True blood: How a pumpkin conveyed the real horror of endometriosis

How did you come up with the concept of the ad? 

Rose Alder, Creative, TBWA/MCR: I am a huge horror fan. I was watching a classic slasher film on tv one night and there was an advert for a sanitary product during the ad break. From then on, I have always thought, wouldn’t it be powerful to create an advert for women who suffer with heavy/painful periods with the horror genre.  

After a lot of research, I then discovered the ‘horror’ of endometriosis. I couldn’t believe the stories I was reading from women who suffer from this debilitating condition and the shocking lack of research behind it. I had drafted several scripts for a short horror film based on the condition but due to budgetary constraints it was very hard to achieve.  

I didn’t want to sugar coat women’s pain anymore, like so many ads for menstrual health do. 

I thought, how can we get this message across in a simple, affordable and therefore achievable way. One shot of a pumpkin, being torn apart, just in time for Halloween. That was it. And what the film has become is more than I ever could have imagined due to the amazing crew who came on board the project.  

I didn’t want to sugar coat women’s pain anymore, like so many ad for menstrual health do. I wanted to create something that really showed people the true horror.   

What materials did you use to depict the flesh?  

Zeynep Oguz, Director, Packer Production: Surprisingly, we simply just used pumpkins. Adding any other textures such as fake blood, or slime would have taken away from the strength of the concept. The natural stringy, fibrous texture of the pumpkin’s insides perfectly captured the feeling we wanted.  

I worked with our DP David Procter to light the pumpkin using vintage theatre projectors with red gels. 

We spoke about this with the Menstrual Health Project founders who both confirmed that in fact many people use this kind of imagery when they are describing the pain. We wanted to stay as close as possible to reality.  

We had a great team of food stylists and production designers who tirelessly cooked and carved countless Hallowe’en pumpkins. I worked with our DP David Procter to light the pumpkin using vintage theatre projectors with red gels to get an overall blood red tone.  

We finalised the look with our colourist, favouring deep tones of red over more pumpkin-like bright orange tones to really make it appear more abstract.  

The Alien-esque sound effects are amazing, how did you make them? 

ZO: The audio overall played such a key role (as in all horror movies) in depicting the feeling of pain and making the edit feel more intense and visceral. Music and sound effects really had to complement each other to drive the edit. Our editor Zoé Desgraupes already prepared a great base for the rhythm of the effects, placing them in places to have the maximum impact.  

Our composer, Mathilde Koechlin recorded sound effects with her mouth making them feel wet and sticky like a weird creature. 

When I first spoke with our composer, Mathilde Koechlin, my brief was to avoid having a melody that caries the edit and makes you feel comfortable, so she created Alien-like sound effects using deep Moog synth notes and recorded sound effects with her mouth to layer with the heartbeat-like effects, making them feel wet and sticky like a weird creature.  

My sound brief was to push the limits of what you see on screen, from creature sounds, impacts of tearing, ripping to slimy textures we had a wide range of effects. Our brilliant sound engineer Vika Vinnikova, got her hands dirty in the foley booth tearing, mashing pumpkins, layering these with celery and pepper snaps, lettuce crunches and the rip of an old dress.  

It was heartbreaking to hear what [The Menstrual Health Project founders] have gone through and how they continue to suffer. 

She amplified these with traditional horror sound elements to build tension. I wanted the sound effects to standout as loud as we could get them in the mix to really make the viewer uncomfortable and feel each impact.  

Do any of the crew have the condition? Did they help with the concept?  

RA: Both the founders from the menstrual health charity, who worked with us every step of the way on the project, suffer from endometriosis. It was heartbreaking to hear what they have gone through and how they continue to suffer. They were incredibly honest when revealing their struggles with the condition.  

1 per cent of [medical research] funding goes on women’s health. It’s shocking. Women’s pain is often disregarded. 

We absolutely had to reflect this honesty to create a film that would not only punch above its weight for endometriosis but also do justice. And their openness spurred us on even more to gift them this film in order to raise awareness. They’re both absolute superheroes and wholeheartedly deserve this film.