Challenging accepted menstrual hygiene norms by presenting a relevant menstrual hygiene and education proposal for young girls in Sweden today
Konstfack, Autumn Semester, 2017
For this personal in-depth design project I have decided to focus on menstrual hygiene products. A field of products that I believe has very narrow offerings. Menstrual products are used differently by each individual in an attempt to fulfil their unique needs, but the one commonality between them all is that no product on the market is even close to being perfect. As a field that has seen little innovation over time and affects roughly half of the world’s population at some point in their lives, there is huge opportunity for development in menstrual hygiene. This project focuses on the context of Sweden and developed societies within Europe and presents a relevant proposal for menstrual hygiene and education for young girls in Sweden today.
I decided to investigate menstrual products, with the goal of designing a product or service that responds to the needs of women and girls in Northern and Western Europe, as highlighted by my own ethnographic research. I identified the need to consider cultural tensions surrounding womens’ health and menstruation, which vary greatly throughout the world. Approaching the subject through a practical lens and focusing my research on the experiences of others rather than my own experiences I aim to create a well balanced, practical and well-informed proposal.
The world feminine hygiene market is growing, dominated by disposable sanitary pads and is expected to reach $42.72 billion by 2022. (Potdar, M. 2015) While disposable sanitary products may be the best option in places where hygiene standards are low and access to clean running water is limited, this is not the same environment as what is considered to be developed societies within Europe. My intention is to design a solution to menstrual care and hygiene for women in the increasingly sustainability and health conscious Swedish society. My goal is to develop a product or service that will help women to learn about and appreciate their bodies, tackle misconceptions of menstrual hygiene, prioritise ergonomics and ease of use and ensure environmental impact is at a minimum.
Menstrual cups; defined as a product that is inserted into the vaginal canal during menstruation, to collect menstrual fluid have been commercially available in the US since 1937, (Finley, H. 2017) when the American Leona W. Chalmers patented a product that looks almost identical to the main brands of Mooncup, Lunette, and Divacup today. My intention is to challenge the accepted standard of reusable menstrual hygiene products to create a product that is truly designed for comfort and ease of use for women today.
I started this project with the broad theme of menstruation but found a focus on the attitudes people have towards menstrual products. I conducted online research to learn about different menstrual products available in Europe and the US. I was amazed by the number of different products I came across and recognised the need to discuss them with women to learn about their attitudes towards them. I started my ethnographic research with a group of menstruating women aged between 20 and 26 from diverse European and US backgrounds. I went on to work with the same core group of 10 women, along with others throughout my project. I will refer to them as my research group throughout this report.
Using photographs and physical examples of a broad range of menstrual hygiene products as prompts, I learned that there are many different cultural tensions surrounding the choices women make in their intimate hygiene products. Statements such as “in my culture, you only get tampons when you’re not a virgin anymore”. Cultural differences were particularly prevalent since my research group was predominantly made up of international students. Comments such as “that’s gross” and “I don’t want to be touching up there” suggest that in our sterile world menstruation feels dirty and unhygienic to women, where of course it is a natural and frequent biological process. At this point, I began to fully realise the importance of my proposal challenging these perceptions, and encouraging self-care and interest in one’s own menstrual health. I was curious to learn if men held the same opinions, so I conducted a survey online. Questions included “how do you feel about menstrual blood?” which gathered very varied responses, most were indifferent, but a few were very negative, such as “uncomfortable” and “don’t want to see it”. I also queried how much education they had received on menstruation at home and at school. With the mean rating for school education 42% and home education 21%, it was clear that menstruation has not been openly discussed with boys in the majority of homes and in many schools. I recognise that this is an aspect of menstrual education that needs to be challenged and plan to address this need in a future project.
In order to better understand some of the diverse personal challenges that each individual menstruating woman faces I decided to design and deploy research probes. I asked several women to keep journals about their menstruation. The journals had very few prompts or questions to encourage the woman to consider the journal as a private and personal artifact, in which she could physicalise her thoughts and feelings and decide the most important information to be included. As well as providing me with interesting insights, most of the women reported that they had never paid much attention to thinking about their menstruation or its psychological impact, and found it to be a valuable personal exercise to manifest their feelings in a physical form.
In all of my research group engagements, I worked with both people who used disposable sanitary pads and tampons, as well as those who used reusable menstrual cups. By observing through a practical lens, menstrual cups could be described as an overwhelmingly more favourable option than any other disposable or reusable menstrual product as they are easy and quick to clean, cost-effective and produce very little waste. I felt it important to consider the cultural tensions and perceptions that dissuade women from choosing to use menstrual cups. From discussions with my research group as well as extensive online research in forums and on youtube, I have drawn the following conclusions.
Many women don’t feel comfortable touching their vulva and vaginal canal during their menstrual period. I have observed that this is partly due to the perception of menses as unhygienic and something that should be carefully wrapped up and disposed of in a special sanitary bin. The use of applicator tampons is proof that some women wish to remain at a distance from their menses. There is also a learning curve to using a menstrual cup which is off-putting for many women.
Before and after each period menstrual cups require sterilisation by boiling. Through research group discussions I learned that this is a barrier as they would wish to be able to clean their menstrual cup in privacy, away from male family members or flatmates. Part of the secrecy and shame is fuelled by the object itself, as most are clear white in colour and stain a rusty brown colour over time from the iron-rich menses.
Another perceived barrier is that most women prefer to rinse their menstrual cup under water before re-insertion after emptying. In most public washrooms the sinks are out with the cubicle, making it uncomfortable to rinse a menstrual cup since this is not currently socially acceptable in European culture. In theory, the majority of women shouldn’t need to empty their menstrual cup when they are out. However since popular disposable products do require changing throughout the day and most women will have had a menstrual period related ‘accident’ in their life, with blood seeping through on to clothing causing deep shame and embarrassment, women naturally feel cautious and concerned that they may need to empty their menstrual cup while they are out.
I was surprised to learn that some women are scared to use any internal menstrual hygiene products at all due to fears of toxic shock syndrome, a life-threatening illness that has been associated with tampon use.
Many women buy menstrual cups and try them before deciding to return to other forms of period protection. One of the main reasons for this is that they find them uncomfortable. Little thought has been put into the design of menstrual cups, with most looking like stylisation and ease of manufacture has been put before comfort. All women are shaped differently, and this has been partly addressed by different sizes of cups for women who have and haven’t had children, as well as specific sizes for women with low and high cervixes. Another issue is that many women with sensitive bladders find that using a menstrual cup makes them need to urinate more often which is an inconvenience.
Alongside the analysis of menstrual cups, I began making quick sketch models of some of my initial ideas for an improved menstrual cup. I spent time in the clay workshop modelling forms that I felt addressed some of the common problem areas I had identified, of ease of folding and insertion, ergonomic shape to relieve pressure on the bladder as well as ease of removal and cleaning.
I found it difficult getting a sense of the objects since the material was so far away from the traditional silicone that’s used for menstrual cups. To get a better sense I took some of my most promising clay forms and made silicone moulds using moulding silicone in order to mould the forms in a thin flexible silicone by pouring in, rotating and pouring out of the mould. I moulded each form twice, first with a thin layer of silicone, and then with a thicker layer. Some were more successful than others. One of my initial casts came out extremely thinly mistake, and I considered this a failure, but on reflection, I realised that I could push the material to the limit and that thinner could be better.
In order to develop the cup to be the optimum shape I met with my research group again and asked them which looked the most friendly, unobtrusive, easiest to fold and insert, most comfortable to wear, and easiest to remove, empty and clean. From these discussions, I learned that there should be clear signifiers such as ridges and dimples to show where to fold the cup, how to hold it and which way round the cup should face when inserted. I also learned that one had a stem that was difficult to grip on to as it was too short, while the others had stems that were considered much too big and that this was a point that I should develop with care.
Through working with the mixed research group of women in their early 20s I realised that this was a complex and broad group of users to work with, since some had tried a menstrual cup and loved it and others were completely disgusted by the idea, on top of the fact that all women are individually shaped and have very varied individual needs. At this point I decided to narrow my user group and aim my proposal towards young girls, having their period for the first few times. I consider it to be of more value to build positive perceptions of menstruation in young people rather than to try to change perceptions in older women. Throughout the project I was certain that my proposal should include a resource to help educate women about their bodies, and for them to learn about their own anatomy by using the cup. Considering that menstrual hygiene education in several European countries is brand sponsored it is logical to consider that my proposal could integrate state-funded education.
In my research, I came across the Essity Hygiene Matters Survey 2016 (United Minds, 2017)
from attending an exhibition at Fotografiska (Borg, 2017) which highlighted several matters to me, including that 16% of women and 29% of men in Sweden face some discomfort buying menstrual hygiene. The survey found that globally 7 in 10 women never talk to their partner about menstruation, and within Sweden only 17% of women have talked to their daughter about menstruation and just 7% of men. Since parents are expected to educate their children on basic hygiene such as hand hygiene and dental hygiene, it seems incredible to me that parents today do not consider menstrual hygiene to be of the same importance.
I decided to test some other reusable menstrual hygiene products including Thinx brand ‘period panties’. On their website, in emails and on their packaging they say “our mission is to totally break the taboo surrounding menstruation” and “we aim to eliminate shame, empowering women and girls around the world.” The New York company has had plenty of media coverage and large advertising campaigns, and attractive branding as shown in the image below, making them seem a trendy option. However, showing them to my research group gathered mixed feelings, with some thinking they looked comfortable and others considering them unhygienic, “wearing them all day long is so unhygienic, you can’t just sit in a puddle of blood all day”.
Another product that interested me was the flex menstrual disk, a product work internally that must be changed every 12 hours. The flex menstrual disk is inserted and removed differently to a tampon or menstrual cup, and sits at the top of the vaginal canal just below the cervix, in the same way as a contraceptive disk.
To help me understand the product from a first time user ’s perspective I asked a woman from the research group, who has only ever used sanitary pads to test it for me. She reported that it was very easy to insert because it remained in the narrow folded shape, and only required one finger to be inserted alongside the disk, unlike with a menstrual cup which can be more fiddly. However, it took several attempts to get the disk sitting in the correct position and then was difficult and painful to remove. From this insight, I was able to recognise that the insertion method of the menstrual cup could be improved by using a similar one to the menstrual disk. I made a model of a menstrual cup with a very soft body and harder flexible rim, however,from making the prototype I could see that it would be easy to insert the cup but tricky and very messy to remove it.
To gain a deeper understanding of my end users I asked my research group to tell me about when they first started menstruating, through a series of open-ended questions. One said “I was only spoken to once at 11”, and described starting menstruation as “such a shock” and “uncomfortable”. This exercise also highlighted the variety of sources young girls learn about menstruation from, other than their own mother, including the school nurse, the P.E. teacher, and biology teacher. It seems to me that different societies use different paternal substitutes, but the feelings surrounding these experiences were negative, suggesting more positive education would be best implemented in the home.
With this knowledge, I created an activity booklet and workshop that I undertook with a 10-year-old girl, which helped me gauge the level of appropriateness for intimate education in young girls. I was also learned about aesthetic preferences in menstrual products, as she preferred non-patterned pastel coloured packaging in pinks, purples, and blues.
Following on from my research group responses I looked into common resources that are used to educate girls. One popular method is by using books, as this allows the adult to avoid conversations on the subject, and the girl to learn independently. This helped me to recognise that the educational resource should facilitate conversations in the home, as well as support independent learning.
I discovered examples of an intimate education resource online in the form of a project called “OMG Yes”. The project focuses on female sexual pleasure and presents scientific findings in the form of educational videos with real women talking frankly about their experiences, as if with a friend. The website also features explicit instructional videos, however they feel completely practical and de-sexualised. I recognised that this resource is a very good example of comfortable and practical intimate education, leading me to develop a similar concept based on menstrual education.
My proposal is a government-run and funded service that removes menstrual education and care from schools and places it firmly in the home where it facilitates conversations between parents/ guardians and their daughters. The idea of menstruation will be planted at age 10 using an online platform with friendly factual videos of real women talking about menstruation, which will encourage and prompt discussions with the girls parents/ guardians. When a girl has her first menstrual period she will be able to view more informative videos about hygiene, and will receive a menstrual kit that will include a menstrual cup that can be cut to size.
With this model, the government can ensure that no young girl ever suffers period poverty, and has a good education on menstrual hygiene and intimate health, as well as the confidence to discuss any problems or concerns with parents/ guardians. This method will also drastically reduce the amount of used menstrual products sent to landfill.
SUMMARY AND REFLECTION
In this project I set out to respond to the menstrual hygiene needs of women and girls in Northen and Western Europe and found focus in the important user group of young girls new to menstruation.
In this project I challenged myself to research with many people and to practice and develop my ethnographic research techniques and methods. I also explored using blogging alongside my physical sketchbook as a tool for project documentation, which allowed me to easily bookmark and comment on digital references, as well as document my own work in multiple streams by uploading my pictures in to blog posts.
I found the topic of menstruation to multi-faceted and complex. In Scotland today there are several pilot schemes offering free menstrual products to those in need, while in England the #freeperiods campaign is calling for similar schemes. While there is little data or evidence of “period poverty” in Sweden there is a growing awareness and sensitivity to gender politics and their role in a fair and equal society.
My proposal is not a campaign against so-called “period poverty” but rather a critical proposal that challenges the troubling accepted norms and attitudes towards menstrual hygiene and education, as highlighted by the Essity Hygiene Matters survey, as well as my own research.
With such a broad starting point in an industry that has seen little innovation and holds so may opportunities, a key challenge of the project has been finding a narrow focus, informed by my research that felt relevant, important and valuable.
I have found it rewarding to work with women to develop the form of the menstrual cup. and to begin to develop the form of the menstrual cup, and to begin to conceptualise the educational resource. I recognise that much more research and development would be required to propose a truly valuable proposal for the educational resource. If I had the time to develop the proposal further I would explore how real life conversations with parents/ guardians could be facilitated by the web resource, as well as how education for young boys could be integrated into the system.
I hope that my proposal will succeed in highlighting menstrual hygiene related issues and act as a critique on the current systems and attitudes.
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