are:
Menopause means you’re officially old
Most women going through menopause experience depression. Menopause happens suddenly. All women experience unpleasant symptoms during menopause Most women need to take hormone replacement therapy after menopause.
Menopause begins at 50 A definite link exists between cancer, heart disease and hormone treatment.
The menopause is an illness There are a number of myths which have sprung up around the menopause. The problem with these is that they further increase the stigmatisation of menopause which is unhelpful for all women. Menopause is still a taboo subject and in our youth-obsessed culture, it can often knock a woman’s confidence.
But because we don’t talk about it, a lot of misconceptions persist
Women gain a lot of weight after menopause. You can still get pregnant after menopause. Women stop having sex after menopause.
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+
source: http://www.yourarticlelibrary.com/history/the-status-of-women-in-india-from-4th-century-bc-to-ad-6th-century/4443/
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2.4 Women’s Healthcare Scenario The concept of “Gender Inclusivity” in its true sense echoes the sentiment of providing equal opportunities and same treatment to everyone irrespective of their gender and special gender sensitive treatment as and when required after rational evaluation. 228+ million Indian women are in reproductive age (15 – 44 years).Various socio-cultural barriers, myths, taboos, superstitions still prevail in our societies when it comes to women’s reproductive and intimate health due to lesser awareness (even among educated, urban women) regarding their bodies. Practices like female feticide, female genital mutilation (in various cultures), and separatist treatment subjected to females during menstruation, irrational approach towards contraception etc. still exist. Even today, something as normal and regular in a female’s life like “periods” is considered an ‘impure’ phase of month when she is not allowed to enter temples and given a different but denigrating treatment.
Major Concerns in Women’s Health To get some hold on the situation of women’s health, the cases of breast/ cervical/ovarian cancers, PCOD (Polycystic Ovarian Disorder) etc. are rising and a major reason for failure is lack of awareness and regular screening for the relevant symptoms among women. Some appalling statistical figures sourced from WHO indicate the gravity of gap between diagnoses of life- threatening diseases in India versus number of patients dying due to them each year. According to Indian Cancer Registry, for Breast Cancer, there were 70,000+ registered cases versus 396000 deaths (2012) whereas Cervical Cancer figures are also disappointing with 70,000 women dying out of 134000 diagnosed women. A metabolic and lifestyle related disorder called PCOS (Polycystic Ovarian Syndrome) is proving to be the increasingly occurring syndrome in young Indian girls and a leading cause of infertility. In India, nearly 40% women are suffering from PCOS.
Socio-economic status of women has also affected their educational status, the space women occupy in the workforce. Women-friendly organizational policies and workplaces are more often than not considered an essential factor which is why there is need for gender inclusivity on a bigger scale at organizational level. When it comes to healthcare, women in spite of being primary caregivers to the family still aren’t the major decision makers for the important issues and this kind of second grade citizen treatment also affects on the way they consider and treat themselves, as often secondary to the males. Organizations like SEWA, Chetna; government initiatives like Janani Suraksha Yojna, primary healthcare centres and Anganwadis are already working tirelessly towards the development of healthcare scenario in rural and semirural areas.
There is “information explosion” on various websites, blogs and social networking platforms. Hence authentic, credible, specific and personalized information from right source is highly essential for avoiding confusions and deriving right amount of information for health issues.
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When we say, socio-cultural barriers and its role in hindering people, especially women to access healthcare or consult a doctor physically for their intimate health issues there occur various behavioral patterns like shyness, embarrassment, reluctance, procrastination on their end to discuss their private health concerns with the doctors and experts, not asking for help or treatment on the right time, which may lead to detrimental situation in some cases. During our lifetime, we must have definitely heard statements like,
Intimate health still remains to be a hush-hush topic, something that can be laughed over text messages and jokes, but is rarely discussed, taught and guided appropriately, with the right of communication. With a jet-setting lifestyle in urban and semi-urban areas, stress has become a major concern in our society. Nielsen survey says that 80% of Indian women remain stressed.
This is a temporary thing, let me wait.” “How do I even talk about this to anyone?” “What if there is a male gynecologist to examine me?” It is also fair to say that India is a country of taboos, myths and various culture-specific beliefs and traditions that govern our lifestyles. And these taboos become even stronger when it comes to intimate and reproductive health. How easy is it for a female in India to ask for a pack of sanitary napkins without getting it wrapped in a paper and a black or opaque polythene bag? How many temples and Indian homes are OK with women participating in any religious activity or entering into the temple during their menstruation? The process that runs the lifecycle on Earth apparently makes a woman “impure” during “that time of the month” How easy and comfortable it is for majority of our men to go over counter and ask for a pack of condoms?
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?
Women are among the most important part of a family in any society. Worldwide, life expectancy of women is increasing, together with the number of years women live after menopause and the number of women who experience menopause. Men and women in India in the 60 plus age group number 60 million. Projection for the year 2025 shows that ageing population would increase to about 12% of the total and roughly half of this population will be women in the elderly age group (Bavadam, 1999).
Therefore, if lack of preparedness exists in a woman’s life, a lot of other associated adjustment problems can also make their way in her personal and professional life.
The years around menopause constitute a period in a woman’s life that is affected by hormonal, physiological as well as psychological and social changes (Mc Kinlay et al. 1992). Menopause and post-menopausal health is emerging as an important issue owing to rapid increased longevity in middle aged Indian women. However, unfortunately, the awareness and management of issues concerning menopause has been limited in India and menopausal health has remained a neglected area in the country. Most Indian women remain uninformed regarding the short-term and long term implications of the morbid conditions associated with menopause, due to lack of awareness and the inability to bear the ever-increasing cost of the medical or health care (Sengupta, 2003).
Awareness about menopause is determined by education, socioeconomic backgrounds and whether women reside in urban or rural settings. The findings also revealed that women who have high level of menopausal awareness were less likely to fall a prey to depression, while women who have less awareness about menopause may be confused about the changes happening to them which can make them anxious, irritated or feel helpless. Such women find it difficult to cope with the changing life, may become depressed. This may further lead to strained relationships and marital discord. Thus, women who are well aware of the menopausal change can prepare themselves in a positive way and lead a healthy life. Women are often wrongly informed about the onset, nature and management of menopausal symptoms. Interventions that provide information and support in a timely and sensitive manner will benefit all perimenopausal and postmenopausal women. There is hence a need for the enlightenment of women and the society at large about menopause.
The present research sought to study the difference between the levels of menopausal awareness among women belonging to different menopausal stages, educational backgrounds, occupational status, urban rural settings and socio-economic status. Another objective of the study was to see if low or high levels of menopausal awareness affect the marital satisfaction of such women or lead to any kind of depression in them.
Talking about menopause is a double-edged sword for while it helps to be informed, dwelling on it may transform an event most women cope with readily into a source of worry.
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source: http://darkroom.baltimoresun.com/wp-content/uploads/2014/05/REU-INDIA_1.jpg
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2.5 Indian Women and Menopause It is not a secret that the common perception is that Western cultures treats older women as if they were less valuable members of society. You may not feel such change in societal attitude, but nevertheless it exists.Yes, the processes in our society obviously move the people’s attitude in a favorable direction, however, the shift in minds is gradual and slow. But in other cultures, menopause is considered as honorable, useful, and spiritual time in their lives. There are also cultures and countries, where the menopause is still considered as untouchable topic for discussion. While menopausal women in India experience the similar emotional and physiological problems, it is almost officially unheard of in public circles. India has traditionally ignored women’s health issues including menopause, and only the latest societal trends are attempting to break the outdated attitudes towards women.
Menopause attitudes in India Women in India are no different in terms of attitudes towards menopause; some women dread and fear menopause while other women embrace or at least accept menopause. The fear and dread of menopause stem from being seen as no longer useful or productive in society. For the most part, life for Indian women centers on home and family while accepting secondary citizen status in this male dominated culture. Women’s issues including health and menopause are almost never discussed.
Bangalore Study (Institute for Social and Economic Change) For the study, researchers of ISEC used data from the National Family Health Survey, conducted in 1988 and 1999, which examined about 90,000 married women ages 15 to 49 across 26 Indian states The study found that 3.1% of women living in India became menopausal between ages 30 and 34, 8% of women experienced menopause by age 39 and 19% of were menopausal by age 41. The average menopausal age in India is 44.3 years. The study found that premature menopause was most common in rural areas, as well as among agricultural workers, women who were illiterate and women who had a low body mass index. According to the researchers, malnutrition and poverty are believed to be contributing factors to premature menopause; however, the study did not address these factors.
Menopause symptoms vary from woman to woman in India as is the case for women elsewhere.
The flip side notes the relief women feel about the end of having menstrual periods. Although women always remain subservient to men, older women in India do enjoy a measure of respect as the senior member of the family. Unfortunately this enhanced status does not make it easier for women to talk about or seek help for menopause.
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Indian Menopause Society Report The Indian Menopause Society’s (IMS) 2008 Consensus Statement contains important statistics about menopausal symptoms, recommendations to improve healthcare for Indian women. Some of the IMS research findings show: The average age of menopause in India is 47.5 years, which is higher than posted in the previous research, but is still slightly lower than the average age of 51 for North American and European women. However, the premature menopause cases are on the rise in India due to a combination of environmental and genetic reasons.
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Indian women living in rural areas (72% of the population) and urban areas both cite having urogenital symptoms and general body aches and pains. Interestingly, women in urban areas complain more about having hot flashes, mood swings, psychological problems, and intercourse challenges. Like their Western counterparts, urban-based Indian women are subjected to more demanding and fast-paced lifestyles which may explain the differences in symptom reporting.
Osteoporosis is a serious risk for Indian women. Osteopenia, or low bone mineral density (BMD) usually means a greater chance of developing osteoporosis. Approximately 35-40% of Indian women aged 40-65 suffer from osteopenia. Indian women tend to have low bone density due to a lack of both sufficient calcium intake and adequate exercise
Cardiovascular disease is quickly becoming one of the leading causes of death in women and Indian women are no exception. Higher HDL/ LDL cholesterol and triglyceride levels, increased high blood pressure occurrences, and obesity rates among menopausal Indian women (and women of all ages) translate into increased risks for heart attacks and strokes. Diabetes rates are also on the rise for women in India.
Arthritis Hypertension Diabetes
12
Menopausal Symptoms
No. of cases
15
10
5
0
<40
40-45
45-50
Age at Menopause
>50
10 8 6 4 2 0
<40
40-45
45-50
>50
Age at Menopause
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Cultural barriers There are cultural barriers along with fears, concerns, and myths about the side effects of hormones in general. Improper compliance of patients on advice of life style changes and medication is another problem. The high cost and non-availability of full range of therapy through the country make tailoring of treatment for individual women difficult at times. Moreover, there is lack of availability of diagnostic facilities for screening and monitoring of menopausal women including those on therapy. Many times, Indian symptomatic menopausal women are subjected to hormone replacement therapy based on Western experiences. Discontinuation rate is very high among Indian women due to myths and misconceptions. Changes in India are slowly happening and though it may take several decades, talking about and seeking help for menopause will help to improve the lives of women in India
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03
Design Process 3.1 Methodology
50-53
3.2 User Study - Women
54-63
- Doctors
64-71
- Husbands & Children
72-75
3.3 User Persona Study
76-79
3.4 Insights from the Research
80-87
3.5 Why Communication Design?
88-89
3.6 OoWomaniya Context
90-93
3.7 Redefined Brief
94-95
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Women
Design Concept
45 - 50 years | < 40 years
02 Persona building
Why Communication Design?
Design Development
OoWomaniya Business Model
User Study
Information Collection
Studying existing examples
01
03
05
ANALYSIS & SYNTHESIS
Children
EXECUTE SOLUTION Insight from Research
Doctors
Focus group
User testing Design Direction
Identifying Touchpoints
04 Stakeholders
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RedeďŹ ned Brief
Design Structure
Final Output
3.1 Methodology After the initial data collection process, the Methodology followed was very complex. Due to the nature of the project, there were many parallel steps taken in a certain direction with the purpose of understanding the subject, stakeholders, target group and the existing problems in the same domain. An attempt was made to understand the topic through different perspectives and different levels in order to come up with an effective design solution. The Design process adopted consisted of various individual stages. These stages are:
Design can make a game-changing contribution to social innovation, but to do that, designers need a way to immerse themselves in the contexts where social innovation happens, acquire the skills they need to play a leading role, and a means to facilitate the process and foster collaboration. The big opportunity is to apply the creativity, skills, vision, and methods of design to the entire process of social innovation—to work from inside the system, helping people see the same things, connect the silos, and make sense of problems by making them imaginable and accessible. Design helps define a path forward. It untangles the complicated processes and players, helping us map what’s working and where.
Discover –identify, research and understand the initial problem. Define – limit and define a clear problem to be solved. Develop – focus on and develop a solution. Deliver – test and evaluate, ready the concept for production and launch. Social Innovation in terms of Women’s Health issues is always a challenge. Design for social innovation is really interaction design in the broadest sense; it’s interaction between people that takes responsibility for positive, systemic impact. It can take any and every physical or visible form but it inevitably begins with the invisible dynamics and forces that drive human behavior. It takes place within the communities and systems it’s working with, not outside them
Design for social innovation includes the design of everything: from the conversations, communication campaigns, experiences, structures, technology platforms, systems, products, business models, strategies, art, and culture. It incorporates all traditional and new design disciplines and mediums— identity, interactive, film, product, movement, and game design. It has the potential to be the single integrating force we need to take on the challenges we face—systemically and sustainably.
Design for Social Innovation is really interaction design in the broadset sense; it’s interaction between people that takes responsibility for positive systemic impact
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Women
Design Concept
45 - 50 years | < 40 years
02
Persona building
Why Communication Design?
Design Development
OoWomaniya Business Model
User Study
Information Collection
Studying existing examples
01
03
05
ANALYSIS & SYNTHESIS
Children
EXECUTE SOLUTION Insight from Research
Doctors
Focus group
User testing Design Direction
Identifying Touchpoints
04 Stakeholders
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RedeďŹ ned Brief
Design Structure
Final Output
Discover The initial part of the project was focuesd on understanding the topic and talking to the target group, stakeholders and others about Menopause. Menopause being very genric in nature, the scope of research was very broad and often overlapping with other issues. The research required a very careful approach considering the fact that it is a sensitive topic. It was considerably easy to talk to women about Menopause. Everyone had something to share. Irrespective of what socio- economic background they came from, they felt connected to it. The only apprehension was when it came to discussing about their relationship with their husbands/ partners. It was often just not about themselves but about all the people within their close family/ friends circle.
The different stake holders considered for the research were: THE TARGET GROUP - 40- 55 years old women DOCTORS - Gynecologist HUSBANDS/ PARTNERS CHILDREN
STAKEHOLDERS
TARGET GROUP
Doctors
Women
Children
Husbands/ Partners
45 - 50 years | < 40 years
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3.2 User Study - Women The women chosen for the interviews were all either in their Peri- Menopausal age or the post Menopausal age. The outcome was so diverse, yet so similar in nature. There was apprehension in the beginning about how much could they reveal about their personal life. And it was very interesting that none of them hesitated when it came to sharing their physical symptoms but only when the topic crossed over to the psychological factor. The anguish and distress expressed were mainly because they werenâ&#x20AC;&#x2122;t just talking about themselves but about people who are close to them.
One common factor that reflected through this research is that women seldom think about themselves first, their priorities are always surrounding the people they care the most about. Health often takes a backseat.
STAKEHOLDERS
TARGET GROUP
Doctors
Women 45 - 50 years | < 40 years
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Children
Husbands/ Partners
OMANA MENON
AGE (in years)
53
Mother of two Works in South Indian Bank
Temper issues Irritation Sleeplessness Dry Skin High Bloodpressure
Anxiety Negative Thoughts Fatigue
Her period cycle stopped at 52. She suffered from excessive palpitation. Bleeding was normal before Menopause. Had temper issues and irritation. The family doctor never connected these symptoms to Menopause. He gave her medicines instead. Her blood pressure shot till 200. She had hot flushes and excessive sweating. No one who was with her ever understood what she was going through. She was hospitalized twice because of high blood pressure. Even that time she asked her family doctor if it was due to menopause but he never said anything regarding menopause because her periods were normal. Her skin had become very dry, throughout my body.
I told my husband about it. He discussed it with his colleagues and then realized that their wives were also going through the same thing. I kept reading about it and started doing exercises, going for walks and doing yoga. I used to take sleep for granted. Used to sleep the entire time. Everyone used to complain about my excessive sleep. I understood the importance of sleep during this period. I used to feel drowsy but not able to sleep at all. All these years I had no fear but suddenly all that manifested into demons that you would have never thought about during menopause. I suffered for almost 7-8 months. Now I have no symptoms.
In her own words, ‘I felt like I had gone insane. My thoughts used to be never ending. I used to be depressed. Everybody says don’t overthink, but that’s when I realized that it wasn’t in my power to control my thoughts. We can’t make someone to think in a positive way just by telling them to think positive. The moment I used to be alone, the negative thoughts used to overpower me. I never felt like ending my life, but I had this constant fear of death. The doctor said you were getting to sensitive and gave me anti-depressant. It made me even more agitated. But I didn’t take it. He then put me on hormonal pills. It made me so much calmer.
I told both my sons and my husband everything. I didn’t hide because they were sons. I told them that if I yell at you, it’s because of Menopause. Not because I don’t love you all.’
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RANJANA HARISH
AGE (in years)
55
Retired HOD English Department Gujarat University
Her period cycle stopped at 53. In her own words, ‘All that I went through must have gone under the name of professional anxiety. I was at space where I was expected to perform. I never allowed it to affect my social image in front of my students. I had hot flushes. But I would be in front of a class of 200 English professors and I had to do it. I had no choice. I was so occupied that I had no time to think about my anxiety and problems. I did notice the symptoms.’ Though she didn’t suffer much during her Menopause, her sister had a very difficult experience. She lost her life to Lung cancer but the initial symptoms were brushed off in the name of Menopause. She says, ‘My sister was detected with cancer at the age of Menopause. She had Lung cancer. She was herself very highly educated. Both , she and her husband were US citizens. Her husband was a practicing doctor. It wasn’t like they were a non- medico family or illiterates who didn’t know anything about Menopause. Very well to do. Very much aware of everything and forward compared to even us, wherein the lady of the family, my sister was very much respected.
Hot flushes Anxiety Excessive Bleeding
Once on her way home, while driving she realized that she was feeling giddy. So she called up her husband and told her she was feeling giddy. She then took a break and then start driving again. She went home, felt weakness. She was almost fainting. Some Indian doctor friend who came home next day told her, ‘You don’t have any problem, you’re just passing through menopause. You just had your yearly checkup done, everything is normal, you’re completely fine’. In that one week , her husband consulted many doctors and everyone after going through the report told her that this was just a passing phase and that it was Menopause. Finally she insisted that she wanted to go to an American doctor. She went to the doctor without telling anybody else. She underwent all the tests and when the tests came, she realized that she was suffering from Lung Cancer and brain cancer. It was metastasis cancer. They did whatever was possible. She was a very courageous women and fought cancer. Children were very young. They suffered the most She lived for 3 years.
Symptoms
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She would constantly blame the mindset regarding menopause whether it is India or America. Whether it is men or women. All of them have similar kind of attitude to female body. If a female body is unwell within the age of 40-55 years, that is a range of 15 years then no need to pay any attention. That is going to be Menopause. If she is upset, then it is the same. Whatever it is, blame it on Menopause. No need to go for a checkup, no need to pay any attention. Her husband was a very caring person and a really good father. He was a doctor too, being supported by a big group of doctor fraternity. So it was not like it was someone with no connection, yet he failed in the diagnosis. Years later, she wrote her own story for a newspaper interview. It wasn’t about her achievement but about how everyone in the society sees menopause. But then later, they found that such a good article with a very strong comment on a female’s body could not be published because the media wasn’t interested in this story, but in her achievement. It was a tragic story of a very successful woman whose death was not due to cancer but due to the interference of misconception regarding menopause amongst Indian men and women who have been staying in US for the last 30-35 years and still couldn’t think beyond Menopause. This is a loss for Menopause.
I hate the term Menopause because I lost my sister to Menopause Screening is very important from the age of 40. Indian girls, they really need to wake up. Everyone must go for Mammogram, PAP test. Women in India are not taught to own their body right from the childhood. We never talk about our body with other women. Whatever comes, comes as a discovery or surprise. You also internalize a message that your body is not worth talking about.
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PREETHA CHAUDHARY
AGE (in years)
55
Mother of two Ex- Bank Employee
Pritha Chaudhary is a 55 year old woman who experienced menopause at the age of 48. She is an ex-bank employee and her husband passed away after certain number of years into there marriage.She is the mother of two children – a young woman and boy. When asked about her experience Ms.Pritha stated that the hormonal changes that her body underwent in the onset of the menopause were very exhausting physically and emotionally. It would cause excessive sweating, irregular or excessive menstural flow, throbbing leg aches, menstral cycles lasting upto 15 days sometimes, mood swings, depression and giddiness among other symptoms. She stated that the biggest solace for her was that she already knew about menopause and she had read material online. She would inform her daughter about her mood swings, thus prepare her mentally. Ms.Chaudhary stated that she suffered from chronic anemia all her life which became an immense burden for her while suffering the symptoms of menopause. But she was never scared or troubled at any level because of her awareness about the subject. She claimed that she often found solace in homeopathic medicines that she took.
Excessive Sweating Irregular menstrual flow Leg aches Chronic Anemia
Mood swings Depression Giddiness
She understood that it was a passing phase in her life. She would read and take a nice shower, which also helped liven up her mood. She never spoke to any of her sisters or needed a gynecologist as she was well prepared in advance.She compensated her body with iron supplements which helped her physically strengthen her body. She also stated that due to her husband not being around she could go through her suffering all by herself instead of having to also undergo the worry of having to reach out for the support of her partner. She strongly felt that men don’t understand what a woman goes through when they undergo all the changes and become highly irritable at a woman’s lessened libido.This is her opinion creates a lot of rift between the partners and adds further to the misery of a woman. She stated that her being busy with work and taking care of her children also added to her easily transitioning into menopause.
Symptoms
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JAYASHRI VASU
AGE (in years)
55
Mother of two Officer in BOI
High Bloodpressure Heavy Breasts Chronic UTI Diabetes
She was the main inspiration to take up this project. Having seen her go through a very difficult phase wasn’t easy.
But small lumps in my right breast first and then in my left breast was detected and I had to undergo all the tests to rule out Cancer. They were found to be nonmalignant. But the hormone tablets were stopped immediately.
In her own words, I started getting irregular & heavy periods from the age of 45 yrs. My gynec gave me the reason for this MENOPAUSE . I was surprised as I felt this was quite early . The reason given to me was - since I had attained puberty at the age of 9 yrs menopause too commences early. Chronic Urinary Tract Infection for nearly last 5 yrs has made my life miserable. Thanks to the support given by my husband , daughter & son . I have not had hot flushes till date, but frequent mood swings and an urge to cry for no reason at all . All the pre menstrual symptoms existed like heavy breasts, feeling of fullness, decrease in sexual desire , pain in the breasts etc and then followed by Urinary Tract Infection. This was my cycle for nearly two to three years. To reduce this attack of UTI I was put on hormone tablets . I had a very good relief and the attacks also was reduced.
Anxiety Negative Thoughts Fatigue
Today I am 54 years old now and a diabetic . Though the frequency of attacks have considerably come down, the problem still persists. As per my Urologist’s advise I have started taking a mild dose of antibiotic ( Nitrofurantone – 100 mg) on daily basis. On stopping this medicine, all the symptoms of UTI crops up .It is almost a year I have been on this antibiotic. Now I am having the side effects like numbness of my feet, sudden attacks of loose motions etc for which I am scheduled to meet neurologist & Gastroenterologist. Thus goes my story relating to MENOPAUSE. I am not sure how long it will take when I will be free of all the complaints but still am happy and grateful to my family members for the immense support & understanding .
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SONAL DESHPANDE
AGE (in years)
50
Mother of two Psychological Counsellor
She has been counselling women for different issues right from Menopause to cancer patients and survivors. With an experience in this field for more than 20 years, her views and points helped this project to shape up in this certain direction. It wasn’t just her personal experience but also the stories she shared about different women she has counselled over the last few years. The excerpt from her interview is as follows: There’s a feeling of insecurity. I don’t know what’s happening with my body. And the worst part is during those stages of menopause, all your mood swings and changes are written off as menopause ‘Oh, she is going through Menopause’ which is terrible. The person needs to understand that this beyond her control. This is not something where she’ll pop a pill and the issues would be gone. There is a level of understanding that everyone needs to possess. It’s a long process, goes on for months. And that is probably the time where the children are getting married or away for studies, she is all by herself. And that’s the time when she is taken for granted. It’s not the initial years of marriage where everything is happy and rosy.
Hot flushes Irregular menstrual flow Chronic Anemia
Mood swings Depression Giddiness
Her mood is off, so let’s take her out for a movie, or shopping and then go back to being ourselves. It’s not that, she needs immense emotional support. Our society doesn’t understand this need at all. They fail to grasp that a woman requires a lot of pampering, gentle words and emotional support. After sometime, we take our parents for granted. Especially if she is a homemaker, we feel she’s always there for us. And one day if she doesn’t feel like doing something, we knowingly or unknowingly end up hurting our moms. Even if we get this level of sensitivity, it’ll make a vast difference. 2 or 3 % women have a very smooth transition during menopause. In the initial stages of menopause, the woman herself is not aware that these changes are because of Menopause. For no reason there is irritability. For no reason she can’t stand certain people with whom she has lived for so many years. For no reason the type of work, house work or whatever she was doing, puts her off. The smell puts her off, the colour puts her off. Unexplainable changes that she doesn’t understand why it is happening. That is the time when heavy periods, irregular periods and when you approach the gynecologist, she would probably tell her about menopause. Symptoms
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There are all these small small triggers that are enough to bring her to tears. She should be encouraged to develop a hobby. We’re too much into external factors and always seeking for approval but never do anything for ourselves. By the time you’re nearing 50, you need to do something that inculcates a sense of peace like walking, music and anything that interests you and is your domain. It makes you feel internally nourished.You engross yourself in something you wanted to do all these years but never got time. Totally soak yourself into this. How a couple function in their personal space is not something that is discussed outside but outside they’re okay and try to understand what menopause is. All these years you’ve been neglected and suddenly you’re showered with attention, then it might probably irritate her. It has to come from inside, not just done for the sake of keeping her in a good mood. So it varies from person to person. There are a lot of emotional backlog that comes to light during this period and the family is shocked as to why is she being so violent and why is she behaving in such a way? That’s why the family needs to be educated and sensitized. If there are children, especially a girl child, it’s better to go through her probably because she will understand whereas men would give a lip service. Menopause is just one of phases. For men it’s difficult to understand that if periods, the back pain of all these years and the PMS is going to get over, then why this distress suddenly? They fail to grasp this. This is where a medical practitioner would be able to help because men are more logical, analytical and practical in their thinking. Women might suffer from physiological symptoms and hence eventually understand what menopause is. Screening tests are something that women of all ages need to get it done. Age has nothing to do with it. Just that the chances of getting one of those ailments is more because of the drastic hormonal changes. Breast self examination, PAP smear test. Specially after 35 years, every year you need to get it done along with Mammogram irrespective of menopause. Only 25-30% women are aware about it, even in a well educated society. They would come and ask ‘ What’s a PAP smear?’
More than over sensitizing, half fed information is dangerous. Internet and social media does more harm than help us. A little bit spiritual approach also helps. By the time she is 40, her life is literally cruising, she’s into family everything. This is probably like a break, intervention which says it’s a time to take a break where she tests the relationships she thought was the most important. This is the boon to the woman to understand where exactly she stands in the circle of society and from then on she can prioritize her life. Her journey within begins because once she has understood well, she starts relating to everything, and finally says, ‘ME NO PAUSE, from now on I’m going to be working for myself. So instead of us crying about menopause, we should be thankful for this break. For being able to take charge of your life. Living life on my terms. In our society, we totally submerge ourselves into everything and in the end think ‘what have I done for myself? I have not lived my life the way I wanted to.’You don’t have to feel guilty. Our society makes us feel so guilty for all choices, for living the way we want to. But this is not the end to your story. After sometime, we take our parents for granted.
Menopause is just one of the phases Menopause should be considered as ME- NO- PAUSE The family needs to be educated and sensitized
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AARTI ABRAHAM
AGE (in years)
Graphic Designer
51 ‘I’m going through something like pre menopause. It feels Painful, Irritating The hormonal changes typically happens at night you don’t tend to sleep so well and therefore a lot of insomnia problems. It’s been almost a year. The unfortunate thing is people don’t talk about this. Menopause is connected with old age and people don’t like to address that. My husband was aware and I didn’t have to tell him. During menopause you will be little cracked. The ability of your sleep goes down, because of hormonal changes. And your body will be working all the time. People don’t understand it usually and will tend to say things that are crazy. Telling things to your children helps them a lot. My daughter is 25 and my son is 18 they think that their mother is insane, but still they know.’
Painful Insomnia Irritation Temper Issues
On being asked if her daughter is sensitive, she said, ‘ Yes she is sensitive , also I am talking to her about this so that when it happens to her she can deal with it. Nobody ever told me anything. Mother has to tell these things to the daughter. I guess that will help. And so many things are available online so its very easy. If my mother, probably some 20 years ago would have explained the whole process of menopause to me, I would would have been prepared.
Symptoms
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OTHER WOMEN INTERVIEWED During the last few months while working on the Menopause project, different encounters with women helped in the better understanding of the topic. Taking a complete detailed interview of all these women wasnâ&#x20AC;&#x2122;t always possible due to space and time constraints. But even a small little chat with them proved helpful. Sometimes it was over a casual dinner where a particular family was discussing how they had a rough start in the morning due to the motherâ&#x20AC;&#x2122;s bad mood and so on or an encounter with a woman sitting at a radiation centre for a sonography to be done. All these different conversations helped me to analyse the project scope of work and decide the design direction to be taken. Few of them are: Margie Sastry
Tridha Gajjar
Meena Srikanth
Lakshmi K Nair
Shampa Biswas
Radha Natarajan
Prapti Iyengar
Geeta Rajesh
Vaishali Kannan
Sneha Iyer
Kreena Patel
Dr Shefali Shah
Preeti Das
Pamela DeSouza
Dr Gauri Amonkar
Dr Aakash Doshi
Dr Vishal Kini
Krutika Katrat
Neeti Chavan
Rishika Bhashyakarla
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3.2 User Study - Doctor Women generally never go to see their doctor when they go through the menopause - they may see the menopause as a normal phase of life and have few problems. Others may use self-help measures such as diet and exercise or complementary therapies to relieve the symptoms. It is often only when women become concerned about symptoms, cannot cope and are at their ‘wits end’ that they see their doctor. Women talked about going to the doctor during the menopause and described positive and negative experiences.
She may consult her doctor during the menopause for reassurance, support, information and/or advice about treatment options. Women’s experiences vary greatly. Women felt supported in making well-informed choices. Along with the medical knowledge, the doctors were also able to give an insight about the psyche of the different kinds of women/ patients they treat and counsel.
STAKEHOLDERS
TARGET GROUP
Doctors
Women 45 - 50 years | < 40 years
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Children
Husbands/ Partners
DR NITA THAKRE
MBBS MD Obstetrics & Gynaecology
PAP Smear Breast checkup Mammography Sonography
Dr. Nita Thakre is a Gynecologist practicing in Ahmedabad. She stated that she deals with a lot of patients regarding Menopause issues. She has a private practice of her own and also contributes to the local Kachi Jain trust where she treats patients who come from poor classes of the society. She feels that it is her way of contributing a little something to the greater good. She stated that the issues related to menopause for which the patients seek her help for are very varied but essentially they fall under the category of
a) Stoppage of menstrual cycles b) Hot flushes patients experience at the onset of menopause c) Decreased libido d) Irritation/burning sensations in private parts
She also clearly stated that menopause is not just related to the patient undergoing the changes but happens to be a social issue. It affects the patient and the social environment around them which includes the near and dear of the patient. Since the onset or conclusion of the menopause is not define and varies from patient to patient, Dr. Thakre mentioned that it more often than not illicit varied range of responses from the family members. She mentions that the burden often falls on the woman to keep it together and not having partners who share the concerns. She also mentioned that exceptions exist to the rule as well. The economic background of the patients also have a major role to play according to Dr. Thakre If the patient is extremely rich, the husbands or partners more often than not demand of the doctor to put an end to the misery the wife/woman is causing to them. If the partner is caring and from a middle class family they often just want to get out of it but donâ&#x20AC;&#x2122;t make a hue and cry.
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People of lower classes, according to Dr.Thakre more often than not donâ&#x20AC;&#x2122;t have the vocabulary or the aptitude to understand the changes happening to the woman as they have other life-altering choices to make. But nevertheless she states that people from lower classes often go for full body checkups and ensure that the partner is healthy. Dr. Thakre quotes an article that she had once read in a leading newspaper where a wife put her husband and children through great misery before committing suicide. The husband, later stated that he was happy about the actions of his wife since it caused a great deal of sorrow and misery for his children and himself. Dr. Thakre goes on to say that she feels that such patients, as the wife mentioned in the article require the most assistance from medical professionals so that the patient and the family does not have to go through such tragic times. Dr. Thakre feels that government is doing a lot for the welfare of the poor but not enough for the middle class. She feels that government should provide more towards the urban classes by providing them subsidies as it does for the poor because they have better capacity to grasp what is happening to the patient. She also states that the existing welfare plans provided to the poor are well put and implemented. According to the doctor another solution in tackling the problem is to setup more women health care centers, across the country and social classes so that more patients are treated and more issues are resolved quicker.
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Dr.Thakre mentions that a routine full body checkup is the most wise and recommended option for woman who are affected by menopause or are showing symptoms of attaining the stage. She suggested that as doctors, one should take down the full history of the patient. Then specific tests like PAPS , Breast checkup, Mammography, Sonography etc must also be done. She stated that most woman undergo weight issues as they near Menopause which adds to the changes happening in the body.
Menopause is just one of the phases Menopause should be considered as ME- NO- PAUSE The family needs to be educated and sensitized.
DR ANU VIJ
MBBS MD Obstetrics & Gynaecology Gynecologist
Peri menopausal depression is typical in people of a particular age group. It is an acute onset. We need to check proper history. The girls will have some patterns already showing in early life. Lower Self-esteem , body consciousness are all the reasons. If the person comes for the first time, you have to find whether it is menopause or something else and accordingly decide if we need to take help of a counselor. Relationship problems also affect depression. When the lady is in peri menopausal and menopausal stages the sexual relationships suffer. They will have urine leakage or their desires doesnâ&#x20AC;&#x2122;t match with their partners. So it leads to many family issues. So one thing adds another and piles up the depression factor. In this age group you will have many other physical ailments like diabetes, pressure, cholesterol, thyroid etc. And if your aged parents are staying with you, you have to take care of them, you have to take care of yourself. One thing causes another and leads to menopause blues.
Diabetes Blood pressure Cholestrol Thyroid
Dr. Anu Vij, in her tenure as chapter secretary in Navi Mumbai with Indian Menopause Society, has completed many projects like CMEâ&#x20AC;&#x2122;s conferences, the memorable one being the zonal conference, besides conduting many camps for the public.
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Women get disappointed at this point. We tell them that this is a new beginning. Their children are all settled. Their husbands are in the peak of their career. They have done whatever they could. It is a new life for you. try to unleash what you couldn.t do so far in life.
Her role in IMS Urban areas people proactively come for tests. Also in corporate companies there are these packages introduced for women. They are making it compulsory for husband and wife to take it.In rural areas it is totally different. Big companies offer annual tests in which everything is covered. in rural areas we have to go and make them aware. Money also is an issue. An average rural woman canâ&#x20AC;&#x2122;t afford a mammogram that too when she has so trouble. Preventive medicine is not active in our country. people will go to doctors only when they have trouble. The society provides a common forum for medical and other interested health professionals and people from all walks of life to work towards the goals of the society. We are still far away from creating awareness about menopause. We havenâ&#x20AC;&#x2122;t covered it all.
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DR DARSHANA
MBBS MD Obstetrics & Gynaecology
PAP smear Diabetes Cholestrol Thyroid
Dr. Darshana is a 45-year-old practicing doctor in the field of Gynecology. She stated that from her personal practicing experience she came to the conclusion that there isn’t enough awareness in people’s minds. She stated that according to the class to which the patients belong to their degree of anxiety related to the subject drastically changes.
She stated that Menopause is not a cut-off line rather different patients experience different symptoms and problems in all the three phases. Primary issues often being, bone care, physical and emotional well being of the patient. Irregular periods, mood swings, insomnia etc., she claimed were the different manifestations she often sees in her patients.
In her opinion, she feels that people are highly influenced by the information they acquire from the media, newspapers & the Internet and let it affect them. She stated that people from upper-middle class, specifically looked at menopause as a source of all the problems they face after a certain age. She explained that menopause has three phases –
She explained that more often than not, women tend to ignore their own health because in an Indian household, a woman often lacks the selfconfidence, is always asked to tolerate any issues or problems in their lives. She holds the opinion that the root of the problem is emotional which transforms into the physical manifestations into the patient’s body. She explained that patients should not consider Menopause as a phase that only brings distress, but instead, should be looked at as a new chapter in the lives of the patients and their families.
1) Pre-menopause – irregularity in periods begins 2) Menopause - 12 months and afterwards cessation of periods 3) Post- menopause – No periods and hormonal changes
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As a practitioner she personally takes care of the fact that she doesnâ&#x20AC;&#x2122;t scare her patients but rather educates them about all the possible issues that they might face. As a practitioner, she has implemented various measures to get the patients to take their health seriously and not let it take a back seat. She provides her patients with health coupons, audio productions where in she explains the issues pertaining to Menopause in a simple language. She suggested that music and reading are also immensely important tools in building the womanâ&#x20AC;&#x2122;s confidence. She also conducts seminars, small group talks where she creates a close environment between her and all her patients. All the patients come together and talk about their issues and feel that they are being heard which in turn improves their health. She was of the opinion that counseling, after understanding the socio-cultural context they come from also provides the extra amount of support that is needed for the patients.
Ultimately, the doctor stated that motivation and listening to the patients helps heal them completely and helps them to proceed with their lives smoothly.
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DR GAURI
MBBS MD Radiology
On asking about how many women come for getting the Menopausal screening tests done, her reply was â&#x20AC;&#x2DC; As we know people in 50s come under this situation and just like during the period of menstruation at the time of menopause also people have this fear, anxiety, excessive bleeding and lot of irritations happens. As its hormonal based we see a kind of depression, irritation and aggression in people because of this. Sometimes people donâ&#x20AC;&#x2122;t even realise this and hence it affects their family members also. It will be there for quite a long time compared to the difficulties caused using menstruation. But all these are very normal and natural.
Mammography Sonography
The moment you understand these changes just alter your habits to accommodate the change and if needed take some medical advice. As this is a very temporary thing in their life and if they take care of their food patterns and sleep patterns they can recover from these easily. Only if they slip to the secondary depression stage they need to meet a psychologist otherwise, all the issues gynaecologist can take care.
Awareness on this matter is very less, among themselves and among the family members. Usually the husband is very less aware of this. Mostly if an elder lady is there, they must now about this from their past experience and can help them. But again to recover from this it may take 3 to 5 years. Anxiety and fear happens because of the sudden excessive bleeding happens and because of that they become weak also Tests to be done Graduation Project Document // Second Innings Communication Design
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3.2 User Study - Husbands and Children Couples can have interpersonal problems that cause emotional distress completely unrelated to menopause. There may be stress over adjusting to issues such as children leaving home, caring for elderly parents, finances, and retirement. These issues need to be addressed with reference to whatever is the root cause of the problem—communication, self-worth, and more.
It is difficult for men to accept that they can do nothing to make menopausal symptoms go away. There are, however, many ways husbands can provide the one thing these women truly need: support. And that support will be awfully hard to offer if they don’t accept certain rules of encountering menopause moments. “Men want to fix everything,” one woman told me. “I just want him to hold me and tell me he still loves me.” Her sentiments ring true for many women. There is no easy fix for every problem that vexes the menopausal woman.
Women want to know they are cared for and cared about. They want to know that their husbands think about them. For women, that means discussing the ageing processes relevant to themselves and their husbands.
While some things can be done to alleviate some physical symptoms, it’s the emotional effects that have women—and men—so bewildered. Combine these two—the physical changes and the emotional ups and downs—and you have a situation that can frustrate a marriage and challenge a woman’s identity as a sexual being. The women agreed that husbands should be assured that they are rarely the true cause of emotional outbursts, but they may often be the recipients. Now that’s a tall order: asking men to bear the brunt of fluctuating emotions—without taking it personally. But if they don’t, they may be hurt in ways their wives never intended.
Menopausal mood swings are not easy for everyone to get around. It is particularly challenging for young children, who tend to have a very selfcentered view of the world, and can become frightened or upset about a situation because they are afraid that they are the cause of the moodiness, even though she is quite aware that the cause is irregular timing for taking medication. These mood swings can also have a substantial effect on other relationships even with adults.
One woman said, “My husband never knows exactly what he’ll find when he gets home from work. Some days I’m my normal self, which is pretty calm. Other days, I am off the wall. I am agitated and tearful. He comes in, and I just light right into him. I don’t mean to take my frustration out on him, but I do.”
Husbands don't need to be experts, but the interest is very encourageing
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The person was the same, but I still couldn’t recognise her
Some men understand, but I didn’t
The tension between us was very intense
Men Speak
It’s a pause for a man too Don’t try to ‘fix’ everything Ask questions, really listen, and respond
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I didnâ&#x20AC;&#x2122;t realize when she changed from my mom to a monster
I had no clue what had changed so much in her
It was like a war
Children Speak
I had no clue what she was going through We became friends eventually
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3.3 User Persona Study
Aruna | 38 years
Sindhu | 49 years
Pamela | 54 years
Works in a Bank
Lecturer in DU
Rotary Club President
Is going through all the symptoms of Menopause but still is not letting it affect her day to day life. Has a very supportive husband and children who understand her
A widow with 2 children, a son and a daughter. Had a very smooth and easy Menopause. Just suffered from 1 or 2 symptoms.
Is aware about Menpause and is dreading the onset of it because she has seen her mother suffer
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Archana | 25 years
Sudhir | 51years
Masters Student
CA Consultant
It’s not just the mother who is affected by Menopause
Had a very good relationship with her mom. But since the past few years, she feels like she doesn’t know her mom anymore. Her mother has changes so much, for bad. She doesn’t know what went wrong.
Trying to learn more about Menopause. He is worried about his wife. Recently got to know that his colleague’s wife is also going through the same. Hopes things get back to normal between him anf his wife
The women themselves are often clueless about it till it happens to them Psychological changes are often more prominent and neglected Support system is the most important factor during this period Awareness is very less amongst husbands and children
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Women
Design Concept
45 - 50 years | < 40 years
02 Persona building
Why Communication Design?
Design Development
OoWomaniya Business Model
User Study
Information Collection
Studying existing examples
01
03
05
ANALYSIS & SYNTHESIS
Children
EXECUTE SOLUTION Insight from Research
Doctors
Focus group
User testing Design Direction
Identifying Touchpoints
04 Stakeholders
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RedeďŹ ned Brief
Design Structure
Final Output
Define After all the interviews conducted, there were a few conclusions drawn which eventually lead to the design solution. The redefined brief was a crucial point in the project because the design development and execution would completely depend on it. After this point, it was equally necessary to go back and keep referring to the work done by OoWomaniya till now to make sure that the proposed design direction would fall in lines with their work done. The crucial stages in this phase were: Insights from the research Why Communication Design? How would it fit in the current OoWomaniya model Redefined Brief
The interviews conducted across the different subjects gave a holisitc view about the perception and the pre-conceived notions about Menopause. The different touchpoints in the research phase were: Identifying the circle of support Awareness level Openness to the discussion about it with not only the concerned woman but also with the others involved The cultural connotation The proactiveness in taking the concept of healthy ageing seriously
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3.4 Insights from the Research Identifying the circle of support
Relatives
The middle years of a woman’s life are surrounded by more myth and mystery than any other season she confronts. These myths can cause much fear and anxiety in the lives of middle aged women as they approach and deal with menopause and its effects. She is not the only person affected by your menopause. The other members of the family are also affected, sometimes in very significant ways.
Midlife is a time when changes in family dynamics, health problems and significant life events may coincide with menopausal symptoms. Husband/ partner
Children
Close friends
Women’s lives are complex, particularly at midlife. As well as balancing a work life with domestic responsibilities, women may be caring for young children, teenagers, grandchildren, ageing parents, and in some cases their partner. Women talked about the strain of looking after toddlers alongside older children, of caring for children with special needs, of supporting teenagers through exams, and of children leaving home only to return at some stage to fill the ‘empty nest’.
The menopause does not happen in isolation
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Lack of awareness about the topic
Psychological Symptoms are more troublesome
Each woman has a story
Lack of communication within the family members
Communication Issues
Sensitivity of the topic
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Lack of Awareness about the topic
Lack of communication with in family members
Many women arrive at their menopause years without knowing anything about what they might expect, or when or how the process might happen and how long it might take.Very often a woman has not been informed in any way about this stage of life; it may often be the case that she has received no information from her physician or from her older female family members, or from her social group. As a result a women who happens to undergo a strong perimenopause with a large number of different effect, may become confused and anxious, fearing that something abnormal in happening to her. This is a strong need for more information and more education among the women regarding menopause.
Parent- Child
Women have a more complex phase of old age than men because of the dominant effect in them of hormonal changes caused by menopause. However the public health care system does not acknowledge the specific health needs of older women. The same holds true for everyone who is around her. They equally lack in the knowledge about what is happening to the her. Menopause may be smooth experience for some women with only symptoms of cessation of menstrual flow while others face one or more of postmenopausal symptoms. But there is a lack of awareness of its cause, effect and management pertaining to it. a wide gap in the knowledge has been documented in the women.
Every family is different and has a different way of communicating. That goes true to even partners. After a certain years in a relationship, they just end up taking each other for granted. The lack of communication especially at the stage of middle life can manifest in very dangerous ways. There’s a huge gap between a parent and a child. It’s very unnatural for a mother to talk to her children about her menopause when previously there has been no talk about any kind of issues pertaining to adolesence or puberty of the child. The similar gap is sensed when a child is curious about what’s happening with her/ his mother but doesn’t know how to approch her because of the similar gap. Children often fail to recognise their parents as a biological beings but rather look at them as just parents.
There’s a thing about us Indians, our parents are literally called Gods and then secretly we start treating them as perfect human beings, people who can’t make mistakes, ever. - Aarti Nair
Overall, most women described menopause as back burner issue but maintain the need for accurate information from which to make informed decision that might impact future health and functional outcome
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Sensitivity of the Topic - My Mother, Myself As a part of understanding the relationship between a parent and a child, the book My Mother, Myself written by Nancy Firday proved very helpful. It contains pairs of interviews of mother- daughter and talks about their bodies. But neither of them know that the other one is talking. So it is individually taken interviews but printed as a pair. A mother talks about her experience of her body and how she prepared her daughter. The same situation been talked by the daughter. All these 1000 interviews were taken because the author wanted to know how generations of women, have talked about their body and how the communication happens. Finally she concludes ‘ No daughter looks upon her mom has a biological woman. The relationship between a mother- daughter is often of envy or competition or misunderstanding. Very often the daughter will confide more with the father. Mother is looked upon as someone who will always interfere with whatever she does. The day a daughter is ready to accept her mom as a biological woman and her needs as a biological woman, is only when the daughter gives birth to a daughter. That is perhaps the moment when she understands that her mother is also a biological woman. Whatever she had done which was socially wrong gets a different perspective. ‘
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She also talks about some pair of Jewish mother daughter. When the girl gets her first menstruation, the mother slaps her. The mother doesn’t sympathize or anything, she just slaps her very strongly, without any explanation. And that is the shock of her life that the daughter has to bear. Once you’re slapped like that when you’re a kid, there is all negative association with menstruation that the menstruations is sinful, wrong , mother does not like it. This was the tradition which reflects that in the community, the female body is of no relevance. So if the mother failed to understand what her daughter went through puberty, why would she make an effort to understand her mother’s menopause. Female body’s socio cultural unimportance gets extended to serious issues like Menopause, onset of menstruation. Both of them are not socio culturally important things. They are sidelined. The woman being dependent on men, she has learnt to internalize her body’s importance. Men of course have always looked down upon the women’s body as just flesh, but women themselves have also internalized their set of values. Unfortunately she ignores her body and her daughter’s body just like men do. Somewhere you can conclude that they mirror each other’s life events. Women collectively as a tradition, set up a tradition against themselves. They’re passing all these wrong messages. Mother acting on traditions and daughter reacting to the same during menopause by being indifferent to it. It’s patriarchal.
Psychological Symptoms are more troublesome Once a young woman starts menstruating, she may begin to experience emotional changes around the time of her period which is commonly called as Pre Menstrual Syndrome This accelerates around the time of menopause. Some women experience exhilaration, relief, and release, since they no longer have to worry about having periods or using birth control. In fact, many women report being happier after menopause than they were before. For other women, though, the rapid hormone fluctuations and the physical changes that are associated with menopause can lead to mood swings, anxiety, irritability, feelings of sadness, difficulties with memory and concentration, and even depression. Women have an increased risk of developing significant depressive symptoms after they enter menopause, even if they donâ&#x20AC;&#x2122;t have a history of depression. In many cases, these psychological symptoms show up way earlier than the actual physical changes like irregular periods, dry skin, weight gain etc. They act as very strong indication if observed carefully, but are ignored very easily. Many a times, women themselves fail to notice these small triggers while the people around her sense the change much earlier. The reason why it has to be studied and spoken about is because it is very closely related to the physical changes that are bound to take place eventually in her body and they effect others around her too.
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Each woman has a different story If there’s one thing we know, it’s that no two women are alike. And no two women experience menopause symptoms the same way. However every woman does have a story to share. Out of these stories come great awareness and assurance for women going through menopause for the first time or women who have been in menopause for a while and experiencing new and different symptoms. The truth is, while every story may be different, a large number of them have one thing in common. They got relief, and got their lives back. Menopause is a different experience for each woman who passes through it. Because our bodies are unique and different, like giving birth, where every labor is different, no two women experience menopause the same way. Some women have no disturbing symptoms and even arrive on the other side wondering what all the fuss is about. Other women have constant and numerous symptoms. The menopausal passage has the potential to alter women’s lives mentally, emotionally, physically, and spiritually, and many women move through this profound life passage alone.
sonder n. the realization that each random passerby is living a life as vivid and complex as your own—populated with their own ambitions, friends, routines, worries and inherited craziness—an epic story that continues invisibly around you like an anthill sprawling deep underground, with elaborate passageways to thousands of other lives that you’ll never know existed, in which you might appear only once, as an extra sipping coffee in the background, as a blur of traffic passing on the highway, as a lighted window at dusk.
This project is an attempt at opening some doors and beginning to explore the deeper roots of the menopausal experience in today’s time
This realisation is helps you cope up with your life no matter how bad it is from your perspective. The fact that you know you are not the only one who has to undergo so much and that there are people who are just like you, is very comforting. If nothing else, then just the whole realisation of ‘I’m not alone in this’ is very important to get through any crisis in life.
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3.5 Why Communication Design? One of the best ways to promote good health in society is through the use of communication campaigns to inform and educate the public about healthy habits and good health care. Although the importance of mass communication in promoting health is widely acknowledged, creating effective communication campaigns can be a complex process. Health messages have a variety of characteristics that differentiate them from other types of mediated messages. Among these are the sensitivity of health issues, the fear that some health messages evoke, the attendant feelings of resistance to some health messages, and the complex nature of many health problems. Many health messages focus on sensitive and personal issues such as sexually transmitted diseases, substance abuse and addiction, abortion, and mental illness. Because these subjects are difficult and emotional for many audience members, they can be especially challenging to develop effective communication campaigns to check. A collaboratively designed, implemented, and evaluated health communication strategies will help achieve the goal of improving health in a significant and lasting way by empowering people to change their behavior and by facilitating social change. Health communication can take many forms, both written and verbal, traditional and new media outlets. Another area is the dissemination of health messages through public education campaigns that seek to change the social climate to encourage healthy behaviors, create awareness, change attitudes, and motivate individuals to adopt recommended behaviors. Interpersonal relationships are crucial to the core of oneâ&#x20AC;&#x2122;s well-being. Oneâ&#x20AC;&#x2122;s interaction and equation with their family, friends, colleagues and peer group plays an important role in their holistic wellness.
Menopause is an important reproductive milestone in a womenâ&#x20AC;&#x2122;s life and it brings a women acutely face to face with the reality of ageing. The middle age is a period of change and develops and for women this includes the gradual winding down of the reproductive system and ending of childbearing years. The study conclude that awareness campaigns is necessary to informed general public health worker, etc.about menopause and associated health issues through various form of mass media. Interventions to change health-related practices take a variety of forms involving both interpersonal communication and the mass media.
For individuals, effective health communication can help raise awareness of health risks and solutions, provide the motivation and skills needed to reduce these risks, help them find support from other people in similar situations and affect or reinforce attitudes.
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Womenâ&#x20AC;&#x2122;s Voices Workshops
Mobile App
Private Online Consultation
Health Experts
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Preventive Care Information
3.6 OoWomaniya Context OoWomaniya was incepted with a conscious attention towards understanding issues in daily lives. Workshops, field study, interviews and literature study helped us understanding and defining our focus on women’s health issues and it further narrowed down to emotional and intimate health issues. OoWomaniya.com is an online consultation platform for women to take advice, ask questions and take counseling sessions using web and mobile application.
OoWomaniya.com is also actively promoting and working on the OoWomaniya - Voices Platform where it encourages women across different walks of life to share their thoughts, opinions, stories and experiences with other women in forms of articles, poems, forum discussions; providing women a channel to express themselves, vent out meaningfully, and connect with other women.
The detailed perspective for providing these services:
OoWomaniya is also preparing a content repository for almost 70 issues exclusive to women’s physical and intimate health issues and symptoms in easy, user-friendly communication with customized designs and illustrations. The Panel Experts are helping in preparing this content database which is available in both online and offline mediums and can be further translated in various languages and customized as per user group/campaign needs.
OoWomaniya.com started with an aim to provide a one stop solution for the women’s emotional, physical and intimate health issues. With reference to the aforementioned issues and gaps we see in the domain of women’s health and information; our solution OoWomaniya.com, a dedicate platform for women, offers a female friendly & non-judgmental space to women where they can vent out and speak out about their issues related to their emotional wellness & intimate health and we connect them to Credible & Experienced Experts like Gynecologists, Physicians, Sexologists, Pediatricians, Childbirth educators, Physiotherapists, Mental Health Professionals, Homeopathy, Fitness & Nutrition experts. Women can ask their queries anonymously and seek a personalized advice/solution and credible information from the experts regarding their emotional and intimate health issues.
The goal is to form a network of users, health service providers and educating women about their health and wellness issues, awareness and preventive care.
They are reaching out to the urban women aged between 15 to 35 years and who have easy access to the Internet (Web and mobile platforms). We have planned to extend our solution to a phone helpline and SMS based subscription once the organization has matured.
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Workshop Structure Along with their online platform, they also conduct focus group sessions and workshops offline with different groups/age groups of women in colleges, organizations, domestic/localized setups etc. in coordination with experts for imparting information, encourageing substantial discussions and for creating awareness about our solution.
Health & Wellness
Women Empowerment
Excursion
Menstrual Health Awareness
Self-Defense Workshop
Sports
Breast Care & Preventive Measures
Finance Planning & Management
Wellness Excursion
Intimate Hygiene & UTI
Laws & Rights
Fun Workshop
Pregnancy Nutrition & Fitness & Post-Partum Care
Gender Sensitization & ICC Training, Orientation
Fitness & Nutrition
Child Care for Working Women
Work – Life Balance
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Their vision statement goes like ‘Our focus on building and featuring health content; presenting and distributing it using both online and offline mediums; our preparedness to design educational health campaigns for government as well as private organizations has made us feel positive about the impact in terms of awareness and preventive care, we as a venture, aspire to make. It has become a space where women can share some of their private but vital concerns without getting judged. A platform where they can ask questions from any part of the world on any subject related to their wellness, which they otherwise cannot ask face to face or are reluctant and embarrassed to discuss with their peers and well-acquainted doctors. An online platform with the assurance of anonymity makes them comfortable and confident to speak out about their gynecological, sexual, emotional and other intimate and important concerns.’
Workshop on UTI conducted at Hi-Tech Outsourcing Services.
Breast Cancer Awareness walk organised with Apollo clinic
In the past few years, OoWomaniya has successfully conducted workshops for women on Healthy Ageing, Cervical Cancer awareness, Breast Cancer Screening Awareness and also Menopause. They have organised Pinkathon along with Samved and Apollo Hospital. They have been actively involved in awareness drives, lectures and preventive care seminars across all the age groups.
The attempt through this project is to create an initiative that speaks for awareness of Menopause amongst women, her peers and family through an already well established platform, OoWomaniya.
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3.7 Redefined Brief Narrativizing Menopause Menopause, in a layman’s vocabulary, stands for the cessation of menstrual cycles (periods, to be colloquial) for women. It signifies the end of the reproduction capacity of a woman’s body. It is a phenomenon that is largely ignored in the Indian society; a neglect that stems from an inherent discomfort with talking about sexuality and things related to it, lack of understanding or simply ignorant sexism which leads to oversimplification of the process and the possible care that it calls for. However, things are rarely simple in the changes pertaining to the body of women with respect to the ability to support life. Menopause is no exception. Contrary to general supposition, Menopause is a process rather than a brief, isolated episode. This can be a strenuous, long-drawn period, when maintaining a sense of balance becomes difficult. A woman’s body is thrown into a severe turmoil of hormonal confusion yet again, usually years after the last pregnancy, and at an age when energy, and recuperative ability is in a natural, general decline. This process becomes harder because of the loneliness it brings, because it is also usually an isolated phenomenon of each household, at a time. This leads to a dearth of much needed empathy. from family and friends.
The most important thing to understand though - you are not alone To make Menopausal phase less of a lonely island To sensitize the family, particularly husbands, children and the immediate peer group To create an informed support system free from sterotypical judgements To help them find support from other people in similar situation, draw inspiration and inspire or affect their attitudes To use Story telling as a medium to get across the message
This project is an attempt to make the menopausal phase less of a lonely island. Just like puberty and pregnancy, Menopause is a different experience for every woman. It takes a toll on a woman’s body and the often even on her closest relationships. Its unpredictability can wreck relationships or form stronger bonds. The odds of making it an easier phase depend upon one’s knowledge and attitude towards it. It is imperative that family, particularly husbands and children, form a strong, informed support system free from stereotypical judgments.
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04
Design Structure 4.1 Design Structure
98-99
4.2 Precedent Study
100-105
4.3 Design Direction
106-108
4.4 Proposed Design Concept
109-110
4.5 Final Design Structure
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Women
Design Concept
45 - 50 years | < 40 years
02 Persona building
Why Communication Design?
Design Development
OoWomaniya Business Model
User Study
Information Collection
Studying existing examples
01
03
05
ANALYSIS & SYNTHESIS
Children
EXECUTE SOLUTION Insight from Research
Doctors
Focus group
User testing
Design Direction
Identifying Touchpoints
04 Stakeholders
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RedeďŹ ned Brief
Design Structure
Final Output
4.1 Design Structure Develop This is the third stage in the process. It marks the beginning of ideation and concept building. The execution process is the most important thing in this phase. The third quarter marks a period of development where design-led solutions are developed, iterated, and tested. Key activities and objectives during the Develop stage are: Multi-disciplinary working. Visual management. Development methods. Testing.
After the research, once the brief was redefined as a part of exploration of ideas, already existing work done in the field had to analysed. When the framework of the design solution was created, again had to explore the different mediums that could be used to send across the message. This included Looking at the existing initiatives on Menopause Exploration of concepts Deciding on the design structure Final Concept
Making sense of complex information through the use of visual frameworks, can create a common platform for discussing alternatives, and make sense of opportunities and resources.
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What Comes to Mind: Menopause and the Aging Brain?
International Menopause Society
promoting education and research on all aspects of adult womenâ&#x20AC;&#x2122;s health www.imsociety.org International Menopause Society, PO box 98, Camborne, Cornwall, TR14 4BQ, UK Tel: +44 1209 711 054 Fax: +44 1209 610 530 Email: leetomkinsims@btinternet.com
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Public Awareness Posters by IMS
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www.indianmenopausesociety.org write to indianmenopausesociety@gmail.com or call 09949621094 Executive Secretary, IMS, India, B210, Green Mansion, Near Crecent Hospital, NMDC Rd, Hyderabad.
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International Menopause Society, PO Box 98, Camborne, Corwall, TR14 4BQ, UK. Tel: +44 1409 221307 Email: leetomkinsims@btinternet.com
Prevention is key to reducing the risk of memory loss as women age
After menopause, the risk of memory loss increases, but simple lifestyle changes can help prevent the effects of aging and maintain brain health and alertness For further information visit www.imsociety.org
International Menopause Society, PO Box 98, Camborne, Cornwall, TR14 4BQ, UK. Tel: +44 1409 221307 Email: leetomkinsims@btinternet.com
Indianmenopausesociety.org
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4.2 Precedent Studies Indian Menopause Society - www.indianmenopausesociety.org The Indian Menopause Society is a multidisciplinary national society. It was launched in 1995. It is committed to fostering the comprehensive well-being of the mature & elderly Indian women. The society provides a common forum for medical and other interested health professionals and people from all walks of life to work towards the goals of the society. The Indian Menopause Society is committed to fostering the comprehensive well being of mature and elderly, Indian women. The society provides a common forum for medical, other interested health professionals and people from all walks of life to work towards the goals are to increase awareness regarding menopause and education activities to promote a muldisciplinary multifactorial comprehensive approach to the care of these women, to facilitate the exchange of ideas and experiences of different since the physical mental and emotional health of women in the year after menopause is truly multidimensional to collect information and data and encourage research with particular reference to Indian women and to help provide awareness and services to the less privileged groups of women in our society.
Multidimensional Society Open to doctors and also to non-medical people Anyone interested in helping with the various aspects & problems of menopause.
The goals of the society are To increase awareness regarding menopause and ageing through public health and education activities. To promote a multi-disciplinary multi-factorial comprehensive approach to the care of these womenâ&#x20AC;&#x201D;medical and non-medical. To regularly update doctors and health professionals in the field of menopausal medicine to ensure appropriate health care for these women. To facilitate exchange of ideas and experiences of different disciplines since the physical, mental and emotional health of women in the years after menopause is truly multidimensional. To collect information and data with particular reference to Indian women. To encourage research on relevant aspects in the Indian context. To help provide awareness and services to the less-privileged group of women of the society.
Although the society is open to non medical people, it functions as a medical fraternity. Not many are aware of the society The awareness material used is very technical and lacks affective communication
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naarihappiness.com
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Public Awareness flashcards
Naari - naarihappiness.com They have succesfully conducted talks, seminars and workshops at different places in Ahmedabad on Preventive care, Cancer Awareness, Healthy Ageing and Menopause. Dr Darshana was also involved very actively in this project right from the beginning, providing her guidance at each and every step The organisation deals with a lot of health issues. Some of the most effective ones are:
Naari is co-founded by two very experienced gynecologists of Ahmedabad, Dr Darshna Thakker and Dr Riddhi Ketan Shukla on 20th October 2010. Dr Darshna Thakker runs her hospital Sarjan Maternity and Nursing Home in Vasna and is driven by sheer passion of making a difference. She has till now addressed over 50,000 thousand females regarding various subjects and has authored various books and launched a series on innovative healthcare management. Dr Riddhi Ketan Shukla runs Aarogyam Speciality Hospital and has been working tirelessly for women health. She is a high risk pregnancy expert and has spoken at various forums on subjects revolving around women health and wellness.
Preventive Care
In their own words, ‘As we take a step forward in expanding our activities from “NAARI”, in order to build a concrete organization we have with us women from different area of expertise in our advisory committee which would be instrumental in planning, strategizing and conceptualizing various campaigns and activities that we wish to run under this banner. With synergistic efforts from everywhere we wish to create a healthy society for women.’
Objective: Taking care of HER health and happiness! Mission: Educate and Empower women for a healthy life Vision: Taking care of women health in society
“Prevention is better than cure” – Its one quote we all must have heard at least once in our lives. In our day to day lives we normally go to a doctor after we fall ill or we have some physical problems or illness. But how about medical doctors themselves reaching to you via online offline mediums from time to time to share tips of being healthy. With Naari , both the doctors wish to create more awareness in the society by sensitizing the masses about regular check-up, screening and giving
Encourageing Healthy Ageing in Women Middle age women are often neglected in terms of their health and well-being. This period is a very crucial phase of transition in a woman’s body. We at Naari recognise this and encourage women to take charge of their own bodies and be more proactive and alert about their self wellbeing.
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Menstrupedia Comics
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Menstrupedia - www.menstrupedia.com Menstrupedia is a friendly guide to periods which helps girls and women to stay healthy and active during their periods. With a team of dynamic and passionate people with complementary skills, Menstrupedia aims at delivering informative and entertaining content through different media. Menstrupedia is a small but definitive step to shatter the myths and misunderstandings surrounding menstruation for ages. The comic book has been developed over a period of 18 months starting March 2013. Girls love to read stories in the book and learn about menstruation on their own. Although this book is specifically for girls of age 9-14 years, younger or older girls and even boys would find it an interesting and informative read. Beautiful illustrations and cartoon characters make it really easy and comfortable for parents and teachers to talk about menstruation. They talk about four most important topics under Menstruation:
Puberty
Their culturally sensitive approach of breaking the taboo associated with menstruation has been widely accepted among girls, parents and educators. The site has one lakh visitors every month, and the Menstrupedia Comic that released this September has been shipped to South America and Philippines. Such has been the response that they have volunteers ready to translate the book into eight different Indian languages and three different foreign languages. Menstrupedia is crafted to present the information about menstruation in a way that is not only easy to understand but also sensitive towards the taboo nature of the subject.
â&#x20AC;&#x153;We can see more and more people talking about the subject. We have many articles on the subject written by people from all walks of life. Fathers and grandfathers are buying the comic book to educate their daughters.â&#x20AC;?
Menstruation Hygiene Myth
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Narrativizing Menopause To tell real life stories to create awareness and sensitize women, husbands, children and the overall society towards Menopause
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4.3 Design Direction Power of Storytelling Our purpose is to move more people to do great things. It’s our philosophical heartbeat: to inspire people to act and behave in a way which will enrich their lives and those of people around them both personally and at work. Everything we do is in service of this purpose, and storytelling provides us with a powerful tool to make change happen.
Stories spark emotions We have an intuitive, emotional side as well as a deliberate, rational side to our character. People may understand what you want them to do but if they aren’t emotionally engaged they just won’t do it.
People use stories to make sense of things A story is the result of thousands of interactions and experiences and it becomes the ‘lens’ through which we interpret the world around us.
People learn from stories Stories are a great way of learning from others, and can help shape cultures and attitudes of people. Sharing emotive stories of best practice inspires individuals and teams, helps them learn more quickly and helps organisations to become more agile.
“The radiation was so strong that I couldn’t sit next to her for two weeks”
- HONY story in Pediatric-Cancer series Humans of New York began as a photography project in 2010. The initial goal was to photograph 10,000 New Yorkers on the street, and create an exhaustive catalogue of the city’s inhabitants
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Objective of Storytelling
Stories
The immediate objective of Storytelling is to make an emotional connect with the audience in order to create an impact. In case of Menopause, since there are innumerable stories shared by women across different race, age and places it is very crucial to showcase them as not only individual stories but also as a learning.
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Factual Data
An initiave/ communication design should also educate and present accurate information regarding the issue. The number of symtoms experienced would always keep on adding as long as women are ready to share them with others. These also leads to a creation of a huge database on the basis of the stories shared. These eventually become the essential factors around which the message is woven. Stories are meaningful only when they are memorable, impactful and personal. Tha factual data shared would have no impact if the users/ audience are not able to connect to it in the first place. Showcase of any data becomes meaningful only when it leads the person viewing to take a specific action.
Emotional Connect
Factual Data
To sensitize the target audience about the issue
To educate and for the dissemination of accurate information at accurate time
4.4 Proposed Design Concept Second Innings - Narrativizing Menopause Proposed Design Solution is in the form an initiative which includes a main Design Deliverable in the form of a video inorder to reachout to maximum people possible. The initiative would be interms of a social awareness campaign that would speak to women and especially men and children about what to expect and what not to expect during her Menopause. It would give an insight into how their life might change after this. The other deliverable would be in terms of an Information design to educate people about the different symptoms that they should look forward to. This is a direct derivation from the different stories already shared by people on the internet. The attempt here is to give a statistical data regarding what are the most common symptoms and what signs should one look for during the onset of menopause. Since Social media is one the most effective medium to get across any message, the initiative would kickstart in the very same platform.
The target audience are children (18- 26 years old), Husbands (35-55 years old) and women in Peri- menopausal or Menopausal age
Second Innings
Social Awareness Initiative
Film Video Communication
Information Design
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Second Innings Social Awareness Initiative
Branding
Data Visualization
Website
Development of an Identity for the initiative that goes beyond this campaign
Representation of the data in terms of symptoms and signs in the form of a story
A common platform as a part OoWomaiya but exclusive to the initiative
Film Social media platform in collaboration with OoWomaniya
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4.5 Design Structure The final Design Structure would consist of 4 major parts which would as a whole, represent the initiative. This break down of the deliverables were also based on different discussions done with the OoWomaniya team and the guide. Since it is already an established brand and they deal with so many Helath Issues, it was very important to give it a completely new approach and yet be a part of the brand. Any initaive has a limited span and as compared to other design deliverables. The challenge lies in getting the maximum output within that stipulated time. A successful initiative campaign should lead to conversations and dialogues amongst the general audience and not only just the target group. To do that, different touchpoints have to be recognised, not only in terms of people to talk to but also the way to talk to them. It should cater to their overall need and not just a part of it. In order to achieve this, the following solutions were proposed
Film Communication Film made for creating social awareness and sensitizing the audience regarding the topic. It would be released on different organisationâ&#x20AC;&#x2122;s social media websites including OoWomaniya and Naari to begin with. The film would aim to include different types of personal stories by women, husbands, children or anyone who has been effected with Menopause in some or the other way
Branding OoWomaniya has been addressing different issues like Breastcare, Menstruation etc very regularly in terms of workshops, talks, and awareness campaigns. Since the last few years, they have been focusing on promoting Healthy Ageing amongst women. This initiative is a part of the same attempt. The Branding would be an essential part of this project because the initiative is going to be long term plan extending beyond this video campaign and needs to accommodate the future initiative projects under the same entity
Data Visualization Apart from the video, it is equally important to present the accurate factual data to educate them. Data visualization would a representation of all the symptoms that are extracted from different stories shared across various online patforms.
Website It would act as a microsite of OoWomaniya.com for Second Innings. The main reason behind designing this is to create a common platform where all the design collaterals would function as a single unit to get across the message
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05
Design Development 5.1 Deliver
114-115
5.2 Film Development
116-131
5.3 Branding
132-139
5.4 Data Visualization
140-157
5.5 Website Design
158-163
5.6 Wayforward
164-165
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Women
Design Concept
45 - 50 years | < 40 years
02 Persona building
Why Communication Design?
Design Development
OoWomaniya Business Model
User Study
Information Collection
Studying existing examples
01
03
05
ANALYSIS & SYNTHESIS
Children
EXECUTE SOLUTION Insight from Research
Doctors
Focus group
User testing Design Direction
Identifying Touchpoints
04 Stakeholders
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RedeďŹ ned Brief
Design Structure
Final Output
5.1 Design Development Deliver The final stage of the design process represents the delivery stage, where the resulting product or service is finalized and launched in the relevant market. The key activities and objectives during this stage are: Final testing, approval and launch. Targets, evaluation and feedback loops. In this project, the deliverables were created in the order of - Video
The continuity of the message across all these mediums were decided as per the need of design intervention and also the need of the client. The OoWomaniya team was very helpful in the entire process of brainstorming. They were very resourceful in terms of whom to contact for the shoot, to referring to the doctors for the project. The Design Development stage was a result of collaboration with different people for video shoot, processing of the Data Visualization and the coding of the website. As a designer, it was very important to know your own limitations in terms of execution and not to hesitate to collaborate with people for the same.
- Branding - Data Visualization - Website Since the tone of voice of the entire campaign would depend on the video interviews, the video had to be shot first. The visual direction was then set accordingly. The adaptation of a uniform visual language across all the deliverables was a challenge. There were a lot of back and forth in this stage right from the beginning. The Branding process though had started simultaneously along with the video, it did take shape after the video shoot. The insights during the video shoot helped in structuring the information architecture of the Data Visualization
Design Development is a direct reflection of the reserach done in the earlier phases. Itâ&#x20AC;&#x2122;s out there for people to respond. Itâ&#x20AC;&#x2122;s testing the waters and being prepared for revision at any point of time.
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5.2 Film Development Need for a Film Connection is crucial when a motion video is made for awareness. Luckily, the popularization of digital video has offered us a slew of new tools and perspectives to use as creative resources. No medium is more conducive to telling stories than video.Video enables you to put a face to your cause; to dynamically represent how the problem you’re trying to solve affects people. With video, people can see, hear, and feel for the message, which is a luxury that no other mediums provide. We need to taake advantage of this inherent authenticity. We need to tell the story honestly, and remember to stick to the landing. It’s got to end with the silver lining. To show that change is possible - that progress is possible - and that your audience can have a hand in making that change happen.You’ll be more likely to see conversions and people will be more likely to share the video with their friends. People respond differently to certain types of content, so there’s a need to hone in on the approach and solidify the message before ever hitting the drawing board. Most people don’t need to be convinced of their interest. Social change films promote “accelerated crowd learning,”
The collective nature of the narrative and visual stimulation makes the experience enjoyable and controlled, thereby offering benefits beyond mere visual stimulation. It is a powerful medium. It speaks with the language of universality. A film through story-telling, documentary, realism or fiction through its very nature demands a universal language. By accessing and understanding what makes a universal issue, the audiences can better engage with the world around them. Films represent and at the same time signify. Use of Social media to spread this awareness video is based on the the following concluded factors that: Social media tools are often personified, but for social change to occur there must be people behind the tools. Social media can increase world awareness of an issue. Social media allows people to help each other regardless of location.
No medium is more conducive to telling stories than video
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Structure The film would have real life stories shared by Children, Husbands and also women about their personal Menopause experience. The video would be broadly classified into sections of Children, Husbands and Women. Along with the personal stories, it was equally necessary to include an expert, in this case a doctor to explain the different medical terms so that even who is new to the topic gets to know what they are talking about. The inclusion of the doctor in the video was thus a very crucial decision in the process
Questions asked during the interview
Children What are the changes that you have observed in your mom in the last few years? Do you know why? How has it affected your relationship? When did you get to know about Menopause?
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Husbands How did you handle your wifeâ&#x20AC;&#x2122;s Menopause phase? How has it affected your relationship? What do you do to make her happy? Do you discuss it with your friends? What advice would you give to someone who is going through the same phase?
Women How was your Menopause experience? How much was your familyâ&#x20AC;&#x2122;s support? How did you get through it? What advice would you give to someone who is going through the same phase?
Doctor
What do you do to make her happy?
How many patients come to you with Menopausal symptoms?
Do you discuss it with your friends?
What do you tell them?
What advice would you give to someone who is going through the same phase?
What are the precautions and measures that every Menopausal woman should take care of?
Pooja Vasu // M. Des // Graphic Design
Existing example
Dear 16 year old me by David Cornfield Melanoma Fund
The DNA Journey by Momondo
This film was made possible thanks to the generosity of real Canadians and Americans whose lives have been touched by melanoma. They talk about how they overcame their struggle and what helped them get through the most difficult patch of their life. The film is shot as if the present person is writing a letter to his/ her own 16 year old. The message shared is very powerful.
It’s easy to think there are more things dividing us than uniting us. But we actually have much more in common with other nationalities than you’d think. Momondo asked 67 people from all over the world to take a DNA test, and it turns out they have much more in common with other nationalities than they would ever have thought. Let’s Open Our World is an invitation to travel across boundaries, embrace our differences and open our world.
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Focus Group Session Once the questions were ready, it was very important to test it out whether people were comfortable talking about the topic or not. The sensitivity of the topic had to be considered before approaching the topic. The group chosen consisted of children between the age of 18 to 25 years old. People had to be intorduced to the topic gradually and not bombarded with the questions about menopause directly. It took a lot of planning before taking this focus group session. Depending on this, a lot of revision was done in the time of the actual shoot. It gave me an idea about what questions could be asked and what not. Few of them who participated in the group session also volunteered to be a part of the final shoot
Place: Venture Studio Date: May 7th 2016 Number of people: 9 Trigger cards For this session, trigger cards were made so that it could be an indirect approach rather than just asking about Menopause. Many were not even aware about the term meaning. This hence turned out as a learning session to few of them.
The trigger cards used were: Always Angry Happy Mom Menopause
Children donâ&#x20AC;&#x2122;t find it easy to approach this topic with their parents. There has never been a conversation about any body issues related topic with them even before this They felt that they have always taken their mothers for granted Few of them didnâ&#x20AC;&#x2122;t even know what Menopause meant After the session, they were ready to go and try talking to their parents
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Script Even though the shoot was meant to be real interviews, just as a precaution in case people were not able to articulate properly, a script was written which had all the dailogues that are taken from the actual interviews taken in research phase.
Many Women, many Stories: Narrativizing Menopause Children
What are the changes that you have observed in your mom in the last few years? She’s not the same anymore. She doesn’t need any reason to nag me. Too many advices. Too much concern She gets irritated very very easily. Even if she is going through a bad phase, it’s not shown on her face. She keeps forgetting things Whenever she gets cranky, she doesn’t want anyone near her. I’m scared of her mood swings. I avoid her
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Do you know why? I think even she is equally clueless about what is happening to them Does a good job hiding her feelings. I’ve never spoken to her about her health. As a son how am I supposed to approach the topic about it. Be by her side. I took her for granted. Give her, her own time. Try to understand her I let her win in the racing video games. That makes her happy They don’t expect us to understand things, but you can make an attempt Don’t do anything that makes her angry. I forward articles/ link to do and health issues on whatsapp Husband How did you handle your wife’s Menopause phase? She might be depressed or wild or aggressive most of the time. It’s beyond her control It’s not you, it’s her hormones. It’s Menopause.
< Insert the definition of Menopause in a very layman language, as told by a doctor> The key lies in understanding that it’s not her mistake, neither yours Don’t try to fix it. It’s just a phase. Don’t give a lot of advices She still loves you All she needs a little rest Take care of her Mothers/ Women How was your Menopausal Experience? You’re 40. Now you’re going to have a different play with your hormones Menopause is generally taken as a phase with problems and complains Not everything that you suffer is linked to menopause. It may be, but not always Don’t read everything that’s on net without understanding Menopause is not a pause, it’s a time to grow gracefully
Mammography is not as painful as you think it is. Go for it. You’ll thank yourself later It’s not to frighten you, it’s just to make sure you’re OK You’ll have mood swings, but it’ll pass through. It’s not your husband, it’s your hormones. He still loves you. At times you might feel like killing your husband, it’s a temporary phase. Talk to him about it. You’ll have excess hair fall, don’t worry it’ll grow back Gaining few pounds is not going to make you look ugly. Talk to your children, they’ll understand Live for yourself. Don’t ignore any symptoms. 3 important things to be taken care of: Bone Care, Physical health care, emotional health care and Cancer screening. Get your mammography, PAP smear test done
< Insert the definition of Menopause in a very layman language, as told by a doctor>
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Cast Talk to your doctor about it. Do not assume the worst It has more than 107-108 symptoms very specific each woman. Just because your friend had heavy bleeding doesn’t mean you’ll have them too Change your thinking pattern, change your disease pattern It’s time to grow up. Whatever you could not do at 16, start at 40. You don’t know when it starts or how long it’s going to last Don’t panic. It is temporary This is a time which is a boon to yourself.
It’s a Me-NO-Pause. I’m going to live for myself. This is not the end to your story
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Dr. Darshna Thakkar Dr. Aakash Joshi
Himanshu Desai Jigesh Shah
Sonal Deshpande Dr Ranjana Harish Dr Kaushal Agarwal Girish Shah Reema Shah Smita Zanzarakiya Natubhai Zanzarakiya
Kinjal Zanzarakiya Eeshan Joshi Krutika Katrat Ayush Kreena Patel Shreya Amol Aarti Nair
Casting Husbands was a very difficult task because of the topic. Nobody wanted to talk about it. Many of them refused blankly saying that it was a very personal topic and that they didn’t want to discuss it. But in the end, three of them agreed to be a part of this project even after knowing that this would be released on social media platforms
Storyboard
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Three different layouts for the three different group of people to be interviewed. Since the mother is the main character here, the prominence has been given to her in the layout. The possibility of including the typography was also considered during the storyboard framing.
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Shoot The location was chosen in Ahmedabad. Dr Darshana and Dr Kaushal Agarwal were kind enough to allow me to shoot in the Health Cafe which is retreat centre created for conducting workshops, support group meetings and yoga sessions. The location was chosen because The Health Cafe is very accessible and since it was owned by the doctors itslef, their participation was also easier.
Camera: Canon 60 D Camera person: Sivaranjini Nair
Stills from the shoot
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Post production
The software used was Adobe Premiere CC
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The colour treatment of the film goes from black and white to a saturated red palatte. The reason for keeping it black and white in the beginning was to show a contrast in the content of the video. The film starts with all negative experiences and gradually progresses towards the better and positive aspect of the issue. The soundtrack used is El viaje de Ulises by La venganza de Cheetara
To emphasize more on certain things said by the character, typography was used along with the video to re-impose the thought by making sure the audience donâ&#x20AC;&#x2122;t miss it out. The typeface used had to humanist and not very rigid because it had to convey the emotions along with the message. The font used was Hipsterish Font Normal.
Final screenshots
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5.3 Branding Second Innings The name of the initiative stemmed out of the process of the shoot. All of them expressed that Menopause was like a new beginning for them. They considered it as a sign to straighten their priorities. The identity had to reflect the same. The care had to be taken to not give it a sympathetic feel. The identity would be used for all the future campaigns, workshops, events on Menopause by OoWomaniya. It should talk about not only Menopause but also about Healthy Ageing. Graphic design for visual branding has several benefits. It visually represents the message to deliver. Transparency and congruency is very important when building a branding campaign. If the visual elements are not in line with the brand, the target audience will feel not feel like the companyâ&#x20AC;&#x2122;s message is believable.
Second Innings also talks about addressing to men and children about the issue. It represents emotional growth.
The keywords are: - New beginning - Happiness - Community - Women
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Initial Sketches
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The before and after
Second Half
Flourishing Second half
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Form Development
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Final Logo Contrary to the belief that post 50s the life loses it’s charm and everything becomes boring, the Second Innings aims at encourageing women to take the Menopausal phase in her stride and look at it as a new beginning. This identity depicts the second half as a flourishing and a colourful phase. A woman is always concerned and worried about everyone else other than her which restricts her own growth as a person This personal nourishment is possible in her middle ages when she is done with her so called duties. The Identity is a representation of self growth and nourishment in the second half of a woman’s life and thus spreading the warmth around her.
It says ‘ I begin from here, I live for myself’
Colour
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The colours had to reflect growth, happiness, celebration and positivity.Hence a warm colour palatte was chosen. The radiating colour effect depicts the self nourishment. The colour palatte used has been adapted in the other design collaterals as well.
Montserrat Semi Bold and Light Montserrat is a geometric sans-serif typeface. This font features friendly and open curves and makes for a more natural appeal. Itâ&#x20AC;&#x2122;s a much more distinctive typeface compared to the others from the San serif typefaces. The curves of the characters of this typeface balances with the form of the identity.
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5.4 Data Visualization Telling Story through Data An excellent visualization is “complex ideas communicated with clarity, precision and efficiency.” An excellent visualization also tells a story through the graphical depiction of statistical information.Visualization in its educational or confirmational role is really a dynamic form of persuasion. Few forms of communication are as persuasive as a compelling narrative. To this end, the visualization needs to tell a story to the audience. Storytelling helps the viewer gain insight from the data.
The main points to be considered while making this Data visualization was What is the data that had to be presented? How will it be presented? What the end result would be? Which medium to use?
Data visualization is regularly promoted for its ability to reveal stories within data, yet these “data stories” differ in important ways from traditional forms of storytelling. Storytellers have increasingly been integrating visualizations into their narratives, in some cases allowing the visualization to function in place of a written story. A good data visualization does a few things. It stands on its own; if taken out of context, the reader should still be able to understand what a chart is saying because the visualization tells the story. It should also be easy to understand. And while too much interaction can distract, the visualization should incorporate some layered data so the curious can explore. Being factual, detail-oriented and data-driven is critical. By finding the real stories in your data and following the best practices above, can get people to focus on the message— and thus on what’s important. Storytelling
When data and stories are used together, they resonate with audiences on both an intellectual and emotional level
Data Engage / Educate
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What Data? Initially when this project started, the only website considered was OoWomaniya.com. Since it is an online consultation portal, they get a lot of questions about all the possible issues by various types of people. The queries asked are presented as anonymous questions in the ‘Questions asked section’. Though you get to read them, it’s fairly unclear how many questions have been asked about one single issue. The attempt was made to classify it according to the emotions it generated. Any symptoms asked has an underlying emotion to it. It tells us the story of the person indirectly. Instead of looking at it just objectively, what if we present it as individual stories said by people that have affected them?
Symptoms Question asked Emotions
oowomaniya.com
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Daughter asking about Menopause / practoconsult,.com
Husband asking about Menopause patient.info
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Woman asking about Menopause http://henpicked.net/how-to-manage-menopausal-rage/
What are people discussing about Menopause There are a lot of health forums, support groups, blogs, consultation paltforms online where people get their doubts cleared and go for any kind of health or emotional supports. The websites chosen weren’t restricted to just Indian domains. The reason for doing this is though the context might be different for women coming from different countries, but the primary problem of ‘not knowing what is happening with your body during Menopause’ is very much universal. The general nature of questions asked are:
What is happening to me? Why is it happening? What should I do? Am I the only one who is going through this?
Apart from the questions there are various other ways people share what they’ve gone through. artciles, blog entries. videos, they also use social media platforms like twitter to express themselves. The study of this conveys that people use online platform for two major reasons:
- To share their story - To ask questions In both the cases, the content shared gives us the quantitative and the qualitative detail about the problem. For eg: if on a certain platform, we know that 150 people are talking about Menopause, and specifically about which symptom. This data then tells us what is the most commonly experienced symptom. The result would not only help the moderators to decide what topic do they need to focus on more for the treatment, but it also acts as an assurance to someone who is going through the same phase but feels lost. The reason for putting everything together in one place would just give the person who is looking at it as much as information possible under one roof. Menopause is a very complex topic with new symptoms being added to it on a daily basis. There are as many as 105 different symptoms recorded by women till now and this is definitely not the end of it. The Data Visualization hence would aim at summarizing all the possible signs and symptoms under one single roof.
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Classification of the Data The data we were looking at are symptoms shared online. The questions asked or discussed point out to the symptoms directly or indirectly. They either talk about the Psychological symptoms or the physiological ones.
Physiological
The data was also classified on the basis of who was asking or sharing the post, ie. the point of contact. We have already established that Menopause doesnâ&#x20AC;&#x2122;t effect just the woman but everyone around her. So itâ&#x20AC;&#x2122;s often not just she who shares or has questions but also other people. The most probable people are Mother/ Women, Husbands and Children
Question asked
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Existing Examples Wefeelfine.org We Feel Fine has been harvesting human feelings from a large number of weblogs. Every few minutes, the system searches the world’s newly posted blog entries for occurrences of the phrases “I feel” and “I am feeling”. When it finds such a phrase, it records the full sentence, up to the period, and identifies the “feeling” expressed in that sentence (e.g. sad, happy, depressed, etc.). Because blogs are structured in largely standard ways, the age, gender, and geographical location of the author can often be extracted and saved along with the sentence, as can the local weather conditions at the time the sentence was written. All of this information is saved.
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Atlas of emotions This atlas was inspired by a series of conversations between the Dalai Lama and Paul Ekman about the science of emotions. With the help of Stamen Design and Paulâ&#x20AC;&#x2122;s daughter, Dr. Eve Ekman, this tool was created to be a visual journey through the world of emotions. In June 2014, Paul Ekman sent a survey to 248 of the most active emotion researchers in the world to establish the consensus that provided the scientific basis for this atlas. This collection of maps is an opportunity for you to explore the landscape of emotions, where they come from, and the effects they can have.
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Data Visualization Structure
The interface of the Data Visualization follows a circular pattern similar to the circle of support. The woman still remains the main focus with husbands and children on the periphery.. The defined space for each character would pertain to the data shared by the respective characters. The symptoms are further divided into Psychological symptoms and Physological symptoms and also based on who has shared it.
The Psychological symptoms are solid circular particles The physiological ones are the hollow particles. The size is same across a single symptom
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Heavy Bleeding Crying
UTI Hot Flashes
Lower Sexual Libido Mood swings
Panic
Vaginal Dryness
Hairfall Temper Issues
Excessive Sweating Sleep DIsturbance
Low Selfconfidence
Headaches
Forgetfulness Fatigue Anxiety Negative Thoughts
W - Women
Psychological Symptoms
H - Husband C - Children
Physiological Symptoms
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Many women, many stories The interface to this data is a self-organizing particle system, where each particle represents one post in a single symptom. The particleâ&#x20AC;&#x2122;s properties â&#x20AC;&#x201C; color, size, shapeâ&#x20AC;&#x201C; indicate the person who has shared it and the symptom. Any particle can be clicked to reveal the full sentence or photograph it contains. The particles careen wildly around the circle depending on the data.
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First Experimentation The first coding of the visual was done using processing.js. This prototype had 20 posts for each symptom. Hence, the number of particles were a direct representation of the data. The number considered, 20 was for testing purpose. The result was a cluttered over populated circles with overlapping particles that werenâ&#x20AC;&#x2122;t individually accessible.
In the next iteration, the number of posts were reduced to 10. So it represented 10 posts for each symptom at a time. This experimentation was done to understand the dynamics of the data to visual translation. To see if it was visually balance and if the interface was productive
The third iteration had the numbers reduced to 5 posts per symptoms. The result was a better balanced visual compared to the other two
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A local dump of the data was created for the prototype with at least one post per symptom. The visual works on numbers. It gets populated by fetching the numbers thorugh the data base. Not all the particles will be visible at a time. It would be according to the symptoms, ie: the legends and the characters, husband, woman or children.
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The data visualization also educates you about symptoms along with giving you an overall view of how many people are talking about it. The call to action after the data visualization is to contact the doctor in case of any doubts because the role of any good design is to guide a person as much as to inform. Since the information might get a little overwhelming to handle in case of some people, giving a proper direction is very important. The data visualization connects different people who are facing similar problems. This way you get to know how theyâ&#x20AC;&#x2122;re dealing with it and also it gives you a reassurance that itâ&#x20AC;&#x2122;s just not you who is experiencing it.
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The user also gets to filter the results using the legends which are basically the symptoms or by the character
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Wayforward The actual implementation of this means the model has to be tried out with the maximum possible number or the least possible number for processing. This would include intense data mining process to come up with the list of websites from which the relevant data could be extracted. There is a possibilty of expanding this data visualization across the other issues too. It would represent how many people are talking about which specific topic. The tools that could be used for this are Relative Data Visualization or a Representational based depending on the extracted information.
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Website
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What is Menopause
Read Stories
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How does it work?
legends/ Symptoms
legends/ Symptoms
5.5 Website Design Communication is one of the foundational elements of a good website. It is essential for a positive user experience and for a successful website that truly benefits its owners. All types of websites are affected by the need for good communication in one way or another. The initiative requires an online presence so as to reach out to as many people as possible. Though Second Innings is a part of OoWomaniya.com, it still needs a seperate entity of itâ&#x20AC;&#x2122;s own to showcase all the features of the initiative at one place. The Website would have the video, the data visualization and the details of the project.
Most website visitors rely on the text to understand the basic messages of a website Uniform message across all the design collaterals is essential to maintain the connection with the visitor
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Header
About Website Posters
Layout and Wireframe
Video
Data Visualization
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The basic 12 column grid was used that can scale out to an arbitrary size (defined by the max-width of the row) so that it could be modified according to the need. The information architecture was done based on anticipated user behaviour. One of the major part of the webportal is the Data visualization page. The colour palatte chosen was according to the brand identity of Second Innings. The main purpose of this website is to communicate about Menopause in the form of stories and make them feel a little less lonely.
R 234 G 87 B0
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Header
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About What is Menopause Read Stories Contact us
Video
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The typeface used is Lato. Lato font is a sans serif typeface family. It consists five weights and corresponding italics. Lato gives a feeling of warmth as well as stability and firmness.
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Data Visualization Page
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People taking the ASL Ice bucket challenge
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Widely recognized as this generation’s feminist voice (Vaz had the women clapping in agreement – Times of India) Radhika has written and performed in online marketing campaigns. Known for her outspoken views on gender roles she has been addressing issues like virginity, societal pressure on being a woman. Her plays called Older. Angrier. Hairier and ‘Unladylike: The Pitfalls of Propriety’ have been critically appreaciated.
5.6 Way forward Social Media Campaign The Second Innings Film just acts as a beginning point for an extensive Social media campaign. Social media is a huge part of our culture. It is really powerful when it comes to spreading awarness about a social issue. Campaigns generally consist of a series of creatives made to send out a particular message over a period of time.Various platforms like Facebook, Twitter, Instagram etc have been used for the same. The idea is to make a web-series about different stories. This would keep it more lively because they would be people we know from our lives who would be sharing them. Every platform has it’s own organic way of functioning. Twitter has been very successful in spreading awareness about Breast Cancer Awareness. Recently there was a campaign where as a part of Breast Care initiative, women shared their facebook status as the colour of the bra they were wearing. It really caught attention because there were thousands of women with their status as pink, yellow, white, red etc. At least because of that, women knew it was the Breast Cancer Awareness month. Campaigns like these, which don’t talk about the issue directly, but address it in a non scary way are found to be more successful. The same goes with the Ice Bucket challenge. The Ice Bucket Challenge, sometimes called the ALS Ice Bucket Challenge, is an activity involving dumping a bucket of ice water on someone’s head to promote awareness of the disease amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s Disease) and encourage donations to research. Since so many people came forward to talk about this topic for this project, it gives us a hope that any topic when approached in an appropraite way, people respond positively. In the process of talking to people to know if they are aware about the topic or not, we have instead ended up educating a lot of them about it. Executing this social media campaign is the next big step for Second Innings.
Stand up comedy is one of the most powerful tools and venues to educate, heal, incite, and make people ponder about ideas and things beyond themselves. It is a very informal platform but yet effective. Satire, especially in the recent years have done a lot of good to us. Apart from spreading the message of taking life easy, and spreading awareness about issues in the socio political arena, but it has taught many of us tricks and ways to put sarcasm to good use to shut traps of all the howling dogs and trumpeting elephants in our daily lives. From the last few years, the young standup comedians have been addressing different issues present in our society like politics, stereotyping, LGBT, gender issues etc. Recently the domain of health had also been explored by these talented group of comedians. The 90-minute event sees the women address ageing, motherhood, being ‘career women’ and the societal pressures to have babies, all cloaked in humour. While internationally, popular actors Tina Fey, Amy Poehler and, more recently, Amy Schumer have thrust gender stereotyping into mainstream conversation, the surge of stand-up comedy in India has given us our own version of feminist humour, one that also takes a dig at women. Last heard, Aditi Mittal’s piece on Sanitray pads,Vaginal Tightening and Bra Shopping have become very popular. The best part about such shows is that they not only address the issues that are considered as a tabboo but also make it easier for others to talk about it. Considering the weird connotations that surround Menopause and the kind of absurd personal stories that people have shared, it would positively make a good subject matter for a standup comedy piece. When discussed with few amateur standup comedians, we got a very positive response. The planning and the script writing for the same is in progress. At the end of the day laughter is great, but intent and purpose is what I’m learning to value the most.
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Like Mother, Like Daughter
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6.1 Conclusion When I started this project, I was looking ahead to work in the service design domain. I was pretty much excited about it because service design for Women’s Health Care, how can someone not be kicked about it? Every day before finalizing the brief, I would have these long discussions with my colleagues and my friends back in college about what are the ideas we could propose for pregnant women, for a teenage girl who’s going through puberty or say a Menopausal women but I found that there were already so many products available for the same purpose. What difference was I going to make? The discussions that I had with people regarding this topic made it very clear that though there are a lot of services/ products for healthcare, people hardly use it or even know about it because of the lack of awareness about the topic. How do you expect them to use it when women are least concerned about their own body? So instead of coming up with a brand new product, what was needed was design intervention in creating awareness about it. Coming from a visual communication background and having worked in advertising before this, I wasn’t very keen to go ahead and make a social initiative campaign. Haven’t I seen this before? Worked in the same domain? But no, there was a huge difference. This was not going to be for a CSR activity. I didn’t have to endorse a product at the end of it. It was going to be an awareness video with real life stories. I knew it would be difficult right from the beginning. To make people comfortable enough to talk to you about their personal issues isn’t an easy task. I was clueless as to how to approach people, whom to approach and was doubtful about how would they react to me. This is where my guide was such a guiding angel to help me out with all these questions. I realized for the first time how networking can be helpful during such times. If it wasn’t for so many people who readily agreed to be a part of this project, it would have been impossible to shoot it.
The support I got from the doctors was incredible. They took time out of their busy schedule, to be there for the shoot. Many people who have spoken in the video are their patients who have gone through some similar situations in life and were ready to share it. People generally get apprehensive when we tell them that their stories would be shared on social media platforms. It took me some time to convince them that the intention behind sharing it is much bigger than a personal story. The biggest challenge was finding middle aged men who would be ready to talk about the topic. It was the most difficult task in this project. Half of them weren’t comfortable talking about it and the other half didn’t even acknowledge this as a real issue. By this time I had lost all my hopes. But thankfully in the end, I found 3 men who were eager to be a part of it. That’s when I became even more resilient about going ahead with the shoot. All the men who came for the shoot felt very deeply about the issue because of their own personal experience. I would take this opportunity to thank each and everyone who took out time for this project. I hope to find more men in the future who wouldn’t shy away from talking about any women’s health issue topics. I managed to make three of them talk, I know three isn’t a big number but it’s still a start. I went out of my comfort zone for this project and I’m happy that I did it because each moment spent on this project was so enriching. there are so many of them we take for granted, this was a reality check. One of them is my mom. The more I immersed myself into this project, the more I realized how much I don’t know so many things about her. Even if I’m able to create this small realization amongst people, this project would be a success. This is dedicated to all the women out there who go through everything but seldom complain. There’s more to her than what’s visible.
So many people come and touch our lives so deeply that it will never remain the same again
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6.2 References Bibliography
Papers and Articles
Design for Care - Peter H. Jones
Demographic characteristics of menopausal women - Indian Menopause Society
My Mother Myself - Nancy Friday The New guide to women’s health-Williams, Norma Who’s got the Power? Transforming Health Systems for Women and Children - Freedman, Lynn
Proforma for Registration of Subject for Dissertation by Ms.AHONGSHANGBAM SANATHOI DEVI Indian Women & Menopause - Indian Menopause Society
Occupational Health issues of Women in the UnorganisedSector Ministry of Human Resource Development
The importance of ethnicity by Tori DeAngelis is a writer in Syracuse, N.Y.
Minding our lives : women from the South and North reconnect ecology and health / edited by Vandana Shiva
Women’s midlife experience of their changing bodies - Banister, E. M.
The Writing on my Forehead - Haji, Nafisa Whose Body is it anyway ?: justice and the intergirty of the person Fabre, Cecile Listening to women talk about their health : issues and evidence from India / edited by Joel Gittelsohn, Margaret E. Bentley, Pertti J. Pelto adn othrts Change of life: facts and fallacies of middle age - Malleson, Joan The cultural context of ageing : worldwide perspectives / edited by Jay Sokolovsky. Visualize This - Nathan yau
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Menopause in northindia- Indian Menopause Society Sexuality through menopause and beyond. - Barbach, L
Webliography Demographic characteristics of menopausal women - Indian Menopause Society
http://www.momondo.in/letsopenourworld
Proforma for Registration of Subject for Dissertation by Ms.AHONGSHANGBAM SANATHOI DEVI
Skin Cancer Campaign: https://www.youtube.com/watch?v=_4jgUcxMezM
Indian Women & Menopause - Indian Menopause Society The importance of ethnicity by Tori DeAngelis is a writer in Syracuse, N.Y.
How to age gracefully: https://www.youtube.com/watch?v=sycgL3Qg_Ak 80 yrs of sexism in 2 min video. 48 things women get to listen that men donâ&#x20AC;&#x2122;t- https://www.facebook.com/HuffPostWomen/ videos/955994504468603/
Menopause in northindia- Indian Menopause Society Womenâ&#x20AC;&#x2122;s midlife experience of their changing bodies - Banister, E. M. Sexuality through menopause and beyond. - Barbach, L What Wives Wish Their Husbands Knew About Menopause - by Lois Mowday Rabey
Typeface used in the documentaion: Lato - Bold, Regular Bembo Std Frutiger
What Your Partner Needs To Know About Menopause - Ellen Dolgen www.informationisbeautiful.net 6 Lessons On The Horror (And The Humor) Of Menopause - JUDITH NEWMAN http://campaign.hundredpercentyou.com/
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She is still the most beautiful woman she has ever seen. She secretly prays that her mom should never leave her, even if it is for her own selfish need.