Welcome to Our Voices Our Future, the podcast
where we amplify the voices driving change and
equity within medicine and beyond. Brought to
you by the Gender Equity Task Force, a community
committee of the American Medical Women's Association.
We're here to challenge norms, break barriers,
and ignite conversations that matter. I'm Rhea
Monohur, and in each episode, we'll bring you
candid discussions with leaders, change makers,
and advocates working to create a more inclusive
and just world. No more silence, no more waiting.
You're listening to our voices, our future. Let's
get into it. So today we are welcoming Dr. Sophia
Yen, a physician, scientist, CEO and co -founder
of Pandia Health, activist, feminist and mom.
Dr. Yen is a leading voice in reproductive health
and gender equity known for her advocacy to make
Hashtag periods optional through education on
the science and safety of saving periods. She's
also pioneered an algorithm for personalized
birth control, prescribing, achieving remarkable
success in patient satisfaction, and continues
to champion research that reflects diversity,
equity, and inclusion. Through her work, Dr.
Yan is reshaping conversations about women's
health, representation and research, and innovation
led by women physicians. Well, thank you so much
for being here with us today. Thank you so much
for having me. You wear many hats, physician,
scientist, entrepreneur, activist, feminist,
and mom. Can you share a little bit about your
journey and what inspired you to combine medicine,
advocacy, and innovation into your career? I
would say once you've chosen medicine, and I
won't give you the story of how I chose medicine,
but short story there is I like stickers. How
I got to from. Yeah, the early starts of my passion
for reproductive health, adolescent health, was
I was a pregnancy test counselor at Planned Parenthood,
you know, pre -med, high school, 15 year old,
volunteering, got to run pregnancy tests, which
was like serious chemistry for me, you know.
Unfortunately, I ran a pregnancy test and it
turned positive for a 13 year old. And I was
like, Oh, and we always ask people before the
results come in because we want them to answer
before they're all freaking out and panicking.
You know, if this were to turn positive, would
you continue the pregnancy, continue and give
up for adoption and terminate the pregnancy?
What would you do? And I knew walking in running
that test that this young woman was going with
continue the pregnancy. And, you know, I then
handed her off to a professional counselor after
getting that result and just knowing where the
roads would fork. I would go on to MIT, UCSF,
Children's Oakland, back to UCSF to specialize
in adolescence, what we call sex, drugs, rock
and roll, and then an MPH at Berkeley just to
get more degrees specializing in maternal child
health. focusing on childhood obesity, and then
go to Stanford where I'm a clinical associate
professor in the Department of Pediatrics and
Division of Adolescent Medicine, and then finally
at Pandia Health where I'm the CEO and co -founder.
And where would this young woman end up? It would
be a lot harder as a 13 -year -old that's like
eighth grade, right? Eighth grader, pregnant.
Are you going to finish high school? Are you
going to finish college? Are you even going to
get to college? Are you going to get to graduate
school? And certainly we've seen it done, but
it's very, very hard. And certainly we've seen
the person with the penis stick by their side,
but we've also seen many of them walk away. I
was like this is so preventable if we had only
given her comprehensive sex ed if we had only
given her birth control and that's my thing is
you can have sex but don't get pregnant and don't
get sexually transmitted infections and also
in any heterosexual interaction only 30 % of
those with the uterus get off and if you're not
getting off then why are you risking pregnancy
and sexually transmitted infections either mutual
masturbation or make sure you get yours you know
and if we had also given her something to aspire
to because I was pre -med I knew that if I was
sexually active I could not afford to get pregnant
because it would make it very difficult to get
through high school college med school residency
fellowship and everything I needed to do to get
where I needed to go. And so where that comes
in is my sorority sister dragged me into co found
she heroes dot org and she heroes is free online
videos targeting third graders and up before
the young people trim their tree of possibilities,
showing them that women can be whatever we want
to be as long as we work hard towards that goal.
And as long as we get some help from some Allies,
but really focusing on we can do whatever we
want to do as and but there will be obstacles
to overcome and so That came she heroes and then
for Pandia help. I was giving a talk to a bunch
of doctors Why don't women take their birth control
and one of the top reasons was? Didn't have in
their hand and my friend and I are like we resolve
that we will just ship them birth control Keep
shipping them birth control until they tell us
to stop And then we ran ads, free birth control
delivery, and 60 % of the people that responded
to such an ad did not have a prescription. And
I'm like, oh, do you not know you need a prescription?
And thank goodness I'm a physician. So I was
like, fine, I will write your prescription. And
so that's how Pantia Health was born. I did not
want to do telemedicine, but it is what was needed
to happen. And it was kind of a perfect storm.
laws, they had just passed a law in California
allowing pharmacists to prescribe. So we took
the protocol that allowed pharmacists prescribe
and threw a layer of doctor on top of that. And
that is our asynchronous telemedicine. And then
lastly, I hit menopause and all my friends are
like, man, I'm hot. And I'm like, yes, I will
find the best treatment for me because I want
the best treatment for me. And then I will share
it with all of you. But in building our hundred
percent physician team, we picked up two OB -GYNs
each with 20 years experience in menopause. And
I was like, you, you are leading the team. You
are developing the protocol. And if any of us
have any questions, we'll consult you. So for
Pandia Health, we see birth control patients
in one business day. For menopause, three to
five business days. In case our doctors have
any questions, they can consult the super menopause
experts. But know that because we are asynchronous
telemedicine, and if I lose my license, then
the whole company goes down. So we can't do anything
off label. We can only do the four indications
for HRT, which unfortunately are limited. And
you'd be surprised the one that isn't on there.
So HRT was originally developed because they
noticed that women had our heart attacks. later
than men. and they actually started with HRT
giving estrogen to men to prevent Heart attacks
didn't work so well. But anyway, the four indications
are hot flashes, night sweats, genitourinary
syndrome of menopause, which is painful sex,
dry sex. I call it sandpaper vagina or the urinary
feeling like you got a pee when you don't have
much pee going on or feeling like you have a
urinary tract infection when you don't or having
recurrent urinary tract infections because when
estrogen goes away, the vagina dries up and the
urethra right above it and that dries up too
and so it increases your risk for urinary tract
infections and then lastly as women of color
I'm always like we don't get a leg up on anything
all of medicine is based on a Caucasian white
you know male and so women of color is the exact
opposite of that But because we're people of
color and a lot of us are lactose intolerant,
then we automatically qualify for at risk for
osteoporosis. So if you are lactose intolerant,
don't get enough calcium, or if you're a small
frames kind of person, then you're immediately
at risk for osteoporosis. And certainly if you
have an immediate family member that has osteoporosis,
that qualifies you as well. Well, thank you for
sharing so much about what has kind of brought
you to where you are now and how that journey
has changed over time. I think a lot of us think
that we need to follow this like singular path
from point A to point B and recognizing that
that journey really changes as the opportunities
and experiences around us modify that. So with
that what I really want to talk about is you've
been a leading voice in the periods optional
movement for listeners who may not be familiar.
Can you explain the science and safety behind
saving periods and why you believe that this
is an important option for people who menstruate?
Thank you so much for asking because this is
really like. My one gift to the world before
I die if I could get this out to like everybody
anybody with a uterus that is bleeding every
single month that is Hashtag periods optional.
You don't have to do that I realized this in
trying to get pregnant with my first child because
I'd been on the birth control pill so long I
had forgotten what it was like to have a period
but in order to have babies you got to come off
the birth control pill and so I want people to
picture a uterus which is like a vase and every
single month it fills up to a level 10 thickness
with blood and nutrients waiting to catch an
embryo and oh no embryo it sloughs all that lining
falls out of the hole and that's the cramps and
the blood that come out every single month and
every time you build that lining it can mutate
and turn into endometrial slash uterine cancer
and then every month you pop an egg out of your
ovary and when you pop an egg we don't know if
it's the popping the healing we think it has
something to do with the tubes that increases
your risk of ovarian cancer and then lastly as
your uterus is going up and down up and down
every single month trying to catch an embryo
of the colon is around the uterus and I like
to think it's sympathetic and it's like oh ain't
sad for you and it either runs faster diarrhea
or runs slow constipation in 30 percent so you
are not alone that's my whole thing is you are
not alone you are not crazy it's not all in your
head it's not a quote hysteria it's real we all
suffer through it and we as women and you derive
bearing people should hashtag stop sucking it
up so um my point is from age 12 and a half to
52 40 years up and down up and down every single
month popping an egg popping an egg when really
on average now we only you know give catch an
embryo trying to catch an embryo two times maybe
four times you know if we're very aspirational
or whatever but like why are we doing this every
single month from 12 and a half to 52 if we only
need to catch an embryo twice. And then I thought
I came up with this brilliant idea of hashtag
periods optional, but Dr. Cuntinho and Dr. Sagal
had written a book in like 1999 with all of the
medical evidence cited in there. And then Malcolm
Gladwell, who's a writer for the New Yorker,
had written an article called John Rock's Error.
And John Rock was the original founder, one of
the original founders of the birth control pill
devout Catholic goes to church every single morning
at 7 a .m. and his two co -founders were like
dude why you make it women bleed every month
we could make them bleed every three months every
six months whatever and he was like no I'm gonna
make periods regular regular regular so we can
get it through the Catholic Church and he got
it through the nuns nuns are very liberal he
got it through the priests I don't know how he
did that and then it hit the pope and the pope's
like so he died a sad catholic but because of
him and also the fear that women couldn't handle
it if they didn't bleed every month every single
birth control method has had this artificial
bleed once every four weeks when it could be
every three months every six months or never
and then people always say oh that's unnatural
well actually this Every single month from 12
and a half to 52 is unnatural. We bleed 350 to
400 times in our lives versus Dr. Beverly Strossman
is an anthropologist that studies the Dogon tribe
in Mali, Africa and they die about when we die.
but they only have a hundred periods in their
lives. They have no ovarian cancer. They have
no endometrial cancer because they're pregnant
with eight babies. And how many periods you have
when you're pregnant with eight babies? Zero.
And then they're breastfeeding every two to three
hours for 12 to 18 months so multiply that times
eight babies and so they have a hundred periods
in their lives we have 350 400 enough for two
or three other people so And also bleeding results
in hormones going up and down, up and down, up
and down. And there are many medical things that
are better with stable hormones, specifically
diabetes, seizures, headaches, migraines, and
then anything involving periods. So PMS or heavy
periods or painful periods. The number one cause
of miss school and work for a person with a uterus
under the age of 25 is heavy. painful periods
so a lot more people could go to work and school
and in some cultures religion they'll kick you
out or like I have a South Asian friend who Couldn't
visit her in -laws because if she were to visit
her in -laws in India They would force her to
stay in the kitchen for three days while she's
having her period and not go out anywhere and
had she known about periods optional or at least
the option to move her period around she could
move it before she visits so she wouldn't be
confined when she is visiting her in -laws and
now she's a menopause so she can go but before
if she'd known we could have changed her relationship
with her in -laws So like, so much could be better.
And then there's a whole bunch of work on period
poverty. And I absolutely agree that those of
us who bleed should give access to free period
products. And if we don't, then it's just totally
sexist. But if we make hashtag periods optional,
there will be far less need and demand for that
while decreasing ovarian endometrial colorectal
cancer and NEM. Well, thank you so much for sharing
and kind of talking through that. I think a lot
of people are not necessarily up to date with
or don't necessarily understand the science behind
it and the public discourse isn't necessarily
there. So it's hard to kind of fathom and wrap
your mind around something when you're not really
educated about it yet. Yeah, and I'm so glad
that we're able to talk about this on the Amla
podcast. So with that, I want to shift gears
a little bit. You developed an algorithm to help
match patients with the best birth control pill,
achieving impressive satisfaction and adherence
rates. What inspired this innovation and how
does your approach differ from traditional prescribing
practices? So I was the original prescriber for
Pandia Health and so I wrote 3 ,000 birth control
prescriptions in two years more than most physicians
would write because we have you know 50 to 100
people coming to our platform a day and so I
couldn't just write the prescriptions and watch
women suffer and I realized that everything in
medicine was based on a 70 kilo white male is
our standard in medicine if anyone's non -medicine
listening to this and certainly for birth control
similarly. All the research and data that we
had was on Caucasian females. And that pill that
we've been taught at the major academic institutions,
Harvard, UCSF, Stanford, is a pill that works
great. If you're a Caucasian female that wants
to bleed every month. And the way most people
are taught is here's a pill, your professor likes
it, if it doesn't work, good luck with that.
And most lay people and doctors know there's
different pills but mostly people don't realize
there's 40 different formulations eight different
progestins and the progestins are the things
that vary between the pills mainly and they have
different side effects and different stuff like
that and so I took the pill that we were prescribing
I noticed a side effect in people of Asian and
Black and Latina descent fixed that and then
we had modifiers if you have polycystic ovarian
syndrome if you have acne if you're a cash versus
insurance patient will offer you two options
saying this one might be cheaper but it might
have more But most people don't notice it's up
to you blah blah and so with that Dr. Yen's algorithm
that we've trained everyone at Pandia Health,
all the 100 % physicians that do practice on
our platform. We have 93 % of our patients happy
with the first pill prescribed at the 10 -week
follow -up, where we're like, breakthrough bleeding,
acne, munchies, anything. You want to change
or you want to stay? And 93 % are like, let's
go. And then more importantly, the gold standard.
At a year, new people to the birth control pill.
How many are still? on it in general research
studies only. 33 percent of people who started
the pill at a year are still on it and probably
gives a side effects possibly because they couldn't
get to the pharmacy to get their drug but with
our company which delivers a drug and the whole
motto is no one runs out of birth control on
our watch um and you know picking a pill that
has no side effects ideally we achieve 82 percent
that is a huge jump and we've seen in our competitors
they'll hit 55 percent with delivery, but we
do delivery and we pick the right pills. So with
that, you can have a lot better adherence and
also I think education of hashtag periods optional
as well. Well, that's super interesting to kind
of hear about and see like how that how you've
used this algorithm to perfect in a certain way,
patient care in ways that a lot of people aren't
necessarily aware that You can have these options.
And I do want to point out, we use race, ethnicity,
self -reported. And so we have, I've noticed,
Black people say they're white. And I was like,
OK, that's fine. If you want me to use the white
algorithm, I'll use the white algorithm on you.
But in the future, we will do genetics. We have
competitors who are charging people $250 to do
genetics. And I'm like, a lot of people have
had their genetics done, so how about you just
give it to me. And if you do, then you're contributing
to making your health better and potentially
for menopause as well. And right now we have
150 people that have given us their genetics.
We need about 300 or 500 to get to a good thing
that we can predict what's the best birth control.
And then just also as a side note, because ADHD,
menopause, etc. Note that for AI, it's really
important that if you have crap data in, you
get crap data out and so we have good data in
and hopefully we'll have good data out because
92 percent 93 percent of our patients are happy
with the first pill and 82 percent are still
on it at a year but I had a bunch of bright -eyed
bushy -tailed undergraduate students were like
we ran this thing on two million humans and we
came up with the best treatment for PCOS and
I was like We'll see. And then they came back
and the first pill was okay. The second pill
was one pill that if you went to UCSF, Stanford,
Harvard, or you followed the World Health Organization's
suggestions, you would not write for. So one
way to check if your doctor's up to date on the
latest and greatest is take a look at your birth
control pill and if it has the three letters
T -R -I. Try. That means that it's a triphasic
pill that there are three different colors and
then a different color for placebo. That is not
recommended because it was trying to mimic the
normal cycle, but it was so super physiologic.
It's a farce and it's just much better to have
smooth hormones then. this this cycling and so
because they put in 2 million rando people not
restricting it to academic centers not restricting
it to the last 10 years practice or whatever
of the best and the brightest they got crap data
out so beware. Well that's something I actually
want to talk about you've been really outspoken
about the need for more funding and women founded
and women led companies especially in health.
in health tech, what systemic barriers have you
encountered and what changes do you think could
help close that funding gap? I think it's really
important for people to realize that companies
exist when they get funded. Companies exist when
you choose to use them. And so I beg you, please
ask, who is the founder? Who is benefiting from
you shopping at this company? No offense, but
is it a bro? Or is it not a bro? And would your
health be best taken care of by somebody who's
taken an oath? Do no harm. Or better by somebody
who went to Harvard Business School whose goal
is to make the most money possible. We see the
push by venture capitalists sometimes to do stuff
that is not standard of care. So people are pushing,
why don't you just spend two emergency contraception
at a time? And I was like, that would double
the health care cost on the entire nation. No,
why don't you use this pill or this patch? That's
not cost effective. Why don't you just, you know,
we see these things and you're pushed by it.
You have to do what your investor funder does.
So know that Only I believe three percent of
venture capital are women so we need more women
to go into venture capital and know that very
few women founded women -led companies succeed
because not because we're incompetent but because
we need the funding and what I saw was two dudes
get funded for birth control companies over me
and I am a woman I am a doctor I I'm a 50 -year
-old, and they're like, well, you're old. And
it's like, well, look at my LinkedIn. My LinkedIn
crushes your LinkedIn. My friends are the head
of everything. You just graduated college, which
is cool for you, but give some of us older people
a chance. And so I've always wondered, if my
husband went to go pitch, Asian, MIT, Apple,
money would fall from the sky. But Asian, mom,
doctor. a lot harder to get. And so please, you
know, encourage If you all know any venture capital
to invest in women founded women led Please patronize
women founded women led and know that there are
a lot of good Organizations out there one. I
have to give a shout out to start X which is
Stanford's accelerator They are very pro DEI
or you know getting to equality. I'm not asking
for more I'm just asking for level footing level
funding and then springboard and enterprises
is focused on women entrepreneurs. It's a nonprofit.
Corliss is a great effort out of Vicky Saunders
of Canada, but she does it in any country. You
get 500 investor donor women to throw up $1 ,100
a year. $100 goes to overhead. $1 ,000 is bundled
together. And then you all vote on five women
-founded, women -led companies that you want
to give $100 ,000 interest -free loan. And then
you pay it back over four or five years. And
if you do well, who can't pay back $100 ,000
over four or five years? You hopefully should
and can. And so that is some good people. The
other, I have to give a shout out to Precursor
Ventures, who is Charles Hudson, amazing, and
his team. And he funds all companies, but with
an emphasis on underrepresented people of race,
ethnicity, as well as gender. And then Arlen
Hamilton with Backstage Crowd, which is... People
who are accredited investors can invest little
bits of money put them together in one check
to help people and know that there are these
kind of vehicles, check out website catacap .org.
They're allowing people to invest as little as
$250 tax deductible. So it's getting to the end
of the year. If anybody needs tax deduction or
just any time you want tax deduction, minimum
$250 can choose what company you want to invest
in. It has to do good. And then they pile the
checks together and then help fund a company.
So Catacap will be launching a promotion to promote
women -founded, women -led companies that you
can invest in in a tax -free manner. Well, thank
you so much for everything you've shared. As
we are kind of moving towards the end of our
podcast and our time here, as someone who's bridged
medicine, entrepreneurship, and advocacy, what
advice would you give to young women and future
physicians who want to challenge norms, innovate,
and lead with purpose in healthcare? I think
it's important to do something that you enjoy.
Because whatever it's going to be, if it's medicine
or startup, it's going to be 24 -7 at some point.
I mean, Pandia Health is 24 -7 for me. I work
one half day a week at Stanford in their weight
clinic. But the rest of the time, 24 -7, always
be closing. If you choose a specialty, you also
don't want to be doing something that makes you
sad or bored. You want something that excites
you. And I thank anyone who's willing to go into
medicine because I've scared all of my relatives
and my siblings and my own children from going
into medicine. It is a hard haul. And, you know,
you come out and you see like my joke is my husband
makes 10 times what I make. And I went to 12
years more. And people are googling stuff and
coming and saying, Dr. Yen, you're trying to
give my kid autism. And I'm like, I'm a pediatrician.
Do you think I want to give anybody autism? No,
I'm just trying to prevent measles, mumps, and
rubella. And if your son gets measles, he's going
to have mumps, he'll get mumps or kitis, and
he'll go sterile. And then he can sue you because
you didn't give him the vaccine. But that is
not to say the vaccine has anything to do with
autism. The research has shown that those who
get the vaccine and those who don't have the
same rate of autism. It just happens that the
measles mumps rubella is given it two and two
is when some people notice that their kid has
autism. But I say if you had paid attention,
you wouldn't have noticed your kid had autism
before too. But that's just me. So it is a hard
haul, but it is absolutely rewarding to help
people. And, you know, I want to leave the world
better than I came in. Well, thank you so much.
That's a wrap on this episode of Our Voices,
Our Future. We hope today's conversation inspired
you, challenged you, and reminded you of the
power of raising your voice. The fight for equity
doesn't stop here. Join us in the movement. Subscribe
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Our Future.