October 18th is celebrated as World Menopause Day to increase awareness of what menopause is and support those going through it. For my postgraduate thesis, I decided to conduct a study on menopause for which I interviewed menopausal women from all over India. While there were a few stories of positivity and praise for supportive husbands, many of the experiences were bitter and lonely.
As a young Indian woman, the concept of keeping women’s health personal is not new to me. It was only during my study that I realised that shame does not just sink in — it grows and it festers and pushes the narrative of being a “strong independent woman.” The inability to ask and receive support becomes a point of pride because the heaviness is too much to bear, for a 10-year-old and for a 50-year-old. Hidden pads and quite literally stomaching the pain have become the Indian schoolgirl’s mantra. It had been my mantra.
And then I spoke to 30 women and realised that menstruation’s silence makes for difficult menopause too.
In honour of 18th October being #WorldMenopauseDay2021, #labhopping member @a_viswamitra takes us behind one aspect of her Masters’ thesis research that looks into lived experiences of menopause in India.
Is the medical system menopause-friendly? ?
Before my research, I was a 22-year-old with a vague understanding of what menopause was. I knew that my period would stop one day and my school textbooks had stamped that exact sentence as the definition of menopause. Only six months ago, I realised that rather than a one-night celebration of throwing your pads out for good, menopause can entail a war before the peace sets in.
Every menopause experience is unique, and thus its symptoms can range from hot flushes (sudden spikes of body temperature) to heavy bleeding (one woman I spoke to bled for 30 days continuously). The lack of awareness about menopause means that women only learn about it once they’re knee-deep in it. I’m not going to lie, I spent the first month of my study looking up ways to avoid menopause. But a call with a bemused gynecologist led me to accept my reproductive fate and dig deeper. Did you know that you might be able to prepare your body for menopause? You can inculcate healthy habits decades in advance that could ensure that you skip past the symptoms and into the garden of an unstained Eden. Unfortunately, as with most women’s reproductive health topics, longitudinal data studies to prove these ideas are lacking, and medical advancements to effectively treat symptoms are far from reality. Considering that a few women I spoke to realised that what they had thought was menopause was just a side effect of the vaccine messing with their menstrual cycle shows us how swept-under-the-rug women’s health is.
Of my respondents,
1??3??women formally consulted a doctor out of whom:
7??went to more than one doctor before the word ‘menopause’ was brought up
5??out of the other 6 were medical professionals themselves
they were disheartened with how menopause was barely taught in med school
I didn’t even have to bring this up to my interviewees. The narrative of having to visit a bunch of doctors for their symptoms before the word “menopause” is even brought up was a common one. I assumed, albeit naively, that a woman clearly suffering in pain would find readily available support at least at the homefront. However, I was met with disappointed smiles pointing out that explaining to their husbands what periods were decades ago had been difficult enough. Menopause was lumped in as a “period-thing,” and bed rest for a few days was allowed begrudgingly in the most progressive households. But menopause is not just a period thing. Its symptoms can sometimes last up to 10 years and I haven’t even explained the emotional turmoil that the dropping hormones add into the mix.
One woman was bedridden for months (she is still at present), and by the end of the first month, the question, “When are you coming back to the kitchen?” arose from her husband and daughter — Indian apathy at its finest.
Where does this come from? Well, “strong independent women” raise “strong independent women.” Some of my interviewees had to fight tooth and nail with their own mothers, who ridiculed them for seeking medical guidance for their menopausal symptoms. “In my time we didn’t make a big fuss like you are doing,” is a common sentiment. Unfortunately, along with perpetuating stigma to their daughters, these mothers also passed ignorance to their sons. So many of the women from my study were tasked with having the period conversation with their husbands post-marriage. And for some, having to explain each and every uterine function was so tiring that they didn’t even tell their husbands that they had begun menopause. But none of them holds resentment for their mothers, “They had enough to fight for.” Our grandmothers’ generation had internalised the period shame that society had made them feel so deeply that the only way they could cope was to see it as strength. If there’s one thing that I have learned from these women, it is that strength is in the eyes of the sufferer, not in the eyes of the beholder. Simply because the difficulty of menopause can only be understood by those who have been through it.
Strength lies in the woman whose male (and might I add doctor) colleague told her that she was looking fat, to which she bit back that she had just had a hysterectomy and gotten over COVID. Strength lies in the woman who had to drag herself to the hospital after bleeding for 30 days straight because her husband refused to look after her. Strength lies in the woman who sat her sons down and told them they had to step up in the kitchen because going through menopause had taught her to put herself first. Strength lies in the woman who had to quit her job because there was no infrastructure in place to help her manage her menopause. And strength lies in the women who have to go through menopause alone and in isolation because society is too weak to support them.
I conducted qualitative interviews with 2??1?? perimenopausal/postmenopausal, literate, upper-middle class women living in India.
1??8?? women have had symptoms like heavy bleeding, hot flashes or depressive moods
1??7?? of them felt ill-prepared in dealing with the symptoms
On the occasion of World Menopause Day, I was reminded of the fact that despite the difficulty this generation of women faced in having to learn about their own menopause, and the taboo that women in this culture have to navigate on a monthly basis, they have been the torchbearers of change and strength. Many young women, myself included, stand on the shoulders of these strong women. Making ourselves aware and being supportive without a prompt is the bare minimum that we can do. For this reason, I hope that this World Menopause Day also brings awareness to those who are not experiencing menopause so that our mindsets are changed and conversations become easier.
Menopause could then be a time of change, self-discovery and an opportunity to tune in. “I just told them that I am going through menopause. They already knew what it was,” should become the only narrative that we hear.
Note: Although I have discussed the experiences of cis women in this thread based on available data, we must remember that menstruation and menopause are not just experienced by cis women. Trans and non-binary persons do too, which only points us towards the need for more inclusive systems.
January 16, 2023January 16, 2023 6min readBy Sejal Sehmi
I was a mere 14-year old on the fateful night of 22 April 1993. The night that witnessed black teenager Stephen Lawrence brutally murdered in a racially motivated attack as he waited for a bus. The night that cemented my fear, that the colour of my skin does matter. The same night that confirmed my indifference as a British Asian in the United Kingdom — were we really united? Fast forward to May 25 2020, the murder of African-American George Floyd by a white policeman was the turning point for British Asian author and my lovely friend, Shweta Aggarwal to finally break her silence and narrate her story of colourism, in her new book, “The Black Rose.”
Aggarwal’s gripping memoir emits so many emotions; that of an awakening, a voice that has been suppressed for years, filled with anger, mistrust and guilt. But most importantly, “The Black Rose” successfully disrupts the narrative that consistently allows society to box someone as indifferent based on a visibility factor. For Shweta, this factor was the colour of her skin. The injustices she consistently endured via some family members and fellow South Asian peers throughout her life, was as a result of her skin tone failing to qualify as ‘acceptable’, or as she often quotes in her book, not ranking high enough on the ‘fairometer.’ Whether she was in India, Japan or London, the scale was never too far behind.
Within the first chapter, she recalls as a child in India, the distinct lack of subtlety displayed by certain family members through direct taunts of her duskier appearance in comparison to her parents. She realised that she wasn’t in complete isolation from this prejudice, as her maternal aunt and uncle were also harshly nicknamed on the basis of their skin colour — Kaali (black) and Savla (wheatish). Aggarwal was left mortified by what many South Asians sadly still continue to casually exercise. Echoing similar incidents within my social proximity, it’s infuriating witnessing the recipients of such remarks surrender to laughing at themselves too.
Except it isn’t funny. Born into a culture where conversations on religion, caste and hierarchy in India are still so prominent, the comparison of Aggarwal’s skin colour being as dark as that of the domestic help (often from poorer families), prematurely planted seeds in her mind that she simply didn’t belong with her family, especially when she was sent to boarding school. Her lack of self-worth coupled with these taunts, gave her a whole new vocabulary for the letter B, that grew in parallel with the ongoing prejudice and anxiety. B for blackie, beggar’s child, bedwetter! Not funny, but derogatory. Post her book launch that Brown Girl Magazine attended, she tells me,
I personally feel we are way behind when it comes to understanding the importance of mental health. Name-calling was normalised and if you objected, you were ridiculed further with remarks such as ‘So sensitive! Can’t you take a joke?’ Body and colour shaming can lead to a feeling of inadequacy in the victim, which can further lead to depression and much worse mental illnesses.
During the 1984 Hindu Sikh riots in India, where over 3000 Sikhs lost their lives, Aggarwal recollects the frightening moment when she and her classmates fled into hiding to escape the violence during a school trip. As a means to save all the students from harm, the Sikh boys were forced to remove their turbans and long hair — their visible identities stripped to keep them alive. Yet, ironically, even in this horrifying situation, Aggarwal felt least at risk, attributing this self-assurance to her darker appearance.
The crux of her self-loathe was the love-hate relationship she formed with skin whitening creams. The birth of Fair and Lovely, India’s most renown brand (now known as Glow and Lovely following a backlash) was notorious for selling the damaging message that fairer skin equated to a happier and fulfilling life. For it was fairer skin women that would qualify for marriage — clearly their only sole purpose!
Tactfully using famous fair-skinned Bollywood actresses in television ads and posters, their so-called perfection would scream out to vulnerable young girls. (Men were targeted much later on, but the importance seemed less). Akin to the wretched beach body posters plastered on every corner in January — because apparently bikinis only look good on a certain body type — the damaging message remains the same. Social acceptance comes at a cost, and that cost is to look a certain way.
It’s an extension of the dated methods imposed on women from the womb, where mothers are lectured on drinking milk with saffron to ensure the baby is fair, traditional matrimonial sites asking women to specify skin colour, and women being told to stay out of the sun. These socially ingrained views are eventually developed into modern day methods in the form of cleverly marketed consumables. Aggarwal admits,
Most people only use the cream on their face just as I did. At that time, I didn’t even think about the rest of the body. I felt that if the face becomes fairer, that will be enough for acceptance. My mum noticed the difference for sure and I was lighter by the time I met my husband, Amit. I must admit the addiction is a combination of three factors: the justification in your own head, the strong marketing message that ONLY fair is beautiful, and the ‘compliments’ from those around you.
I admired Shweta’s honesty on admitting what essentially was a dangerous obsession that she remained faithful to throughout her teenage and adult life. A ritual that, whilst prompted gradual results in her appearance, was never going to eliminate the insecurities she felt within herself. Moments of joy with her husband and children on holidays abroad, would be broken up by the need to ‘fix’ any damage the sun may have inflicted i.e. reverse her tan. The booming tanning industry in U.K., her now home, and admiration of her ‘sun-kissed’ look by Brits initially surprised Aggarwal — as if her colour had now gained acceptance.
But who are we seeking acceptance from? A society that is still deep rooted in patriarchy forcing women even now to adhere to dated rites of passage that holds no relevance? Or a society that seeks to point out one’s indifference because of how they look — their skin, their religious attire, their weight? Or a society that passes judgement on a woman’s self-worth, and continues to abuse that same woman behind closed doors under the eyes of Goddess Kali? Aggarwarl goes on to explain,
The more damaging perceptions of colourism, are that ‘fair is rich’, ‘fair is successful’ and ‘fair is better educated’. Essentially, ‘fair is supreme’ in every sense. And if that’s the case, where does that leave dark-skinned people? In Ukraine, for example black and brown people were discriminated against and not given a fair chance to save their lives. Is it fair to be denied a basic human right — survival — based on your colour?
I personally was curious to know from my family what the definition of prejudice in the Hindi vocabulary is and how it is/was applied to in India. “Pakshappat” (taking sides) or “poorva dhaarna”, were the closest pure Hindi definitions known to my cousin, yet rarely used. However, my dad stated that “hum bedh bhau nahin hai” was the common term used to state amongst family and friends when someone was not biased and believed in equality. Somehow, colourism never really came under that category. A sentiment echoed by some of my Chinese and black friends . Even in parts of China and Africa, the belief that darker skin is perceived as inferior, is accredited to stereotyping certain groups of people as manual labourers working under the sun, and therefore of a lower class or caste. Does Shweta believe we can change this attitude?
A couple of my aunts are still reluctant to help me with my mission. One even said ‘it’s pointless fighting it’, while one said, ‘everyone has the right to define beauty for themselves and being fairer is what beauty is for some.’ The problem with this is that people then start to look down on people who aren’t. Colourism, casteism and classism divide people, creating more unrest in society. If we continue to aspire to be fairer, we’re still encouraging white skin privilege, and encouraging colonial values. The more we allow ourselves to succumb to these social constructs, the more enslaved we feel internally. Melanin is crucial for protecting our skin against the harmful radiation of the sun. Feel blessed that you have it and wear it with pride!
I wonder how we can dare to walk shoulder to shoulder with our black friends in the Black Lives Matter movement, if we refuse to face up to our own biases against colour? We seek equality in the U.K., but deny our deep-rooted prejudice, whilst a white privileged man lectures the world on the difference between racism and unconscious bias (yes Prince Harry, I’m looking at you!). “The Black Rose” has paved a way for many more voices to speak out against the damaging impact of colourism, and in my view, rightly belongs under the definition of prejudice in the collective South Asian vocabulary.
“The Black Rose” is available to purchase on Amazon.
Ten to 28% of the world’s population of women experience painful sex. Keep in mind, that this is just what is reported. As embarrassing and as vulnerable as you may feel, you are absolutely not alone. The good news is that in addition to your traditional medical care to treat painful sex (also known as dyspareunia) such as medication, injections and surgery — a conservative approach is effective and long-lasting. Conservative care ranges from pelvic floor physical therapy, chiropractic care and acupuncture which are beneficial in treating the root cause of painful sex, as well as symptoms, for long-term healing.
Some of the signs to look out for if you experience pain are:
Treatment options for painful sex such as pelvic floor physical therapy, chiropractic care and acupuncture provide a long-lasting and profound effect on the pelvic floor and address your entire physical well-being.
The pelvic floor is a layer of muscles that range from the pubic bone to the tailbone. The purpose of these muscles is to assist in bowel and bladder control, support a baby during pregnancy and contribute to sexual sensations. Just like any other muscle in your body, these pelvic floor muscles can become tight or weak which can be a contributing factor to pain.
Pelvic Floor Physical Therapy
Pelvic floor therapy can assist by strengthening and relaxing the muscles which is necessary to relieve pain during sex.
Chiropractors can be extremely beneficial with assisting in helping relieve pain. Associated pain and discomfort can originate from the lower back and buttock muscles. Chiropractors are trained in taking a history and performing a neurological, orthopedic and soft tissue examination to identify treatment options. Deep tissue massage, skin rolling, Active Release Technique, muscle energy technique, ice, heat and electrical stimulation are just to name a few.
Acupuncture can activate the human dopamine system which helps regulate hormone levels and can assist in psychological factors. Acupuncture can improve mood, decrease pain and can be vastly beneficial in managing pain and mental health symptoms.
Ask for help
“Everyone is having pelvic pain and no one is talking about it”
Start with seeing your gynecologist who you trust for a history and examination of current symptoms to rule out any other medical conditions that could be a contributing factor to symptoms.
How to talk to your partner about this in a safe/healthy way
Being open with your partner about your symptoms and painful sex may seem like a difficult conversation. Intercourse should never be painful and learning when to stay ‘stop’ is important in communication. Talking about pain before, during and after sex is important also in your own health diagnosis to see if pain symptoms are improving or becoming worse. Having open communication does not only benefit your relationship but most importantly, your own health.
To experience these symptoms may seem taboo or unheard of but quite frankly, they are common in many women. Women deserve to be directed to proper healthcare.
Disclaimer: These are based on recommendations from a board-certified chiropractic physician and licensed acupuncturist. If symptoms become new or worse, consult with a primary care physician and or OBGYN to co-manage symptoms.
In July 2022, Sania Khan’s life was ruthlessly taken from her by her ex-husband. Sania was a young, vibrant South Asian woman – a creator and photographer who had the courage to step out of an abusive marriage, even in the face of community norms that discourage women from speaking out. While this tragedy seemed to stir a consciousness in the South Asian diaspora that we can no longer justify the status quo, it is far from the only such incident. Just months later in December of 2022, Harpreet Kaur Gill was stabbed to death by her husband in Vancouver. While the most extreme cases like those of Sania Khan and Harpreet Kaur Gill are highlighted by mainstream media, a small body of research provides evidence that intimate partner violence experiences are equally, if not more, prevalent in South Asian communities than the general population in the US or Canada. That’s why we need to do more as a community and throw light South Asians and intimate partner violence.
Despite the identification and investigation of these norms in South Asia, there’s so much we still don’t know about diaspora communities, especially in relation to South Asians and intimate partner violence. In the US, South Asians have become one of the fastest-growing populations, but we remain unaware of how the stresses of raising a family in a different culture, and the weight of growing up between two worlds, affect these norms, expectations, and experiences among South Asian immigrants, the second generation and beyond.
In this article, we’ll take a deeper look at how these norms are enacted to influence intimate relationship dynamics, discuss the recent rise in intimate partner violence, and explore the work that researchers, policymakers, and program implementers can do to address violence in South Asian diaspora communities.
Social Norms and Violence in South Asian Diaspora Communities
Why does it take catastrophic events to serve as a call to action? For one, the “model minority myth” continues to portray South Asians in America (who originate from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) as a healthy and wealthy group. As a child of Indian immigrants, I always thought this was just a frustrating trope that lived rent-free in my head next to the eternal question, “Log kya kahenge?” (What will people say?) However, I have realized that this constant worry is not just an innocent preoccupation. It’s the result of a dangerous spiral beginning with the portrayal of South Asians as a model minority and the need to maintain that well-to-do image. This only reinforces the traditional gender norms that overlook men’s perpetration of violence and encourage women’s silence, crippling any efforts to understand the scope of the problem and draw attention and resources to address it.
The Impacts of COVID-19 on Intimate Partner Violence
Prior to the start of the COVID-19 pandemic, the frequently-uttered phrase among researchers, practitioners, and advocates alike was “one in three” — one in three women ages 15-49 experiences physical and/or sexual violence inflicted by an intimate partner in their lifetime. Under the cover of the COVID-19 pandemic however, rates of violence against women rose dramatically, prompting UN Women to call for recognition of this “Shadow Pandemic.” During the height of the pandemic, the social isolation that came with lockdowns and quarantine procedures to curb the spread of disease made home a more dangerous place for an increasing number of women. As communities seek to rebuild, the inequities in access to and use of potentially lifesaving services have deepened. Now more than ever, it is critical that we shine a light on the many intersections of our society to prevent South Asian women’s experiences of intimate partner violence from being pushed even further into the shadows.
First and foremost, to better understand South Asians and intimate partner violence, we need better data disaggregated by racial/ethnic group. Since the 1980 Census, only those of Indian origin have had a fill-in bubble.All other South Asian groups have to write something in, decreasing their participation. South Asian communities in the US are not a monolith and they are certainly not all of Indian origin. This perception, fed by our lack of data, likely privileges the Indian community in America and limits the visibility of other South Asian communities.
More accurate information will help us better understand where the need is greatest. We can make a stronger case for more equitable resource allocation, improve South Asian language materials for survivors, and enhance provider training programs, accounting for the specific cultural implications of disclosing and seeking treatment for violence in South Asian communities. Public health researchers should increase efforts to understand the prevalence of experiences of violence, the environmental factors that make South Asian women in America vulnerable to experiences of intimate partner violence, and how it impacts their health.
While outstanding organizations such as Narika in California and Sakhi in New York are leading the charge in raising awareness, running active helplines, and providing support, they cannot be the sole safe space for survivors. While the system’s failure to protect Sania is not an isolated incident, it has served as a wake-up call.
All South Asian women in America should be able to be healthy and safe and lead lives free from violence, coercion, or abandonment. To achieve this, we need better data, more research, culturally-tailored resources, and appropriate legislative action that will allow for prevention, screening, and treatment efforts to finally take root.