Strategies to combat stigmas

Stigmas bother me.

Women, homosexuals, the obese, or mentally ill encounter messages indicating our culture’s discomfort with them. These messages act to shame those who are stigmatized, robbing them of power and voice. This disempowerment contributes to a lower quality of life for those who are stigmatized.

Communication designers have an opportunity to reframe stigmas in a way that encourages dialog and new ways of thinking and acting.

An example stigma that needs reframing is PMS because women continue to be shamed and dismissed when their actions appear to be influenced by hormones. This is due in part to women’s lack of knowledge of and apathy towards the menstrual cycle. If women were motivated to re-learn the menstrual cycle they could benefit from the ability to predict their PMS and periods and gain a level of hormonal self-awareness which could ease stress and reduce interpersonal friction.

Communication strategies may inspiring people to act differently towards PMS and stigmas in general by:

  • Recognizing that the topic is uncomfortable.
  • Make it more comfortable to discuss by using humor.
  • Use a speaker who represents the stigmatized group.
  • Use a heavy dose of persuasion to motivate people by
    showing the problem with the way things are and the
    personal benefits involved in changing.
  • Instruct people on how to act differently and when to
    spring into action.


28 Days of Fluxuations

This prototype makes a concrete visualization of the menstrual cycle and uses color and pattern to show the different phases within one's cycle. Each panty represents a day of the cycle and is made from paper.

A participant checks out the 28 Days of Fluxucations panty rack display.
This prototype displays the phases of the menstrual cycle visually and concretely.


28 days of panties in flux

Days 9-19 of the menstrual cycle features peak fertility. To describe this, I
used baby colors. The fertility phase shows baby stripes while ovulation or
peak fertility features cross hatching.


The last day of the cycle most likely conincides with a dark mood expressed
by solid black panties.


Red polka dots are used to show the bleeding phase as it goes from big dots
(heavy flow) to smaller dots.

A handout to accompany the rack shows participants the phases of the
menstrual cycle visualized in a way that generates curiosity and provides
concrete, memorable learning.


Your 5 Hormone Personalities Finger Puppets

The finger puppets take their inspiration from the fact that estrogen fluctuates during your menstrual cycle in a pattern that roughly mimics the outline of your hand. Estrogen is the hormone that's responsible for our changing moods throughout the cycle. I have created five characters which show how the fluxuations manifest in how you feel.

Starting from the left, the characters are:

MESSY When you start your period, estrogen is low.  
HAPPY Over week 1 and 2, estrogen begins to climb.  As it does, so does your mood, outlook and productivity.  
HORNY Estrogen reaches its peak around day 14.  This coincides with peak fertility which means you will be very interested in fertility related activities...if you know what I mean.
SLEEPY During week 3, estrogen begins to plunge.  Lowered levels of estrogen mean you feel more withdrawn, quiet and are more interested in staying home and resting.
CRABBY During week 4 estrogen rapidly plummets taking your mood with it. You will be grumpy, emotional and crappy.

A participant tries on the glove and imagines explaining where she is in
her cycle to her boyfreind with the puppets.

An informational sleve accompanies the puppets.


Be a clever girl: re-learn the menstrual cycle.

This video aims to motivate women to re-learn the menstrual cycle by highlighting that being fooled by PMS over and over again is foolish. I'm pointing to the fact that the current state, being a foolish girl is negative, and that a new identity, the clever girl, is better. I still need to make the video which explains the menstrual cycle that focuses on hormones and not anatomy because as I found, anatomy doesn't motivate women to care.


Ovulation education in the snow video

I created an educational video in an unusual location; out in the snow. I created an oversized uterus out of snow and used real eggs to explain what ovulation is and what signs women can observe that indicate ovulation. By using physical props, viewers can more easily picture what is happening anatomically during their cycle. Being in the snow gives the video a playful feel which may disarm the audience.

This prototype reflects a hypothesis that women need a place to express themselves and connect over their struggles with PMS. They would create a caricature of themselves showing what they're like when they're experiencing PMS. They would then anonymously upload their picture and give a "witness" to other women's picture to which they can relate.


Literature Review

Timeline sketch of the Sex Ed Gap showing the phases of life when learning about the menstrual cycle occurs: early puberty; when having
trouble conceiving.

When do women encounter menstrual cycle education?

As a girl

The first encounter with the menstrual cycle generally happens in school or at home when the girl is expecting her first period around age ten or eleven. The health teacher or a parent will explain the basics to her. In this phase, the mechanics of the menstrual cycle are simplified and glossed over. PMS, if included at all, will be vaguely mentioned. I think this is an appropriate approach for young girls who may be already overwhelmed with the number of changes in their bodies.

As a women struggling with infertility

If a woman is having trouble getting pregnant, she will have many fertility guides written for her situation, all designed to teach the detailed mechanics of the menstrual cycle. It is likely that this will be the first time she will learn about ovulation, cervical mucus and predicting her period.

The problem with the current set of encounters

  • As I see it, the problem with the current distribution of menstrual education is that for much of her life, a woman only knows what she learned as a girl. If a woman is unmotivated to learn more, she will be operating on those simplified descriptions of the menstrual cycle with little or no knowledge of how fertility works or how her hormones effects her mood and body.
  • Modern women will spend the vast majority of their lives avoiding pregnancy yet most of the literature available to her on the menstrual cycle focuses on getting pregnant. None of the literature focuses on avoiding pregnancy or on how hormones effect mood and the body.
  • All women can benefit from learning about the menstrual cycle and how to track it in detail. These benefits include:
    • Predicting your PMS and period within four days
    • Greater self-awareness of how changing hormones effect
      your mood
    • Understanding when conception is likely

Common strategies for breaking a taboo

I gathered a list of strategies commonly adopted by campaigns working to end taboos or soften stigmas. These include:

  • Find a charismatic spokesperson to champion the cause
  • Create a media spectacle which celebrates the taboo
  • Connect with social networks who support the cause
  • Work for policy change
  • Get science to study it
  • Take a personal pledge to act differently
  • Create a contest to solve the problem

The underlying goal for all these strategies is to start talking about the topic in an intelligent and compassionate way.

User Research


Generative research over traditional interviews

During the 12 interviews conducted, I had participants engage in a number of generative research activities including:

  • Drawing or making a 3D models of the female reproductive anatomy
  • Reviewing diagrams from sex ed books
  • Doing a panty and card sort
  • Writing letters to their periods and their PMS

I thought generative research methods would do a better job at getting women to talk about this subject than a traditional interviews. It is a taboo topic afterall! I found that this strategy worked well and I came away with great insights and a new PMS-centered direction.

Drawings & make tools reveal the gaps in her knowledge

The first exercise was to make or draw a model of the female reproductive anatomy and then to explain how the menstrual cycle works. This helped to reveal what women know, rather than what they think they know.

Most had the basic anatomy correct but no one was able to explain the menstrual cycle well.

What I realized is that understanding the anatomy doesn't really matter because we can use it without understanding it. Plus we can't see it so does it really matter what it looks like? What matters more to women is the physical symptoms and mood changes that women feel during ovulation, PMS and menstruation.


uterus drawing

uterus model

Diagram review

I collected the diagrams used in sex education materials such as health guides, period guides, text books, anatomy drawings, pornography and tampon instructions. I organized them so that the diagrams showing similiar topics or processes were grouped together.

Participants looked at these collections of diagrams and told me which ones they had had encountered in the past, which ones they found more informative, which one they were likely to learn from, which ones they found unappealing and why or why not.

Most of the diagrams were unfamiliar. The ones that had the most familiarity were anatomical cross sections seen in textbooks or in doctors' offices. Their reported exposure to these diagrams was infrequent.


Card and panty sort

I bought a variety of panty styles and made a card sort with word like "horny", "sexy", "bleeding", "everyday", "safe", "getting pregnant is likely". My hope was that there would be some consistent sorting which would allow me to use panty styles as a way to visually represent the different phases of the menstrual cycle.

No such luck.There were no discernable patterns to the sort and many were confused by the premise.

card sort

Letter writing: PMS emerges as the
greater taboo

I had my participants write two letters, one to their period and one to their PMS. What emerged from this exercise is that women desire more predictability from both their period and their PMS.

Additionally, the attitude towards PMS was much more negative than towards the period. A level of frustration and near hatred could be felt in nearly every letter to PMS.