152 Periods Optional: Dr. Sophia Yen on Revolutionizing Women’s Health with Innovative Technology
Sophia Yen is an entrepreneur and doctor who has figured out that women don’t need to bleed every month. CEO and co-founder of PandiaHealth.com, Sophia shares with WINGS the latest medical and technology innovations for women’s reproductive health that can also make women more successful in business.
Melinda Wittstock: Welcome to Wings, Sophia.
Dr. Sophia Yen: Thank you so much for having me, it's an honor to be here.
Melinda Wittstock: Well, it's great that you could join in. I am so curious about periods optional. I didn't even know you could do that.
Dr. Sophia Yen: Exactly! So we surveyed women in our target demographic of 18-35, and found that 30% of women knew that periods are optional but 70% did not and since the invention of this medication, physicians have known that having one week off to have that bleed is totally optional. And so what's really hard for lay people to understand is if you're not on any medication yet, you should have a period every single month, or we, as physicians, need to look up and see do you have a thyroid problem, a cancer problem, are you not eating enough, are you exercising too much or whatever.
But, if you're perfectly healthy and normal and you don't like having your period, we can put you on some medicines and turn them off. And I had this epiphany when I was trying to get pregnant that the only reason we build that lining in the uterus every month is to accept an embryo. And if we're not trying to accept an embryo from age 12 to 26 on average in the United States, or 35 for those of us who had to go through more education, then that's 10-20 plus years of incessant menstruation with no purpose and we're just wasting blood, we're wasting energy, we're risking endometrial cancer, which is that lining of the uterus turning over every single month. We're risking ovarian cancer because when you pop out an egg from your ovary, you're hurting the ovary, and anytime anything has to break and repair, you risk cancer. And one of the top reasons women miss school or work is their periods, so if we can turn off their periods we can increase productivity, we can decrease cancer, we can decrease land fill.
Melinda Wittstock: Wow, you just rocked my world! I think of all … I think of all the months lost over the course of my life … And so what do you have to do? Is it just taking a pill, or … How does it work?
Dr. Sophia Yen: Yes, exactly. So what it is, is one of the three founders of the pill was a devout Catholic physician, Dr. John Rock and there were two Ph.Ds who were also founders and Dr. Rock said, “Let's make women have a period every month.” And then the other two were like, “No! Why not have it every three months or every year?” But Dr. Rock won that argument because he was trying to get it through the Catholic Church because the Catholic Church was totally fine with the rhythm method. So Dr. Rock was just saying, “We're going to make periods regular, regular, regular. And then you can practice the rhythm method.” He got it through the priests, he got it through the nuns, but the Pope at the time figured it out and vetoed it. But because he won that argument, every method since has had one week of bleeding, which is purely optional.
So the way the pill or the ring works is it gives you three weeks of hormones and then one week of sugar or one week off and during that week you have this withdrawal bleed. But that one week off is purely optional.
And then there are new methods now, such as the IUD with hormone, the implant and the shot that also turn off your period, and it's perfectly fine because there's a great article by Malcolm Gladwell called, “John Rock's Error”, and it talks about, as I mentioned before, incessant menstruation is a modern construct, and women, in general, were supposed to get pregnant when we were 15 or 16, have each baby breastfeed for 18 months. But in today's world, we are having two babies and we are breastfeeding from zero to three to six months and therefore, all that incessant menstruation in between is not quite natural.
And they actually studied a tribe in Mali where they are banished to the menstruation hut a hundred times in their lives, whereas we, in the western world, are banished to the menstruation hut three hundred to five hundred times in our lives. So we have three to five times the number of period that would be “normal”.
Melinda Wittstock: Oh my goodness, and so does it also get rid of all the kind of PMS symptoms, the cramps, the kind of ups and downs of the hormone … All of that?
Dr. Sophia Yen: Exactly! So if you're on a smooth hormone every single day, I think your life, and I know from other scientific evidence, such as people who have diabetes or people who have seizure disorders … If you're messing with the hormones and cycling every single day, that's going to be a lot harder to deal with than if you're just straight solid, flat normal. You know what I mean, just a solid one-level of hormone as opposed to something changing everyday going up and down and up and down because that's what's going on without the medication. The cycling, right … Building the lining, waiting for a baby … Oh the baby didn't happen … Cleaning, repairing, and then repeat that cycle every single month.
Melinda Wittstock: Wow, so I am imagining you right now, going and raising money and sitting in a meeting with a whole bunch of dude VCs. How does that go when you talk about … Do they just look like … How do they deal with it?
Dr. Sophia Yen: [crosstalk [spp-timestamp time="00:05:55"] I've had a difficult time raising from the older male VCs and even the not-so-older, if they're like not as Americanized, if they just came from Taiwan or China, or if they're in a very traditional household where the men and women don't talk about birth control. I'm having better success with the 40-something VCs, but the 50 year olds and up say, “Is this really a problem?” And I'm like, “You don't understand.” I actually coined this term called “Pill Anxiety” where if you're on that last week of pills, you start freaking out that if I don't get to the pharmacy by this last pill, there will be a dire consequence. And women suffer this pill anxiety for 20-30 years of their life. I've personally suffered the pill anxiety wholly, I need to get my medicine, right, or there will be a dire consequence. And men who haven't had to go through that, don't get that. Or men who don't talk to their significant other, if they're hetero, about that, don't get that.
And so, when I walk into a room of 70 plus year old, Caucasian males, they're like, “I don't understand why that's a problem. Can't your assistant just deal with that?” No I don't have assistants and as a woman this is something vital to my life and so the women get it and the younger men get it and interestingly enough it's the younger men that are financing me because women are more conservative I guess. I don't know what the deal is but it's been disappointing in that way but I am very thankful for the young men that are stepping up and backing us. We do have one woman financier, as you would call her, considering and I'm hoping she will cross the line and help.
Melinda Wittstock: That's really curious that you found it difficult with women. You think that they would be like lining up to invest in this because apart from anything else you have a massive market like a huge address of market.
Dr. Sophia Yen: Exactly and it's, I guess you know, I'm not the hot thing right now … The hot … I mean some tech is cool and hot but if you ask all of the [inaudible [spp-timestamp time="00:08:05"] tech entrepreneurs we're having a really hard time getting funding. And yeah the hot thing is AI … The hot thing is, I don't know, clothing or make up or something but birth control is the elephant in the room that 80 to 90% of women will use birth control some point in their life. But will anybody talk about it? No. Will America talk about it? No. And the example I give is there was this show, I believe, called Temptation Island and it was twenty couples trying to break them up, you know, by, you know, one pitting one versus the other and a birth control company approached them and said can we run our ad during your show and they said, “Oh that's not within our values”, and I was like, “You're trying to mix people up with sex and you won't run a birth control commercial”, and that's how backwards our country is.
Melinda Wittstock: It's getting … All these things are so politicized and such hot button issues and I wonder if that is one of the reasons for the difficulty getting funding. I know that a lot of women, you know, go to get try and get VC funding if they have an addressable market that's mostly men and often get the answer, ‘well you know, we don't really understand your market.' And that has flummoxed me because you would think if you were, you know, as an investor, you want to find opportunity or a place where a market is underserved.
Dr. Sophia Yen: Yes.
Melinda Wittstock: So yes, it's astonishing. So how long ago did you launch the company and what's its trajectory been like … Like where … When did you start and where are you now in terms of customers and revenue and all of that good stuff.
Dr. Sophia Yen: Yeah, so about three years ago, came up with this idea when I was preparing a talk to give to physicians or medical students about birth control and realized one of the top reasons women don't take their birth control is they don't have it on hand and I said, “This I can solve.” I will just become a white label, make a delightful pharmacy experience, ship it to you and keep shipping it to you until you tell us to stop. But then when they ran ads for free birth control delivery, 60% of the women that responded didn't have a prescription. Either they had let it expire or they never had one to begin with. And I'm a doctor and I said, “Well I can write prescriptions”, and so we came up with this asynchronous telemedicine where somebody just fills out a questionnaire and pays the 39 bucks. The doctor looks at it at their leisure 24/7 and then says, “Okay, looks good.” … Writes the prescription … Sends it to our partner pharmacy, bills it to their insurance for the medication and the woman's done for the year.
And so then, March of last year, we started this women founded, women led, reproductive rights activists founded, practicing reproductive health physician founded company in this space and then launched the product July of 2016 and since then we've been growing 20-30% month over month and I know that I have about ten times the amount of customers that my competitors had at this same stage so we're smarter, better, faster than what my competitors have been.
Melinda Wittstock: That is awesome. Congratulations on your progress. And so, the transition from being a doctor to being an entrepreneur … What is that like or were you always sort of entrepreneurial underneath, you know, the doctor's coat? I mean …
Dr. Sophia Yen: Yes.
Melinda Wittstock: How did that actually because, you know, I'm just going to ask that question again because I stumbled all over it. So [inaudible [spp-timestamp time="00:11:43"] and edit here. So you transition from being a doctor to an entrepreneur. What was that like, that transition?
Dr. Sophia Yen: Yeah, so when I go to pitch, I instantly get trust because and expertise because I'm a physician but entrepreneurship has always been in my blood. My grandparents had their own company in Taiwan, which was manufacturing clothes. They had two stores. And then my parents have lived the American dream from rags to riches in Silicon Valley back when people were manufacturing chips, they actually opened a company through their garage, which was the standard back in the day. My dad being a scientist coming up with the product. My mom with the EQ going door to door selling to 3M and Motorola and IBM. So I have … It's in my blood.
And it comes from both sides and I have the science from my dad and I have the people skills and entrepreneurship from my mother and growing up in high school we had a great opportunity Junior Achievement where back in that time you would actually incorporate, sell stock, write a business plan and pay back and we paid back nine dollars on the dollar and we hustled and we did everything we could to make money for our shareholders and that continued through high school, through college … I've been the treasurer of every organization … I have a perfect last name for that, Yen = money = treasurer.
Melinda Wittstock: Yes, which begs the question, why did you become a doctor?
Dr. Sophia Yen: The doctor was because I love people and I love science and I love to help people and this company came because it was a perfect storm of laws, the Affordable Care Act was making birth control available with no co-pay, no deductible. So the product would be free to the end user. We'd just bill it to the insurance and then the American College of Obstetrics and Gynecology in 2012, and again in 2016, said birth control is safe and should be over-the-counter and that they did research, if you give women a list of 20 questions and say “Do you have breast cancer? Do you have liver cancer? Have you had migraines with wacky symptoms? Have you had a stroke” etc, etc., that women were perfectly able to disqualify themselves from taking the birth control pill if they fit any of those conditions so they said perfectly fine to send over-the-counter.
Then three states have passed laws that allow pharmacists to prescribe birth control and so when California was considering this, I put on my hat as a clinical associate professor at Stanford, gave them all the data saying you don't have to do it in person. Envision that we can bring birth control to wherever women are and provide them confidential, reliable and convenient health care if you don't require this in person. Because if it's in person, they have to go Monday thru Friday nine to five, or if they're in a small town you can envision every time you walk in … Oh, Sophia, you again, for birth control … And then the whole town would know by the end of that 20 minute interaction that you are on birth control so I lobbied them. Unfortunately they weren't into it and so I said, “Fine, I will open this company because this company has to happen. We need to bring birth control to women wherever they have Internet and a mailbox.” And that's what we're doing.
Melinda Wittstock: How fantastic. So where do you see the company in ten years? What's your big moon shot with it?
Dr. Sophia Yen: So yes, what differentiates us, I think, from our competitors … But if they keep hearing me talk about it on podcast, they will see the light … Is that one, we're women founded, women led and physician founded, physician led and practicing reproductive health physicians founded so they can't go back and do that. But the vision is become the brand that women trust with their health. We start with birth control and then we grow with them as they grow so when their birth control stops, we say, “Oh, do you want some prenatal vitamins? Do you want to be hooked up with my friend here who specializes in fertility? Or my friend over here who does breast pumps?” And then we're happy to take on your baby's, then your children's, you know, medications and we could easily add on acne for the younger generation and eventually we can do menopause and a wrinkle cream and also we see ourselves for our investors as the Dollar Shave Club but for women and recession proof. So in a recession you're going to get rid of Stitch Fix, you're going to get rid of Birchbox, you're going to get rid of, you know, luxury or little things that are really expensive but you cannot afford. But you cannot afford to let go of your birth control.
And, in general, your birth control should be covered by insurance. As I like to say it's fiscally smart and morally right for insurance companies and corporations to cover birth control. For every one dollar they spend on birth control, they save four to nine dollars because an unplanned pregnancy can cost $800 for an abortion, $10,000 for a vaginal delivery, $40,000 for a c-section and that's not including pre and post-natal care and blood work and ultrasounds then simply those, you know, three end points. So better to pay $10-20 a month for birth control than those outcomes.
Melinda Wittstock: So you are … You say female founded, you know, team … Not just you but your team. What makes women different as entrepreneurs? And we bring a lot to the table that's … A lot of strengths. But potentially some weaknesses too or perceived weaknesses. How do you view us, as like, where we do generally? I mean it's always a, sort of a, scale but where do we do well and where do we get in our own way?
Dr. Sophia Yen: So I would say the perceived weaknesses are actually our strength as we're hearing more and more companies with a woman at the table or with diversity at the table do better because you make a better product, because you have different viewpoints and as you say then we are able to access a whole different segment of the market that a whole bunch of people that are the same gender, same race, same age, wouldn't get before. So diversity brings a better product … Makes a better product. And they've shown that women have better [inaudible [spp-timestamp time="00:18:00"] are better able to manage, make the team happier, have better retention. But the bottom line is we improve the bottom line because we make a better product.
The other perceived negative is, I'm a mother and so I have children and the children must be distracting but I actually say it's my strength because I've survived my young children and as I tell all the women that … Behind me, that coming up that you will be at full productivity when your youngest is five and my youngest is eight.
Melinda Wittstock: That is so true. I discovered that as well. I was so, I was so blown away by it. There's something about a mom with young kids where you just go into … I don't know what it is, it's some sort of overdrive. I remember launching one of my businesses when I was pregnant with my first daughter.
Dr. Sophia Yen: Wow.
Melinda Wittstock: I remember like running around to meetings with, like, a breast pump all the time and you know …
Dr. Sophia Yen: Yes.
Melinda Wittstock: But I got stuff … I mean, you know, the company took off in that period.
Dr. Sophia Yen: Women are very responsible and I think the benefit is that, you know, once you've had a kid, you look at everyone who doesn't have a kid and you go, “Why aren't you give five times more productive?” because I know you have evenings and weekends and all this time in the world that you don't realize until you have a child that sucks all that time from you. And then, they release it back to you when they go back to school right? And so I would say having a child makes you realize how much time and how much energy you have and also having a child drives you even further because you want to make money for your child but you also want to make the world a better place.
So being a mother, being a parent absolutely makes you, I think, realize how much productivity there is and being a physician … Some people, as you mentioned, will look down on that because what could you possibly know about business but I've had it in my soul … I've done it my entire life. I've run budgets, I've balanced books, I've made sure we've always made a profit. So being a doctor, again, we will do whatever the hell it takes to get into med school. We will do whatever the hell it takes to get into residency and fellowship and I will do whatever the hell it takes to make this company shine. It's about strength.
Melinda Wittstock: It's so inspiring. So if you had three bits of advice that you would give to young women who are thinking of becoming entrepreneurs or women a little bit later in life who after a corporate career or after having children or whatever want to come back and reinvent themselves as entrepreneurs, what would be your top three pieces of advice for either group?
Dr. Sophia Yen: I would say that there is bias out there and know that it's there and that you may have to work harder, faster, smarter to get as much credit as a male counterpart but leverage our community. We, as women, love being together and hopefully helping each other out and there are a ton of women communities out there such as springboard enterprise, such as women start up labs, such as female founders conference and there's a female founders group on, on Facebook, as well. And so, what's good for me is that I am in a female oriented company and I'm hoping these other women will help get the word out and that we can help each other while you're working on clothing, you can promote me and I can promote you and we can work together. So that would be point number one, know that it will be a harder road but you can totally do it with your sisters with you or with, without the sisters …
Melinda Wittstock: Oh my god, that's my whole …
Dr. Sophia Yen: … But I always believe it.
Melinda Wittstock: Yeah that's the whole new reason for even launching this podcast, really, in my case, just wanting to be the change that I want to see in the world. Really inspire women to help each other … Like write checks for each other … Really be there for you.
Dr. Sophia Yen: Yes. Write checks. Speak up. Get the word out. Ask customers to question who are the founders of this company and why are all the top women companies serving women, companies run by men? Why can't they be run by women? Why don't their boards have at least 50% women? Why are we settling for ten? You know?
Melinda Wittstock: Absolutely.
Dr. Sophia Yen: And then number …
Melinda Wittstock: Number two?
Dr. Sophia Yen: Number two, yes. Get everything in writing. So I have heard so many horror stories to women, to minorities, to non-minorities, to non-women, that they were promised XYZ by their co-founder or by somebody that they presented their idea to and then that person took the idea, ran with it and pushed them out. And that may still happen when you start a company and that may be … May be your time to go but there's been a lot of ugly stuff where it wasn't your time to go and they pushed you out and it was your baby and it was your idea and it was just demoralizing. So don't trust anyone even if they're the nicest looking person in the world or even if they're your best friend because sometimes when it comes to money and greed, people get evil so get everything in writing.
Melinda Wittstock: Uh-hmm (affirmative). Good advice.
Dr. Sophia Yen: Unfortunately. And then lastly, for younger women, as you are growing up, make sure you have a supportive significant other, make sure they're clear that everything is 50/50 and their radical idea is given to women, who are just about to pop out a baby. And to test the waters is that … I set up with my husband and I love him for it and he is the most supportive significant other … he's just, you know, huge to my life, is that if I'm doing input: breastfeeding, you will do output and until I stop doing input, you will do all the output, because it's going to be 50/50. It's not going to mean me doing 80, 90% of the baby caring stuff. It's going to be 50/50. And that set the tone from the beginning of our children's lives that if I'm doing 50, you're doing 50. I'm not going to do the breast feeding and the diapers because that's 80, 90% or 100%. I'm doing the breast feeding, you're doing the diapers. I didn't have any diapers for three months.
Melinda Wittstock: I love it because, you know, when you come at this with a business mind and an understanding of the concept of leverage … I remember thinking, hmmm, me doing the laundry right now as opposed to me working on the latest product that could be worth millions of dollars, will be worth millions of dollars to my company … Let's see, what's my hourly rate. So I'd be the most expensive laundry lady ever. It's just not the best use of my time and to start to think like that, really understand our value. Because, I think, sometimes we just try and do it all because that's what …
Dr. Sophia Yen: Yeah.
Melinda Wittstock: … we know but it's not what's right.
Dr. Sophia Yen: Yes. And it's also like, what was the other thing? Like our children's school, they wanted people to volunteer for hot lunch and we feel guilty because we can't volunteer at our kids' school but it's ridiculous to ask my husband who works at Apple who has some crazy hourly rate and it's ridiculous to ask me who's a physician and C.E.O. and has a crazy hourly rate to be serving hot lunch. Can you really not find a sixth grader or an eighth grader or someone on minimum wage to serve hot lunch? To have a physician serving hot lunch or a C.E.O. or an Apple programmer miss work, come drive, serve hot lunch and go back is ridiculous. And so don't feel guilty. Don't feel … And that's what I feel too. I feel a whole bunch … We have this Lean In Women physicians group and the women are like, “Oh my gosh I feel so guilty for being at work. I could be home taking care of my kid.” And I'm like, “Does your husband feel that way? Because if your husband doesn't feel guilty, why the hell are you feeling guilty?” It should be equal, right? He should feel as guilty as you or you can feel equally not guilty.
For me, my parents were busy running their company when I grew up and so every minute my child has is more than I ever had with my parents. Though they did give me time [inaudible [spp-timestamp time="00:26:13"] Yeah, I don't feel guilty. I don't feel guilty at all.
Melinda Wittstock: Sophia, it's amazing talking to you. You're so inspiring and I am also inspired by your gift to our listeners today because if they go to pandiahealth.com and enter the code ‘wings' at the checkout, they will get five dollars off a telemedicine visit. That's pretty good.
Dr. Sophia Yen: Absolutely. We are happy to help women get access to what they need to make their lives better and that birth control can be used for more than just birth control. It can be used for menstrual manipulation, menstrual elimination and decreasing cancer, making the world a better place.
Melinda Wittstock: That's awesome. So enter the code ‘wings' at pandiahealth.com. And also you can follow Sophia on Twitter and Facebook and LinkedIn and if you look at the show notes for this podcast, we'll have all that good stuff so you can follow her and keep track of her career. This is awesome. Sophia, thank you so much for putting on your super she-hero wings and flying with me today. It was great to have you on.
Dr. Sophia Yen: Thank you so much for doing this podcast and investing in women and helping us inspire the next generation and I appreciate this opportunity.