The Menopause Manual : Major Project by Trisha Rathod

The Menopause Manual A guide for individuals to own their Menopause experience

Trisha Rathod Major Project MA Service Design 2020-21 1

Disclaimer This report along with the appendices is the original work of the author and has not been submitted to any institutions or organisations previously for assessment purposes. This project is designed for individuals undergoing Menopause in the UK. All sources have been cited and acknowledged. The names in the report have been altered to maintain confidentiality.

Acknowledgements I am eternally grateful to everyone who contributed to the success of this project, starting from my parents, my partner Vrajesh, my friends Sampada, Chen, and Fianda, and my mentor Martyna for their encouragement and support. I would like to extend my gratitude to the London College of Communication and all my tutors, Silvia, Cordula, Veron, Hena, Lara, Marion, Fernando. I would like to especially thank my mentor, Cordula Friedlander for her continuous guidance and for sharing her valuable insights throughout the project.

This project is a note of gratitude to my dear mother, Sangeeta, whose menopause journey has inspired me to extensively study this as my major project. I hope this will be a model of inspiration for countless other women who are experiencing the same. This project would not exist without the countless efforts of you all!

I would also like to thank all the women who shared their menopause journey with me, and I am grateful for the guidance I received from Positive Pause. Thank you, Ann and Jo, for providing all your inputs and for believing in the potential of my project.

00 INTRODUCTION Disclaimer Acknowledgement Executive Summary Methodology

01 BACKGROUND & CONTEXT 02 03 06 08

Project Motivation Menopause Menopause in the UK Emerging Trends Initial Research Question

Table of Contents 4

11 12 14 16 18

02 DISCOVER Menopause Survey UK Experts Interviews Project Partner Focus Groups Initial Insights Men in Menopause Co-discovery Workplace Interviews Key Insights

22 24 26 28 32 34 36 40 42

03 DEFINE Persona Stakeholder Map Design Directions

46 50 52

04 DEVELOP Ideation Value Proposition Canvas Co-design : Future of Workplaces Final Research Question Ideation Co-design : Online Initial Concept Development Initial Testing

06 CONCLUSION

05 DELIVER

56 58 60 62 64 66 68 70

Service Concept Service Testing Final Service Concept System Map Menopause Manual Journey Map Testing with Experts Business Model Canvas Service Blueprint SWOT Analysis

74 78 80 82 84 86 98 100 106 108

Next Steps Conclusion Reflection

111 112 113

07 BIBLIOGRAPHY

114

08 APPENDICES

116

0.2 Executive Summary This project started with a focussed approach towards the lack of awareness and support for individuals experiencing menopause within at work. However, as the project evolved, through research, findings and testing with users, it transformed into a service that empowers individuals experiencing menopause to own their journey. Initially to gain a sense check of the subject, women from India were approached. However, the final outcome has been designed keeping in mind the individuals and organisations from within the UK. The service aims at providing relevant information, guided reflections and encouraging to express the user’s menopause journey. Not only so, it facilitates collaborations with menopause experts and involves the family members of the user in the menopause journey.

What does it solve?

Who needs it?

Individuals undergoing menopause feel hesitant to share their menopause related issues due to fear of being judged or asked to retire early.

Any individual who is confirmed with menopause and is seeking guidance to navigate through their experience smoothly.

Why?

And how does it work?

Workplaces in the UK don’t have sufficient awareness to support individuals experiencing menopause as a result policies developed to address menopause at work are not entirely inclusive.

The service facilitates connections between menopause experts and individuals seeking advice, who use the service toolkit to build their own Menopause Manual. Alongside this, the family member of the user can also participate in the journey, thus gaining awareness. 7

0.3 Methodology Since its conception, this project has followed the Double Diamond process, coined by the Design Council, which highlights the importance of convergent and divergent thinking at each phase (Design Council, 2005). Over the course of time, this formula has shapeshifted into a dynamic process consisting of multiple design methods and countless iterations of prototypes that transformed this project into its final facade. Illustrated to the right is the representation of the design process that was loosely adapted throughout the project, with each phase highlighting the core tasks and achievements.

e v o

sc i D

Motivated to pursue the stigma around Menopause in the workplace.

Online survey : 20 women, 12 men Facilitated 4 focus groups : 12 women in total Engaged with 30 individuals for co-discovery Attended 2 Menopause Networking events Conducted 8 deep interviews

Deep dive into the vastness of Menopause in the UK using a variety of research methods of interviews, focus groups, online surveys, co-discovery and networking. 8

Collaboration

Identifying HMW q

Identifying back into down on research q

efi

The point of great hesitation.

with Positive Pause Building personas g design directions question variations

g the core problem area, jumping secondary research and narrowing the user profiles to declare the final question once and for all!

p o l e

Co-design through alternative means Filling up every wall of the house with ideas (the post-it addiction) 3 rounds of prototypes Individual testing interviews

Ideation, multiple iterations, user testing, consultation fatigue and concept development and testing again is the way forward.

liv

Impact map Business model canvas, Value proposition canvas, Service Blueprint Concluding and reflecting upon the project and personal capabilities.

Motivated to make the service a reality!

Packaging the service into an official proposition. Looking into its future by depicting its impact, indepth functionality, its business case and addressing the steps to make it viable for the future.

Figure 1 : Interpretation of the double diamond 9

Background & Context

1.1 Project Motivation 1.2 Introduction 1.3 Menopause in the UK 1.4 Emerging Trends 1.5 Initial Research Question

1.1 Project Motivation As a young designer, I was always drawn towards healthcare as a sector and within it the invisible nature of conditions. I was inspired by the TED Talk, Confronting the Invisible, where Olivia Larner talked about her struggles of living with chronic illnesses and the tough choices that she had to make between prioritising her health and her social wellbeing (Larner, 2019). We are quick to prescribe instead of empathise.

that led to her feeling invisible. Women who experience menopausal symptoms during the Perimenopause phases are often dismissed and prescribed antidepressants. Dr. Nighat Arif, from the documentary, also shares light on the fact that Menopause is not a mandatory subject for all GPs but studied voluntarily. Despite there being a need to make this module mandatory, additional training around Menopause & hormone therapy is not advised by the UK During menstruation, the thickened lining of the government yet. To make matters worse, there uterus is eliminated causing women to bleed are only 97 Menopausal clinics for women in every month. This, in my opinion, is the most the whole of the UK catering to over 13 million discrete condition we experience, not because women (Davina McCall: Sex, Myths and the the bleeding is not visible to others but because Menopause, 2021). of the stigma around the subject. One thing that we were never explicitly taught is that this This array of gaps in the existing system menstruation cycle is a loop and the end to this inspired me to pursue the context of Menopause cycle is never discussed until we experience it. within the UK by approaching individuals of It is ironic that as a society, we applaud the act different ethnicities, urging them to share their of pregnancy but fail to accept the biology that experiences and navigate through the process causes it to exist. with hopefully support from large organisations.

“Healthcare is personal and universal - it is the one value that everyone cares about.” (Jones, 2013, pp 16) For years I watched my mother navigate through her menopause with immense pain and suffering. Due to the lack of resources available at her workplace, she was forced to step down despite being in a leadership position. Upon further inquiry, I came across several stories of women experiencing Menopause sharing similar episodes.

Karen Arthur, a teacher turned fashion designer from Catford, talks about her menopause journey, in the documentary titled “Sex, Myths, and the Menopause, of experiencing perimenopause and shares the dismissal around the transition 11

1.2 Menopause The climacteric change in a woman’s life is referred to as the decline of ovarian activity until the end of its function resulting in the arrival of Menopause. (Taechakraichana, N et al. 2002) Menopause in the simplest terms is when a woman stops having her periods and is no longer able to reproduce. A natural part of aging occurs around the age of 45 to 55 as oestrogen levels decline. (Gupta, 2019). The menopause transition, commonly known as perimenopause, begins several years before and is noticed due to the fluctuation in levels of hormones, causing a number of symptoms such as the ones listed to the right. Contrary to widespread belief, there is no relation between the age at which a woman gets her first period and her age at menopause. Although there are several lifestyle factors such as diet constituents, smoking, physical activity that influence early onset menopause. (Ceylan et al, 2015).

Irregular Mentrual Patterns Hot flushes Vaginal Dryness Night Sweats

Fatigue Mood Swings Brain Fog

Reduced Libido Migraines

Loss of Sleep

I intended to approach the women transitioning into Menopause for my target group. However, due to the lack of urgency around the subject, only the women who had experienced menopause were interested in sharing their stories.

Rise in Oestrogen levels due to pregnancy

No period for 5 years or more . Reduced bone and muscle mass, memory, concentration, failing heart and cardiovascular health can be impacted.

Reproductive Years

Transition : Peri Phase

12.8 years to Late 30s

Mid 40s to Early 50s

Age 60 and above

Early 50s to 60s

Later Post Menopause Phase

Early Post Menopause Phase

When periods are more than 7 days different to the normal cycle (21-35) Late stage : miss two or more cycles or no period for 60 days or more

No periods for 12 months or more. Ovaries no longer active. Decline in muscle tone. Noticable dryer skin and hair Figure 2 : Stages of a Woman’s Hormonal cycle ( Promensil, 2021) 13

1.3 Menopause in the UK In the UK, the average age at which women experience menopause is 51. However, one in a hundred women experience menopause before 40 years of age and in a few exceptional cases, women may be menopausal even at the age of 30. It is estimated that over 13 million women in the UK are perimenopausal or menopausal, which is 1/3rd of the entire UK population (Women’s Health Concern, 2017). In a recent article by MegsMenopause, a women’s health platform in the UK, on the perception of Menopause in the Black Asian & Minority Ethnic community, it was highlighted that due to English being a second language, women tend to partially understand the implication of menopause. They often don’t associate it with a medical condition and continue to suffer from symptoms for years on end. In subcontinental cultures, early menopause is viewed as a sign of infertility in women and often the male counterparts are even encouraged to take a second wife. At the same time, there is a sense of victory through menopause as religious women are then ‘allowed’ to visit places of worship. Moreover, there is also a sense of belief around God that illness is caused and healed by divine power (MegsMenopause, 2019).

Menopause in Workplaces

“Your worth has nothing to do with your ovaries.”

In the UK, 8 out of 10 women at work are menopausal, which means that menopausal women are the largest workforce demographic in the country. Despite this majority, they are under constant turmoil whilst seeking support from ( Gunter, 2020) coworkers. The Chartered Institute of Personnel and Development (CIPD) conducted a survey with over 1400 women experiencing menopause symptoms. The survey had shocking results stating over two-thirds of women who faced a negative impact at their workplace also felt a loss in concentration, experienced more stress, and felt less patient with their clients and colleagues. But despite their uneasiness, they chose to not disclose their symptoms due to privacy and embarrassment of taking leave. Over 32% of these women shared that they would rather not disclose their condition due to their unsupportive employer. (CIPD, 2019)

More studies in recent years have also highlighted the mental health impact of delayed diagnosis of menopause leading to increased anxiety, loss in self confidence and feeling blamed for their incompetence. The survey by Newson Health UK, highlighted the reality surrounding menopause support in workplaces (Newson, L. Lewis, R. 2019). According to the survey, 1132 women experiencing menopause shared that :

shared that the menopause symptoms had a negative impact on their work.

94% of women

76% of women

41% of women

did not receive any menopause related assisstance from their workplace

feel a loss of concentration and lose interest in their work.

Figure 3 : Representation of the statistics mentioned in the Newson Health survey 15

1.4 Emerging Trends Addressing the need to emphasize reproductive and family health is crucial as it is expected to play a significant role in the organisational structure and benefit its strategy. As an increasing number of organisations adopt an inclusive approach to policies, catering to diversity in culture, ethnic minorities, and sexual orientation, women’s reproductive health has also gained some attention. In a survey conducted by the Willis Towers Watson Group in 2021, 34% of employers across all sectors in the UK are enhancing policies around menopause in the workplace (Willis Towers Watson, 2021). The report also highlights the emergent need for restructuring in policies. Approximately 1 in 6 women in the workforce will be over 50 by 2022 and according to the Wellbeing of Women’s Survey, 1 in 4 women may consider giving up their jobs due to menopause. However, a shift in company policy could make a difference. According to the McKinsey Woman in Workplace 2020 report, only 21% of women are promoted to leadership roles (C-Suite) while that of men remains at 78%. Consequently, the pandemic brought in more challenges around the roles of women in the Work from the Home scenario as well. The lack of flexibility at work paired 16

with their additional role as a caregiver, had them worry about their employers judging their performance negatively. Companies offer mental health support by providing training programs to line managers, however, when it comes to Menopause, there is extraordinarily little action taken (McKinsey, 2020).

It often seems as though we, as women, are trying to fit into a man’s world. We are trying to follow policies that were not designed for us. I believe highlighting the importance of inclusive work policies, including menopausal health of women, would help uncover many of such suppressed issues.

Enhanced Support

Sectors Financial Services

Surrogacy or adoption leave, including partners Pregnancy, new parent, inclduing partners Menopause

Professional Services

42%

50%

39% 11%

24% 15%

35% 30%

14%

18%

39%

16%

26% 30%

48%

41%

Manufacturing

IT & Telecom

23% 15% 18% 15%

43%

8% 18%

Figure 4 : Graph representing emerging trends in enhanced support for various sectors

After doing one round of initial research, I asked m

How can we reduce t around menopause a empower women to p their life and career a they imagined it to b 1.4 Initial Research Question

myself,

the stigma and pursue as be?

Let’s talk Menopause

Hot & Bothered No fear of fertility Positive Pause It’s personal to discuss out loud

Menopause Cafe

Discover

Education, understanding & practical support

Losing fertility at a young age

Feeling liberated Men in Menopause 20

Davina McCall

Menopause Survey UK Experts Interviews Focus Group : Indian Women Initial Insights Co-discovery Menopause Networking Workplace Interviews Key Insights

2.1 Menopause Survey UK In order to understand the opinion of the individuals around Menopause, an online survey was conducted in which over 18 women participated. The survey aimed at establishing the demographic of women in the UK that experience menopause, their understanding of the subject, and their current and past experiences of navigating through menopause while being employed. The survey was shared across multiple social media channels such as Nextdoor, Facebook, LinkedIn and was also forwarded to personal contacts via friends and family. Over 56% of the women are currently employed and when asked about the support they received from their employer, only one woman claimed that she was given time off based on the GP note that she provided. Each of these women also shared their own desires for the future of workplaces such as better understanding, awareness about the subject, and practical support.

Describe your menopause in 3 words

Headaches, headaches, headaches

Tired, Sick, Stressful Lethargic Sugar Craving Challenging, Unfair, Scary Soul destroying Sustain hell Incredibly confusing unsettling

What according to you would help working women transition smoothly into Menopause? Acknowledgement & awareness by surroundings

Counselling, herbal remedies More awareness by management & HR

These inputs helped me gauge the basic perception of menopause and identify the expectations of the women experiencing it. As an indirect form of research, I believe this would be a good entry point into the project to understand the ecosystem around women and address the hesitancy based on the number of responses received. Moreover, the age group of women that answered the survey also indicated the importance of menopause as perceived.

Wellbeing information, job flexibility

Information, communication & recognition

Emotional support

2.2 Expert Interviews “We started the Menopause Movement to reach out to women, men, children and young adults and educate them about their roles in this massive Menopause Ecosystem”

Ann Co-founder of Positive Pause

Through the online forums, some of the women who had pioneered platforms for women to speak about their menopause experiences came to attention. Upon approaching two women founders of Positive Pause and Menopause Cafe, who after experiencing menopause had started their respective non-profit organisations to increase awareness around the subject. They shared their struggle over the years of establishing Menopause-related initiatives in the country but also pointed out the recent recognition around the lack of awareness of Menopause at work.

“We are starting at the wrong end of the spectrum. We need to be addressing the whole menstraution cycle not just the menopause.That is when, we will see the real impact!”

Rachel Weiss Founder, Menopause Cafe

2.3 Positive Pause : Project Partner Through the survey conducted, it was evident that workplaces need a push to better understand the implications of Menopause on the day-to-day lives of their employees. Through a quick search, it was found that there are multiple non-profit organisations that collaborate with corporates to make them aware of menopause, provide training to line managers and conduct lunch and learn sessions to help individuals express their concerns and make them more aware of their own symptoms. One such organisation, Positive Pause, based in the UK, was co-founded by Ann and Jo who themselves have experienced menopause and are now inspiring countless other women and organisations to take upon a positive outlook towards their own health. The organisation aims to revolutionise menopause within the UK Parliament by sharing their contribution to the new menopause policies for companies. Not only so, but they have also been instrumental in bringing about a Menopause Movement, to inspire individuals experiencing menopause and their families to address the issue aloud. They aim to educate everyone who visits the website about Menopause by providing detailed information about symptoms, home remedies such as diet options, supplements, and blogs written by women attending the sessions. 26

“PositivePause work with organisations to understand the impact of menopause symptoms on women in the workplace and how they can support this crucial segment of their workforce.” (Positive Pause, 2021) Upon approaching Positive Pause for their mentorship and guidance for my project, they responded promptly and agreed to monthly sessions where I could share my research in exchange for opportunities to network with their existing clients and their feedback on my work. The conversations with Ann were helpful as not only have they attempted to address every gap in the Menopause ecosystem through their work but also being individuals who have experienced menopause, they were able to share inside stories to many of my assumptions.

Figue 5 : Images showcasing interaction with Positive Pause

2.3 Focus Group While surveys are an effective way to attain data from the users due to their prolific nature, the element of it being indirect makes it a passive form of research. On the other hand, the dynamic nature of focus group sessions makes it qualitative. Over four focus group sessions were conducted with a total of twelve working women between the ages of 48 to 60 who had previously experienced menopause. Each of the focus groups was asked to reflect upon their own menopause, talk about their immediate ecosystem of trust, share some insightful memories, negative experiences, and express any advice they could give to their younger self if they could. Hypothesis: The questions asked were similar to the questions in the survey to gauge an understanding of whether women felt more comfortable talking about their menopause within a group or reflecting upon it in their own time.

Through this form of research, it was clear that women experiencing the same kind of menopause resonated with each other’s stories and wanted to empower one another. As each focus group consisted of a group of friends or family members, the users felt a sense of comfort while expressing their issues especially around their work-life and dealing with workplaces that were inconsiderate of their condition.

Figure 6 : Images showcasing women’s participation during focus groups

2.3 Focus Group Findings What comes to mind when I say the word,

MENOPAUSE

“Bloating”

“Relief”

“Calcium Depletion” “Losing Fertility” “Restlessness”

“Mood Swings” “Hot Flushes”

“No more sanitary pads”

During the focus group, the women were asked to relfect upon their menopause experience and share their stories with one another. One of the contrasts in thoughts was noticed when they were asked about their Menopause experience and most of the women spoke about feeling wise and liberated but when they were asked to give some advice to their past self, it immediately took a rather isolated turn as they advised themsevles about facing the harsh reality of society and its perception of Menopause.

YOUR MENOPAUSE FEELINGS “People look up to you. It makes you feel confident, being able to share freely.” “Heavy bleeding ( pad leak), feeling embarrassed almost 2 years”

“Self reflection helped me understand that my symptoms were a part of Menopause” “We don’t talk enough about Male Menopause”

ADVICE TO YOUR PAST SELF

“Realization that you need to take care of your health for your kids”

“It’s okay to prioritise yourself and your health over other things” “Its a transition, just accept it positively” “When in doubt, just blame it on Menopause” 31

2.4 Initial Insights Most of the answers in the survey highlighted the problems during menopause, while the focus group women bonded over their menopause experience. Facilitating the conversation live helped the women reflect upon their menopause experience.

The focus group participants also shared that they felt judged upon sharing about their health concerns with their peers and wanted to avoid ‘making a big deal’ out of it.

While comparing the survey results to the focus groups, women filling out the survey voted for their Local GP as the most trusted source while their family members were least approached for any concerns.

The common keywords noted in both the scenarios have a drastic difference due to the acceptance of the subject within the demographic.

On the other hand, all the women who participated in the focus group tend to confide in their family (partner / kids) and refrain from any social media or local community groups for menopause related sharing.

The common keywords noted in the Survey : Need for emotional support, Creating awareness, Normalising the experience While in the focus group : Taking ownership of your own health, Being positive about menopause Feeling isolated.

Currently, there is a lack of awareness and understanding around hormonal health of the elderly. Menopause and male menopause are not subjects that are addressed openly, but often expected to ‘deal with it’. Pivot Point :

Menopause support at workplaces is considered a privilege due to the uncertain nature of the menopause journey (unlike maternity leave) and the level of investment for their employees (may not be affordable to all organisations).

Highlighting the importance of Men in Menopause

Women are hesitant to share any menopause related concerns with their employer due to the fear of being perceived as incapable and insufficient to do their job.

2.5 Men in Menopause The focus group insights combined with the survey indicated a need to explore the role of Men (ecosystem around women) in Menopause. In order to approach them, an online survey was forwarded across social media channels to gauge the hesitancy around the subject and understand their actions to support their loved ones.

Have you reached out to someone experiencing Menopause at your workplace? Yes No I don’t know if someone is experiencing menopause

Out of the 16 responses received, over 80% of them were able to describe Menopause based on their own understanding. While 42% of the men were aware of the women around them experiencing menopause, only 7% shared that they reached out to someone within their workplace to support them. How would you support a family member ( partner / mother/ daughter) who is experiencing menopause? Accompany them to the GP and invest yourself in the process Be approachable and reach out to them if they need to have a conversation Give them their privacy but try to support them if asked I would prefer to not reach out as it doesn’t affect me All of the above as possible

Define Menopause in your own words

“Monthly process of impure blood flow for 4 days”

Within the first 48 hours, despite sharing it across multiple channels, the survey only received 3 responses: my partner, my dad, and my classmate. This revelation proved to be an insight depicting the level of hesitation from the professional male population.

“One more stage of growing up, similar to puberty but in reverse manner, loss of power”

“Women stop going through the painful process of bleeding every month?” “Let’s face it together” 35

2.6 Co-discovery : Kings Cross Station The method of conducting an online survey, although quantitative, was not providing the right area for intervention due to the lack of reach. To tackle this, a co-discovery session was conducted at Kings Cross station and Peckham high street to engage with the men in-person. We carried a massive yellow board titled “Menopause” and below it, a scale was drawn to understand the hesitancy around the subject. The scale was divided into four parts: • I don’t know about Menopause • I want to know about Menopause • I know about it, but why discuss it here? • I am comfortable discussing Menopause The interaction was efficacious to understand whether these men were aware of someone who was experiencing menopause and if so, what were the actions taken by them to support the individuals undergoing menopause. Out of the 32 men and 6 women that were approached, most of them were aware of Menopause and were comfortable discussing it but very few had approached or supported their loved ones and their colleagues at their workplace. They felt as though they were stepping into unfamiliar territory. 36

“Menopause isn’t something that just occurs, it starts at the age of 50 and goes on for the rest of our lives” - Male, 40

“ This is a woman’s subject, it is about their body. I don’t think we need to discuss this here” - Male, 38

“ It’s not about having a space space for conversation but about my relationship with my employer” - Female, 48

Figure 7 : Images showcasing co-discovery at Kings Cross Station

2.6 Co-discovery : Peckham High Street On the contrary, while interacting with the residents at the Peckham high street, only 5 people agreed to speak about menopause out of which two men shared how they have supported their mothers through their journey by accompanying them to the GP. One of the girls shared that her trans-man partner is going through induced menopause and due to the lack of awareness at his workplace, his symptoms are misunderstood as lethargic behaviour.

This made me realise that there are resources available to educate people about Menopause, but it often goes unnoticed as the situation is not relative to all age groups and gender profiles. This indicates the need for better signposting of resources for not just individuals undergoing menopause but also, for their immediate ecosystem such as their partner/husband, children, friends, peers.

“I think its a personal topic to discuss. My office has some menopause events, but I don’t feel like attending them. It’s not my territory or my concern.” - Male, 45

“The place where I’m working is male dominated, so I don’t think they know how to support me with my menopause” - Female, 52

“ There is very little awareness at workplaces about menopause with regards to trans-men” - Female, 21

Figure 7 : Image showcasing co-discovery at Peckham High Street

2.7 Workplace Interviews

Rachel, Business Manager

Raina , HR

Mathew, Associate Director

Bromley Healthcare, UK

Godrej Tooling, India

Royal Bank of Canada, Jersey

“It’s just making sure that they (women experiencing menopause) can contact HR or their line manager to have these conversations”

“A menopause session at work is like a ladies toilet, a man is not expected to walk in there”

“What you want is a better company where everybody feels that they can solve their problems, or their personal circumstances or the biological circumstances in the best possible way”

Despite the previous information indicating the Key Learnings: lack of support at workplaces for menopause, there were a few organisations that stood out, • Companies prefer to outsource menopause which provide menopause-related benefits, take training to experts in the domain instead of upon initiatives, and have redefined their policy building their own personalised policies. to ensure inclusivity. • Organisations are willing to include Bromley Healthcare is one of the organisations Menopause-related initiatives within their that have partnered with Positive Pause to Diversity & Inclusion policy, but there is no implement menopause training modules formal measurement of impact recorded. within their organisation, hence they became a prime example to highlight the efforts around • Often the involvement of Menopause implementing Menopause-related initiatives. Awareness Organisations (Positive Pause/ Subsequently, reaching out to international Henpicked) is decided by the corporate companies (Godrej & Boyce in India, Royal authority and not the employees which makes Bank of Canada, Jersey) to understand their it a top-down approach. approach from a cultural perspective due to the prevalent taboo of menopause visible globally and witnessing them achieve their corporate responsibility was informative.

2.8 Key Insights

Pivot Point :

Transfering the power from workplaces to the women

Due to the lack of resources available during the perimenopausal phase, symptoms are misunderstood as stress and anxiety leading to self-doubt.

Younger managers are now managing older employees without any knowledge about menopause.

No woman has the same menopause experience or even the symptoms, hence there is uncertainty around Menopause leave, unlike maternity leave.

The ecosystem around women aren’t aware of Menopause and hence don’t want to overstep by offering to help

Workplaces talk about supporting their employers by implementing policy but no concrete actions are taken.

Most women are hesitant to share any menopause-related issues with their employer for the fear of being judged.

Let’s talk Menopause

Support groups Need more support from GP

Define

Anti-depressants

No woman menopaus

A wom repro

Educating the youth abo Menopause Ecosystem 44

Menopause policy

n has the same se experience

man is expected to oduce and that is horrible

Persona Stakeholder Map Design Directions

out menopause 45

3.3 Persona Holly, 42 Office Co-ordinator Post Menopause

Bio : Holly is a married woman who experienced her Menopause at the age of 14 while she was in school. She is currently working with Menopause Organisations to spread awareness about premature menopause. She has previously managed multiple jobs, but none have supported her through her menopause.

“A woman is meant to be here to reproduce and its horrible”

Motivations :

Pain Points :

• Work with people who understand her menopause and give her the required space. • Inspire other women through their menopause journey • Take part in training programs to mentor younger women for their career goals • Build a menopause support system online.

• People constantly nudging her to have a baby or adopt a baby paired with judgment from society because she can’t reproduce. • Access to GP for support through Post menopause phase is exceedingly difficult

Olla, 48 University Recruiter Early Menopause

Bio : Olla is a mum of two kids. She was confirmed with Menopause 6 months ago by the GP and will be starting treatment soon (Hormone Replacement Therapy). She does not prefer to discuss her health-related issues with people other than her partner as she is afraid of being judged.

“I won’t be my usual ‘up and off for an adventure’ Mum and that’s really hard to accept.”

Motivations :

Pain Points :

• Loves to spend time with her children. • Satisfied with her current job • Excited about transferring to another department within the university. • Comfortable with technology: Often uses applications such as Flo to keep a track of her periods.

• Disappointed that she doesn’t receive any support from her workplace • Required to take leave for her GP appointments to conduct the tests for Menopause • Does not feel comfortable sharing her Menopause experience at work as other women experiencing the same have not complained or expressed their journey. 47

3.3 Persona Vanessa, 52 Nurse Menopause

Bio : Vanessa has been working with the NHS as orthopaedic nurse. She assists patients daily and had to conform to daily shifts. Her menopause symptoms have begun to increase but she is unable to ask for support due to the obligation of her job profile. Due to the partnership of NHS and Henpicked, she feels motivated to approach her new young manager about her menopause.

“Menopause, simmilar to mental health, is often perceived as a weakness that we need to overcome”

Motivations :

Pain Points :

• Active on social media and menopause • Long hours of her job strain her body as it groups to support other women through their goes through menopause journey • Due to lack of understanding of menopause, • Passionate about her job relationship with her husband was strained • Likes to maintain a journal to make a note of leading to separation her menopause symptoms • Has trouble remembering thoughts, which is affecting her job • Would like more support from NHS (regular check-ups) for her Menopause.

Judy, 50 Extrepreneur Perimenopause

Bio : Judy started her own investment banking company with the help of her friend a few years ago. She is married and has two teenage children with whom she feels comfortable to share about her Menopause. She motivates her employees to engage in conversations about menopause by conducting Menopause talks.

“ Speaking up about menopause is a challenge, but it hopefully empowers the women to think that they can reach out as well”

Motivations :

Pain Points :

• Passionate about her company and her day to day operations • Independent and set financial goals • Motivated to involve all individuals to discuss Menopause • Public speaking at forums ( Menopause groups on social media, menopause cafe events)

• Family members don’t take efforts to understand her menopause experience • Lack of support from GP • Less time for herself as the start-up and menopause related events keep her busy

Workplace Close Friends

Menopause Support Groups

Menopause Clinics

Partner Children Service Concept

Social Media

Parents

Individuals Age 45 - 55 Employed Perimenopause / Menopause 50

Menopause Tracking App

Local GP Family / Relatives

Community Groups

3.5 Stakeholder Map Upon conversing with women about their current menopause ecosystem, a stakeholder map was developed consisting of various touch points. This map consists of three layers based on the comfort level of the user. The primary layer contains members that act as immediate support to the user such as partner/ husband, children, parents. The secondary layer highlights other important relationships such as Local GP, close friends, co-workers/peers. The third tertiary layer suggests the indirect interactions that have an impact on the menopause experience such as social media groups, menopause tracking applications such as Balance, local community groups, and workplace policies.

I believe that the service would act as a bridge between the user and its primary layer, to communicate their menopause effectively with themselves and their immediate support system.

3.4 Design Directions The need for Awareness

The importance of Identification

The option of Expression

Through all the research that was carried out, the one that stood out the most was the lack of awareness about the subject. This merely doesn’t mean that there aren’t enough resources about Menopause, but also indicates that the resources that are present are overwhelming to the user. Women often complained about not receiving the right support at the right time which led to being exposed to misinformation and experiencing panic.

The symptoms associated with menopause are often misunderstood as other underlying health conditions such as depression, anxiety, heart palpitations and so on. While the accessibility of resources may be able to tackle the issue at large, the menopause journey is also about being able to communicate one’s natural biological change to oneself.

One of the greatest contradictions in my research was around addressing the change, voicing the concerns, to share or not to share your menopause, that is the question! Every woman has a different menopause experience and each of them have the right to choose their mode of expression as per their comfort level.

Furthermore, it was noted that only the individuals experiencing menopause were interested in gathering information around it, someone of a younger age or a different gender was not interested in the subject unless it affected them directly. Consequently, women experiencing menopause felt isolated and alone during their journey as their closest confidants could not relate to their misery. My aim is to ensure easy access to information about menopause and provide the right resources at the right time to the women and family members affected directly by it.

This at large can be achieved through intrapersonal reflections of menopause. Women endorsed the act of journaling as a way to keep track of their symptoms and thus were able to find underlying patterns to further address them with lifestyle changes. Identification is not just about diagnosis but about taking the time to address the change, reflect upon their actions and thus move closer to accepting it.

I believe that being able to communicate their apprehensions with themselves would invigorate them to own their Menopause experience.

But it was very common to see that women who had a relatively easy menopause experience often complained about others exaggerating their experiences. This often led to women choosing not to confide in people despite their troubles, leading to them feeling that they were the problem. Expressing something personal that is causing the fear of judgment and guilt needs to be addressed. Motivating women to share their experiences is about giving hope to the women who can’t share their voice freely, just to let them know that they are not alone in their journey. For the longest time, I believed that sharing is the only way to overcome your anxiety, but this is not ‘one size fits all’ approach. It’s about creating a safe space for conversation for women to choose their mode of communication at their will.

“The outer world is a reflection of the inner world. Other people’s perception of you is a reflection of them; your response to them is an awareness of you.” (Bennett, 2020)

Social Media Menopause Influencers

Documentaries

Awareness Books

Newsletters

Podcasts

Service Concept Family

Menopause Clinics

Local GP

Identification Menopause Apps Balance, Peppy

Partner / Children

Friends

Expression Workplaces

Blogs/ Vlogs

Menopause Community groups Figure 8 : Representation of the design directions 53

Ideation Value Proposition Canvas Co-design : Future of Workplaces Initial Concept Development Final Research Question Design Concepts Co-design : Online Testing Initial Concept Development Initial Testing

Refle exper 54

We can signpost them but not own the service

Future of workplaces

Menopoly

Develop

ecting upon their rience

Balance App

Own Your Menopause Peanut App 55

4.1 Ideation To identify the different opportunities that could support women in their menopause journey, multiple ideation techniques such as building a visual mood board with examples from parallel industries, crazy 8 sessions to explore various touchpoints and co-design sessions were carried out.

101 steps to understand ‘HER’ Menopause ( A guide for all men)

Children’s books highlighting the real stages of a Woman’s life : Periods, Pregnancy, Menopause

A service that helps women in organizations to come together and support each other to share

Self-diagnose / assessment tool helping to identify menopause and provide the next steps

Design system / icon / symbol to represent Menopause

Set of comms / package employee can use to communicate topics related to menopause

Engaging with teaching aids for young men/women undergoing puberty

A Guide to Owning Your Menopause

Redefining School curriculum : Menstrual Health ( Periods, Pregnancy, Menopause)

4.2 Value Proposition Canvas Cheering (quotes / messages to add on daily page of Menopause Manual) by Support system

Showcasing the positive side of Menopause

Giving tips on employee benefits as they go through menopause Menopause forum for specific issues

Menopause prompts to share with support system

Share their menopause journey on Social media

A step by step guide of their menopause

- I am a Mentor - I am an Explorer - I am a Supporter

Breaking the Menopause Manual in stages : gradual acceptance

Building a confidentiality agreement between Mentor and Explorer (to maintain trust)

Setting a standards and approvals for information / resources

Stories of women undergone menopause to make it relatable

Menopause Meter (indication of time lift until liberation)

Menopause Manual shared with GP

Post Menopause check-ins

Menopause buddy (Acting as sponsor) to support emotionally

Involving partner / children / friends in their journey or Sharing their manual with them

Helping women find a Menopause Buddy to share their journey

Small victories for each goal that users accomplish

Career goals as a part of Aim to Achieve to remind themselves of their efforts and future plans

Symptom tracker to prepare users for the upcoming changes

Stories of women sharing their menopause priorities : A way for you to write your monthly / weekly priorities

Right treatment at the right time

Being able to comfortably share any Menopause related issues with Dream about moving people around them forward, surviving their menopause

Sign posting to authentic resources to avoid misinformation ( overwhelming amount of information) A support system while they go through menopause

Not being judged / underestimated due to their menopause

Better understanding of their symptoms at an early stage

To work without any negative impact of the menopause

Better Menopause policies at work Want to understand their Menopause better

Feeling isolated & lonely Not having a support system in early stages

Feeling guilty for prioritizing your health above your work

Not receiving sufficient support from workplace leading to retirement

Not being able to sleep at night

Recognition for their years of work at their workplace

To understand, be understood and accept their menopause

Self doubt while applying for promotions

Erratic symptoms during working hours

Achieve a Menopause work-life balance

Hormone deficiency after menopause continues

Better support from their GP while diagnosing menopause

Struggling to keep up with small life goals ( exercise)

4.3 Co-design : Future of Workplaces Navigating through consultation fatigue:

Key Takeaways:

• Two out of five of the participants shared their desire to see infrastructure changes and the introduction of inclusive policies. • While the rest talked about creating safer, comfortable workplace dynamics for conversation. • All the participants mentioned that it took them a few years to be able to speak about their menopause aloud which was facilitated due to their support system and reflection of their journey over the years. • They shared that irrespective of workplaces taking the effort to reach out to women, the bigger problem of hesitation and fear of During the individual co-design session, the judgment will always remain until resolved by participants were invited to picture a workplace in the women themselves. 2030 and how it would pertain to the rising need for menopause support. The design process is not a linear path neither is it idealistic. It is iterative and constantly evolving in the most unconventional ways. Co-design is often associated with workshops where the designers facilitate conversations and engage with the participants using various ideation tools. However, due to clashing schedules and consultation fatigue, I was unable to assemble a group of women for a traditional workshop. Instead, I opted to test my hypothesis by reaching out to women individually and brainstorming about their vision for the future of menopause.

Menopause Policy at Work

In the future, I believe ...

“Local GPs should conduct open day sessions at work where woman can sit, listen and be heard”

“ Menopause would be merged “Workplaces would build safe with the Diversity & Inclusion spaces, for women to relax in policy, where companies can during their menopause time” sign a pledge”

- Hayley, 40 Post Menopause

- Julia, 49 Late Menopause

- Victoria, 52 Early Menopause 61

Awareness

How might we increase the maturity of menopause within workplaces? Reiterated Research Question

How can we reduce the stigma around menopause and empower women to pursue their life and career as they imagined it to be?

Expression

How might we create safer spaces within workplaces to mitigate the hesitation around sharing menopause related experiences?

Identification

How might we make it easier to identify menopause at work?

4.4 Final Research Question

How might we support women to communicate their menopause to themselves thus empowering them to own their experience? e

4.5 Design Concepts Own Your Menopause Guide After modifying the research question and shifting the focus from the workplaces to empowering the women, one of the design concepts focussed on building a guide to help women take ownership of their Menopause. It could be an online or printed guide that provides a bank of resources that women can refer to, helps reflect upon their own needs throughout the Perimenopause, Menopause and the Post menopause phase and shares conversation guides for those who wish to communicate their experiences with others. Own your menopause Guide aims to provide: • Bank of resources • Reflective activities • Support group suggestions • Symptom trackers

Figure 9 : Images of the Own Your Menopause Guide

Menopoly

Approaching schools to incorporate Menopause in their curriculum and finding ways to instigate conversations from an early age would be an ideal solution, but it was not noted as the need of the hour. Women expressed that playing a board game or even having conversations with young adults going through puberty may become a challenge as they’re trying to navigate through their own hormonal changes. Through their insights, it was observed that by providing guidance for women experiencing menopause and helping them reflect upon their own experience will foster conversations at home and at work thus creating the desired impact

Inspired by the Womanopoly game designed by Stella Dadzie, the second approach is based on increasing menopause awareness for the youth. Stella’s game provides a snapshot of the issues that preoccupied feminists and working women in the late seventies while Menopoly aims to spark a conversation between an individual experiencing menopause and the younger generation (kids / younger relatives) (Dadzie, 2021). The game also aims to denote a positive spin on the existing stereotype of menopause symptoms. Some of the cards of the game are illustrated as Figure 10.

Figure 10 : Images of the Menopoly Cards

4.6 Co-Design : Online Testing Hypothesis: I believe that women experiencing menopause may communicate their experiences with themselves by carrying out reflective activities. To verify that I reached out to various Menopause groups on Facebook and LinkedIn and came across a platform that is solely built for women to find support during their pregnancy, motherhood, and menopause called Peanut. Upon posting questions around feeling afraid to share menopause-related issues with coworkers, it was received with the warm support of women trying to empower each other. These posts were intended to spark a conversation to help understand the touchpoints of the service. Women shared the need for menopause to be discussed at home and at school, to be included in the curriculum. Along with that most women expressed their discomfort of being forced to share their menopause while at work, while it needs to be a choice and treated as a personal experience.

Figure 11 : Screenshots showcasing co66

These quick polls also helped me shape the guide. A majority of the women voted for menopause awareness resources for not only themselves but also their family and suggested online platforms such as Balance developed by Newson Health. This made me realise the extent of online presence within the menopause community and that I needed to find ways to leverage these existing channels to signpost towards the service.

-design evidence on Peanut Application 67

4.7 Initial Concept Development

PRE-SERVICE

While developing the service, it became clear that the service needs to exist within a common touchpoint and since each woman has a different menopause experience, the Local GPs are a common element due to their interaction during Menopause diagnosis. Another touchpoint would be the Menopause organisations such as Positive Pause or Henpicked as they can co-create the guide with the user, transfer the ownership to them and help them pass it on within their network. Approaches GP for support, GP confirms Menopause diagnosis & shares guide

User notices their symptoms

Approaches friends / family for guidance, suggests social media groups 68

DURING SERVICE

POST SERVICE

The Menopause Manual

Menopause Event Enroll as a Menopause Explorer Enroll as a Menopause Mentor

Comes across Menopause events on Social Media

Positive Pause introduces the guide

User receives the guide and uses it for their Menopause journey

Champion the Guide & share their story to inspire others

4.8 Initial Testing I tested the journey map with the founders of Positive Pause and shared the content of the guide to understand if they would prefer to host the service. But they shared that they would be more comfortable sharing the guide if it were in a digital format, thus eliminating the cost of printing. One of the key takeaways from this interaction was the push towards making the guide accessible by keeping it open source and modular so that the users are not exposed to yet another giant book of information.

Figure 12 : Images showcasing testing with Positive Pause

“ Women need some reassurance, and sometimes they will get it from the GP or they will get it from other groups or from other people that they’re going through and that is important ” - Ann, Co-founder Positive Pause

“ It’s been proven that journaling is a form of therapy, but I like is that once they’ve identified their symptoms and then are wondering what happens next and, thats when they can join a group so that they can talk about it ” - Jo, Co-founder Positive Pause

Service Concept Prototyping & Testing Final Service Concept Menopause Manual System Map Journey Map Testing with Experts Service Blueprint Business Model Canvas SWOT Analysis

Would prefer something digital, the brain fog is very severe for me

Balance App

Menopause Peer System

The Menopause Manual Character Cards

Deliver Awareness, Identification, Expression

Task Cards 73

5.1 Service Concept Introducing the Menopause Manual. It is a physical printed guide supported via online channels, for individuals to own their menopause experience. The manual aims at providing relevant resources, guided reflection sessions, and methods of expressing their menopause in a personalised manner.

THE MENOPAUSE MANUAL

How are you feeling today?

The manual has six sets of cards accompanied by a template for arrangement. The top three sets are Character Cards designed to build a persona by prompting questions about their feelings, pain points, and menopause motivations. The bottom three sets are Task Cards that are derived based on the persona that is chosen. Each of the Character cards has number and colour tags that guide the user to pick the relevant Task card. As the user builds their persona, they follow the number tags on each card and build their own Menopause Manual. This manual provided by the service will be developed in partnership with the local GP, menopause organisations, and menopause influencers to make sure that the content on the cards is relevant to current times. The beauty of the manual is that each time the user shuffles the persona cards, they’ll be able to build a new menopause manual and receive a relevant form of support. 74

Feeling Cards

Information

Title of Source

Wish to Seek

Seeking Support

Reflection

Journal Entry

Aim to Achieve

Menopause Goals

Expression

Medium of Expression

Figure 13 : Images showcasing the Service Toolkit

5.1 Service Concept CHARACTER CARDS

MENOPAUSE MANUAL TEMPLATE

Feelings Cards: Cards with a range of emotions such as joyful, liberated, annoyed, irritated, and more. Wish to Seek Cards: Cards with suggestion prompts such as diagnosis advice, treatment options, support for symptoms, and more.

How are you feeling today?

Wish to Seek

Feeling Cards

Seeking Support

Aim to Achieve

Menopause Goals

Aim to Achieve Cards: Cards those prompt goals for the user’s menopause journey such as achieving a menopause work-life balance and more. Feelings Card

I am feeling low

Wish to Seek

Aim to Achieve

Customized diet plans for Menopause

Inspire other women through their menopause journey

MENOPAUSE MANUAL EXAMPLE

TASK CARDS

MENOPAUSE MANUAL TEMPLATE

Information Cards: Cards that signpost to different menopause related resources such as online articles, blogs, social media platforms. Reflection Cards: Cards that share questions for reflection based on the persona.

Information

Reflection

Title of Source

Journal Entry

Expression

Medium of Expression

Expression Cards: Cards that motivate the user to take upon small challenges based on their Menopause goals.

Information

Menopause Diagnosis

Reflection

Write down three things that you achieved today?

Expression

Try a new hobby that challenges you!

MENOPAUSE MANUAL EXAMPLE

5.2 Prototyping & Testing The content on the cards was created based on the comments from the Menopause social media groups. I tested the interaction with a group of young women, age 25 -30, who shared that they would be interested in using it as a conversation tool for their mothers. While testing it with the user, they shared that it would be more convenient if it were digital as they could customise the search for resources, menopause support and their goals. They also expressed an interest in including a menopause symptom tracker.

For the longest time, the one big problem revolved around the idea of individuals feeling a lack of support from their employer, feeling unheard and detached from their own career during their menopause. However, after analysing all my research, it has come to my understanding that what the system lacks is not awareness but a moment of reflection and intrapersonal communication. 78

Figure 14 : Images showcasing testing with users

“ This seems interesting, I would like to try this, but I am not sure if cards is the best medium. I would prefer something digital”

“ I would love to try this with my mom but as a conversation. I would want to use this as a way to support her through her journey “

- Sangeeta, 53

- Gayle, 28

Post Menopause

Menopause Supporter

5.4 Final Service Proposition The Menopause Manual service aims to support individuals navigating through their menopause by providing the tools to build personalised resources, facilitating reflections, and encouraging expression. This service also assists collaboration between the users (Menopause Explorer), their immediate ecosystem such as their partner, children, friend, acquaintances (Menopause Supporter), and a menopause expert, someone who has previously experienced menopause and is willing to inspire others (Menopause Mentor). Eventually, as the Menopause explorers continue with their journey, they emerge victorious to become the next Menopause Mentors and inspire others. No woman has the same menopause experience, but that doesn’t imply that they need to go through it alone. Building an effective peer network would contribute to being able to recognise patterns within their menopause, seek help at the right time and gain access to information that is tailormade and relevant for the user.

Service Touchpoint: Online application and website where users can enroll as a Menopause Explorer or a Menopause Mentor or a Menopause Supporter based on their needs.

Service Elements :

Menopause Explorer • Seeking peer support while navigating through their menopause • Seeking Menopause related resources / advice

Menopause Mentor

Menopause Supporter

• Has previously experienced Menopause • Wants to inspire and guide others through their menopause journey!

5.5 System Map

Menopause Mentor • Has previously experienced Menopause • Wants to inspire and guide others through their menopause journey!

Find your nearest mentor

Menopause Explorer The Menopause Manual Menopause Explorer Menopause Mentor

Enroll as one of the Options

Seeking peer support while navigating through their menopause • Seeking Menopause related resources / advice

Menopause Supporter

What’s New?

•

Menopause Supporter • Willing to support their peer / partner/ family member through their Menopause Journey • Eager to understand the process better

If they choose to Approach a Mentor If they choose to Involve their Peers

Search customized by Organizations or Sectors or Location

Menopause Mentors assist the Explorers using the Menopause Manual template by suggesting resources for reading and useful tips

The Manual prompts questions for reflection which the Explorers can use while writing their journal

There are weekly challenges that the Explores can take up and share these victories with their Mentors (For eg : Talk to someone new about your Menopause)

The Menopause Manual

As the Explorers progress in their Menopause journey, gradually they become Menopause Mentors

The Menopause Manual Articles For You

The Menopause Explorers can share the Manual experience with their peer / partner

The service prompts the supporters to familiarize themselves with resources as well

Supporter can upgrade to Mentors

Supporters can build their own network within the platform 83

5.4 Menopause Manual App The service is supported by a mobile application that consists of the digital Menopause Manual. Through this platform, users can enroll themselves as an Explorer, Mentor or a Supporter. Basic wireframes of the app were developed and are represented in Figure While testing the service concept with some of the users, they shared the possible collaboration between the Menopause Manual and the Balance Application developed by Dr. Louise Newson. Some of the wireframes in Figure have been designed to accommodate the service within Balance for easy access and leveraging existing user data base.

Welcome to your Manual!

The Menopause Manual

Contact Mentor My Manual

Menopause Explorer Menopause Mentor Menopause Supporter

Build Your Persona

What’s New? Menopause tips NHS

Figure 15 : App wireframes for Indepedant Service provider

The Manual

Menopause Manual Community Latest Updates

Check out the latest

View all Manuals

updates from your Mentor!

Figure 16 : App wireframes for collaboration with Balance

Integration with Balance

5.6 Journey Map

Menopause Explorer

Feeling scared

•

Online via social media / in pe

User notices her symptoms Feeling confused

Independent Service

Seeking peer support while navigating through their menopause • Seeking Menopause related resources / advice

Friends sug on socia

Approaches friends / family for guidance

Menopause Policy at Work

Workplace informs about their Menopause Policies

Shares acc Signpos

Feeling Interested

Online via email / in perso 86

PRE-SERVICE INTERACTION

The Menopause Manual

ggest Menopause Groups al media/ Balance App

eeling hopeful

erson

Balance App shares their new Menopause Manual initiative Feeling intrigued

Menopause Explorer Menopause Mentor Menopause Supporter

What’s New?

Online App

Introduced to The Menopause Manual Feeling intrigued Online Service Platform

cess to company platforms / sts to Menopause Manual Feeling excited

on 87

5.6 Journey Map

DURING SERVICE INTERACTION Menopause Explorer •

Seeking peer support while navigating through their menopause • Seeking Menopause related resources / advice

User Journey Emotional Journey Touchpoints 88

Approaches a Menopause Mentor for guidance Feeling hopeful

Conducts Monthly sessions with the Mentor to share small victories Feeling content

Seeks frequent interaction and support Feeling low

POST SERVICE INTERACTION

Asks a friend to join the service as a Menopause Supporter Feeling Supported

Completes Menopause journey

Upgrades to a Menopause Mentor

Inspires other women through their Menopause Journey

Feeling Liberated

Feeling empowered

Feeling Joyful

Online Service Platform 89

5.6 Journey Map

PRE-SERVICE INTERACTION Menopause Mentor • Has previously experienced Menopause • Wants to inspire and guide others through their menopause journey!

User Journey Emotional Journey Touchpoints 90

Menopause Policy at Work

Menopause influencers share their previous experience of Menopause on social media

Workplace informs about their Menopause Policies

Feeling empowered Online via Email / In-person

Feeling Interested

Encourages women who have p experienced Menopause to becom Feeling Interested

Online via social medi

previously me Mentors

DURING SERVICE INTERACTION

Menopause Manual Training

Balance approaches influencers within their network to join the Menopause Manual as a Mentor Feeling flattered

Menopause Mentor training and introduction to the Manual

Mentors fill registration form: define commitment time

Feeling overwhelmed

Feeling excited

Online via service platform 91

5.6 Journey Map

DURING SERVICE INTERACTION Menopause Mentor • Has previously experienced Menopause • Wants to inspire and guide others through their menopause journey!

User Journey Emotional Journey Touchpoints 92

Enrolled on the service as Menopause Mentors

Approached by Menopause Explorers for mentorship

Using the manual to provide guidance

Feeling excited

Feeling nostalgic

Feeling heard

POST SERVICE INTERACTION

Sharing stories on the website forum Feeling empowered

Upgrade from Menopause Mentors < Menopause Experts Feeling proud

Networking through the Menopause Mentor club Eager to connect

Endorsing the service on social media Feeling content

Online via service platform 93

5.6 Journey Map

Menopause Supporter • Willing to support their peer / partner/ family member through their Menopause Journey • Eager to understand the process better

Menopause Policy at Work

User Journey Emotional Journey Touchpoints 94

The family member learns about the User’s Menopause

Workplace informs about their Menopause Policies

Empathetic

Feeling informed

PRE-SERVICE INTERACTION

The Menopause Manual Enroll as a Menopause Supporter Enroll as a Menopause Explorer

Introduces Menopause Manual to support their loved ones through their Menopause

Shares information with the User

User requests them to join as a supporter

Feeling excited

Eager to share

Exicted to help

Online via service platform 95

5.6 Journey Map

DURING-SERVICE INTERACTION

Menopause Supporter • Willing to support their peer / partner/ family member through their Menopause Journey • Eager to understand the process better

User Journey Emotional Journey Touchpoints 96

The Menopause Manual Menopause Explorer Menopause Mentor

Menopause Manual Training

Menopause Supporter What’s New?

Enrolled on the service as Menopause Supporters

Menopause Supporter Expectations & Training

Using the manual to provide guidance

Feeling excited

Feeling informed

POST SERVICE INTERACTION

Feeling aware of their partner’s menopause

Joining the Supporter Forum on the app

Willing to upgrade to a Menopause Mentor ( giving a test)

Sharing their experience to inspire others

Feeling aware

Feeling supported

Feeling inspired

Feeling excited

Online via service platform 97

5.7 Testing with Experts “There are women still really struggling who don’t want to talk out so I think the more that it’s pushed that there are mentors there for them to contact and things because so not everyone wants to be open on social media and talk about their life.” Hayley, @prematuremenopause14 Menopause Influencer

“ I think this would be a great initiaitve especially if it were incorporated within existing online channels. Balance App would be a great start!“

Clare, Menopause Coach

Menopause Mentors 98

“I think it’s a great idea! Definitely think that having a mentor is key. And I think this is something we (Catapult) could someday implement, and have a link to have more information to use. I definitely think that there would be interest.”

“ t r a l i b t

Izzy,

HR at Connected Places Catapult, UK

B o

“This service lets us signpost the women to some expert resources and make those available so that they can learn about these things to inform themselves & always be improving. And I think that fits with us”

“ Our focus has always been around educating workplaces, but we are soon planning to look at the other side of the spectrum. I think this would be a great next step for us to consider!”

Helen,

Sally, Director at Henpicked

Business Partner at Royal Bank of Canada, Jersey

Menopause Manual Service Provider 99

5.8 Service Blueprint STAGES MENOPAUSE EXPLORER

PRE-SERVICE Receives confirmation of Menopause from GP

Approaches friends / family for Menopause advice and support

Joins Menopause groups on social media

Online (NHS App) / In-person appointment

Online ( social media) / In-person

Online (Social media)

MENOPAUSE MENTOR

MENOPAUSE SUPPORTER

TOUCHPOINTS Line of Interaction FRONT STAGE

Sending out invites for users to join the service

Social Media promotions

Line of Visibility

100

BACK STAGE

Update the Application

Creating social media compatibility (plug-in)

SUPPORT SYSTEM

App Developers

App Developers, Social Media manager

DURING SERVICE Introduced to the Menopause Manual

Enrolls as a Menopause Explorer

Reads the instructions for using the Menopause Manual

Presented with options : Menopause Mentor / Supporter / DIY

Selects a mentor based on preference

Receives an invite from the Explorer

Is aware of their friend / partner’s Menopause

Online ( Service Platform)

Sharing prompts for referrals

Create a Landing Page

Explanation of Menopause Explorer

Create a Login Page

App Developers

Provide instructions for Menopause Manual use

Sharing options to use the manual

Share options to select the Mentor

Create instruction set

Create page hyperlinked to Menopause Mentors, Menopause Supporter registration

Create filters with location, ratings, organisations & sectors

App Developers, Content Writer

App Developers, UI/ UX Designer

App Developers, UI /UX Designer 101

5.8 Service Blueprint STAGES MENOPAUSE EXPLORER

MENOPAUSE MENTOR

Mentor and Explorer agree upon commitment time

Facilitates the Menopa Manual persona build

Meets with Explorer to understand their Menopause goals

MENOPAUSE SUPPORTER

TOUCHPOINTS

Use the Manual to conduct sessions

Builds their persona us the character prompt

Is aware of their friend / partner’s Menopause

Online ( Service Platform)

Online (Service Platform) / Inperson

Line of Interaction FRONT STAGE

Prompt conversation starters

Provide space for collaboration

Line of Visibility BACK STAGE

SUPPORT SYSTEM 102

Create communication channel ( chat box)

Build interface to allow simultaneous collaboration

DURING SERVICE

sing ts

Signposted to resources, custom journal questions and challenges based on persona

ause ding

Facilitates the Menopause Manual resource sharing

Explorer feels comfortable to share their experience with their family

Explorer and Supporter are suggested resources

Provides support whenever approached by Explorer Family member / friend is encouraged to join the service as a Menopause Supporter

Explorer and Supporter are suggested resources

Online ( Service Platform)

Provide resource suggestions

Prompts the Explorer to ask a supporter to join

Provide space for collaboration

Share resources based on key word search

Push notification for Adding a Menopause Supporter

Build interface to allow simultaneous collaboration

App Developers, UI /UX Designer 103

5.8 Service Blueprint STAGES MENOPAUSE EXPLORER

DURING SERVICE Explorers continue on their journey with guidance from Mentos and Supporters

Explorer completes their Menopause Journey

MENOPAUSE MENTOR

Provides support whenever approached by Explorer

MENOPAUSE SUPPORTER

Supporters are familiarsed with the Manual

Upgraded to others thro

Mentor

Supporter

Online ( Service Platform)

TOUCHPOINTS

Line of Interaction FRONT STAGE

Showing progress of Menopause Journey

Sharing Rewards

Building a database of the customers

Collaborations with companies to give rewards

Showc

Line of Visibility BACK STAGE

SUPPORT SYSTEM 104

Building a

App Developers, UI /UX Design

POST SERVICE

a Menopause Mentor to inspire ough their Menopause journey

Share story on social media

rs continue to guide others

Mentors endorse the service

rs Upgrade to being Mentors

casing a profile upgrade

a database of the customers

Online (Service Platform) / Social Media

Incentives for social media promotions

ner 105

5.9 Business Model Canvas Key Partners • Social Media : Facebook, Instagram, LinkedIn • Menopause Apps : Balance, Peanut • Organisations / Corporate Partners • Menopause Organisations : Henpicked / Positive Pause (for endoresement) • Menopause influencers

Cost Structure

106

Key Activities

Value Proposition

• Maintain a repository of information and Signposting to different resources

• Virtual support system through their Menopause Networking with Menopause Experts

• Pairing individuals to Mentors (key word search & analysis of application

Key Resources

• Helping Individuals going through their Menopause smoothly by providing resources, space for reflection and helping them express their issues / concerns

Human Resource Technology infrastructure

• Able to involve the menopause ecosystem (partner/peers)

Technology Development & Maintenance, Marketing Cost, Human Resource

Revenue Stream

Cus

• Weekly u tracking • Menopa collectiv • Weekly n (increasi their sup

Socia So (Men C Me

Freem sessi 2. Ap man aime

stomer Relationships

updates and prompts for g symptoms ause Manual Mentors as a ve notifications for reading ing awareness) and rewarding pport through virtual badges

Channels

al Media : Word of Mouth ocial Media Marketing nopause Manual as a brand) Corporate Partnerships enopause Organizations Influencer Network

Customer Segment • Individuals who are going through Perimenopause / Confirmed with Menopause (Women age 45-55) • Individuals who have already experienced Menopause and want to guide others through their journey (Women : Post Menopause / Menopause coach) • Individuals who want to support their loved ones through their Menopause Experience (Partner, Child, Friend, Coworker) • Individuals who are employed and are seeking Menopause related guidance (Women at workplaces)

mium Model : 1. Give 1 freew session with a mentor and charge for additional ions; Productize the mentor sessions and share the revenue with the mentors. pproach organisations to provide Menopause Manual training for line nagers. Alternatively approach insurance based companies as the manual is ed at wellbeing and support 107

5.1 SWOT Strengths:

Weaknesses:

• A comprehensive guide, fostering peer support providing relative information and tips to the users experiencing menopause.

• The service is present online, which also requires a level of digital literacy

• Easily accessible to everyone in the Menopause Ecosystem • Hassle free for the user as the service is available online and all the necessary data (reminders, symptom tracking, goals) are stored on cloud • Networking through the service to meet other women who have experienced menopause • The service encourages the family members of the menopause individuals to participate in their journey, while most applications are designed only for the individuals experiencing it.

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• Reflection can be facilitated online, but not everyone is comfortable to type. Users may choose to maintain paper journals instead. • The process of approaching a mentor may become a daunting experience.

Opportunities:

Threats:

• If the service is owned by an existing online platform such as Balance, it would be easier for the users to adapt to it.

• Due to the existing popularity of the Balance app within the menopause community, the Menopause Manual may be overlooked until it gains credibility.

• The service may also be successful if menopause organisations such as Positive Pause and Henpicked hosted it. Using their network and trust in the menopause community, the service would gain acceptance.

• Menopause mentors may not always be proactive while responding • Menopause Explorers and Supporters may lose interest over time due to the required commitment.

• Under the ownership of a menopause influencer, the service would thrive due to its democratic approach (by the women, for the women)

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Conclusion

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Next Steps Conclusion Reflection

5.1 Next Steps This service concept has further potential to grow and expand into: • A licensed plug-in for Menopause • The service can also be promoted by applications such as Balance, Flo. insurance companies such as Vitality or Currently these apps focus more on Bupa that are offering Menopause benefits providing resources and building a forum to boost wellbeing and preventive care. but with the integration of the Menopause Manual they can facilitate peer interaction and involve the support system of the women into their menopause journey as well. • With the introduction of the new bill in the UK to make provision about menopause support and services at work, organisations have begun to make policy level changes for their employees. The Menopause Manual can transform into a professional training program for organisations to adopt to not only support the individual’s experiencing menopause but also spread awareness amongst other employees.

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5.1 Conclusion The project started with a defined focus towards the lack of support at workplaces for individuals experiencing Menopause. However, over the months, through interviews, focus groups, and various testing methods, the project shifted from utilising the power of the workplace to empowering the individuals experiencing menopause to create impact. The Menopause Manual service, as a physical toolkit would be personal and used for instigating conversations, but it would be limited in nature. Overtime, a digital platform would be sustainable and personalised for the user to engage with and also involve their family members in their menopause journey. Being an independant service, it could face some hesitation from the community, however, if it is adapted within the existing ecosystem of Balance, the service can gain a higher customer segment. The Menopause Manual aims to help communicate the experience of the individuals to themselves, while empowering them to seek guidance from peers and share their journey with their family member. 112

5.1 Reflection This project was driven by personal motivation of designing within healthcare and in particular invisible illnesses. Being a woman and researching on menstrual health, contributed to being able to empathise with the user. The project started off with an aim to normalise the conversation about Menopause, but it also helped me reflect upon my own menstrual health experiences and gain the courage to approach not only women but also engage in discussions with men.

at leadership positions and HR managers was key and it was achieved thankfully to the colleagues at the workplace. While exploring the service platform, I was inspired by some of the work done for the Public Collaboration Lab for Access to Meanwhile Spaces. Working on that project for latter part of the year, helped me to build my personas and find interconnections between the menopause community as well as addressing the service from three different stories made it holistic.

Working on a project can be a daunting experience, but multitasking this project with others is a victory in itself. While wandering in the deep realms of menopause and stories of women, I interned at a company as a Service Designer. Gaining a sense of the work culture in the UK helped me shape my project into its final outcome. Building a network of women

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5.1 Bibliography Bennett, R (2016) The Light in the Heart. Google Books : Roy Bennett Ceylan, B., & Özerdoğan, N. (2015). Factors affecting the age of onset of menopause and determination of the quality of life in menopause. Turkish journal of obstetrics and gynecology. Available at: http://cms. galenos.com.tr/Uploads/Article_10267/43-49.pdf [Accessed: 12th June 2021] CIPD (2019) Majority of working women experiencing the menopause say it has a negative impact on them at work. Available at : https://www. cipd.co.uk/about/media/press/menopause-at-work [Accessed: 15th June 2021]

Gupta, P. (2019) The Menopause. Available at: https://www.womenshealthconcern.org/help-and-advice/factsheets/menopause/ [Accessed: 10th July 2021] Jones, P. (2013) Design for Care: Innovating Healthcare Experience. Brooklyn, New York: Rosenfeld Media. MegsMenopause (2019) How The Menopause Is Viewed In BAME Communities. Available at : https://megsmenopause.com/2019/08/23/ how-the-menopause-is-viewed-in-bamecommunities-dr-nighat-arifgp-wsi-inwomen-health/ [Accessed: 12th June 2021]

Davina McCall: Sex, Myths and the Menopause (2021) Channel 4, 12 May, 21:00.

Larner, O. (2019) Confronting the Invisible. Available at: https://youtu. be/4QyUdMFNb6s [Accessed: 20th July 2021]

Dadzie, S (2021) Womanopoly. Available at : https://artsandculture. g o o g l e . c o m / s t o r y / w o m a n o p o l y - b l a c k- c u l t u r a l - a r c h i v e s / OAUxXI933cCqFw?hl=en [ Accessed : 28th September 2021]

McKinsey (2020) Women in Workplace. Available at : https://wiw-report. s3.amazonaws.com/Women_in_the_Workplace_2020.pdf [Accessed : 8th June 2021]

Design Council (2005) What is the framework for innovation? Design council’s evolved double Diamond. Available at: https://www. designcouncil.org.uk/news-opinion/what-framework-innovationdesign-councils-evolved-double-diamond (Accessed: 20th June 2021)

Newson, L. Lewis, R. (2019) Menopause at Work: a survey to look at the impact of menopausal and perimenopausal symptoms upon women in the workplace. Available at : https://d2931px9t312xa.cloudfront.net/ menopausedoctor/files/information/323/Lewis%20%20Newson%20 BMS%20poster%20SCREEN%20(1).pdf [Accessed :13th June 2021]

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Positive Pause (2021) Menopause Training Courses. Available at : https://www.positivepause.co.uk/menopause-training [ Accessed : 25th September 2021] Promensil (2021) Menopause Health Hub. Available at : https:// promensil.co.uk/menopause-health-hub/ [Accessed : 4th June 2021] TED (2021) What really happens to your body during menopause | Body Stuff with Dr. Jen Gunter. Available at : https://www.youtube.com/ watch?v=cheqkrcHkrI [ Accessed on: 19th August 2021] Taechakraichana N, Jaisamrarn U, Panyakhamlerd K, Chaikittisilpa S, Limpaphayom KK. Climacteric: concept, consequence, and care. J Med Assoc Thai. 2002 Jun;85 Suppl 1: S1-15. PMID: 12188398. UK Parliament (2021) Menopause (Support and Services) Bill. Available at : https://bills.parliament.uk/bills/2897 [ Accessed : 29th October 2021] Willis Towers Watson (2021) Emerging Trends in Health Care Delivery survey (United Kingdom) Emerging issues –Reproductive & Family health. [Accessed: 10th June 2021] Women’s Health Concern (2017) New survey highlights the impact of the menopause on every aspect of women’s lives in the UK. Available at: https://www.womenshealth-concern.org/2017/10/newsurveyhighlights-impact-menopause-everyaspect-womens-lives-uk/ [Accessed: 13th June 2021] 115

5.1 Appendices : Menopause Manual Cards

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5.1 Appendices : Own Your Menopause Guide

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Thank You

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