Expert Insights on the Business of Women’s Health

[00:00:00] Hi, welcome to Beyond The Paper Gown, I'm Dr. Mitzi Krockover. If you're a regular

[00:00:13] listener then you know that my goal is to bring you the thought leaders in the areas

[00:00:17] that affect our health, whether it be healthcare, research or policy. One of the exciting factors

[00:00:23] that's having a significant impact on our health is a growing area of femtek or innovation

[00:00:29] in women's health. And today I am thrilled to host two dynamic and insightful women, each

[00:00:35] of whom is deeply embedded in advancing women's health through supporting innovators and advocating

[00:00:41] for removing barriers to innovation. Joining us is Rachel Braun-Scherl, co-founder

[00:00:47] of Spark which is a consultancy specializing in business development and strategy. Rachel's

[00:00:52] impressive client roster includes Johnson & Johnson, Allergan, Pfizer, Merck, Bear and

[00:00:58] many more. Beyond her consultancy role she often speaks out on challenges and opportunities

[00:01:04] in the field. Rachel brings a unique perspective and calls herself a vagina pernora which is

[00:01:09] a term we'll explore shortly. Additionally she co-hosts the Business of the V Podcast. We also

[00:01:16] have with us Dr. Brittany Burretto who holds a PhD in Molecular and Human Genetics and

[00:01:22] is also a serial entrepreneur. Brittany's innovative spirit led her to create Pharamore, the

[00:01:28] world's first DNA-based dating app. She's a prominent figure in the femtek community hosting

[00:01:34] the femtek focus podcast and contributing to femtek Forbes. Brittany founded FEM Health Insights

[00:01:41] which is a boutique consulting firm equipped with market research software dedicated to women's

[00:01:46] health innovation. As you can see we are set for a vibrant and enlightening conversation that

[00:01:52] I believe will not only educate you but certainly will also inspire.

[00:02:08] Good morning or good afternoon to you ladies it's still my morning.

[00:02:12] Hi, Mitzi. Hi. So Rachel I'm just going to start with you. What's a vagin pernora?

[00:02:20] A vagin pernora is a person who is in the business of Women's Sexual Reproductive Health. The name

[00:02:27] was created by this brilliant journalist Abby Ellen who was the first person we ever spoke to

[00:02:34] before our story. A period of the New York Times and she said oh I get it. Fajin is in business

[00:02:39] you're a vagin pernora and it's just become a shorthand to describe the kinds of things I focus on.

[00:02:46] The part to the one part of the body that I focus on and the fact that I come at it from a very

[00:02:51] much a business perspective. Terrific thanks. And Brittany I'll ask you how does a DNA dating app work?

[00:03:01] Well scientists have actually shown that people are attracted to one another through pheromones.

[00:03:06] So pheromones are hormones that affect somebody else. That's actually the definition what a pheromone is.

[00:03:11] And we release pheromones through hair follicle pores typically in places like our underarms

[00:03:18] and the tops of our heads. And so when we go on first dates we're actually picking up signals from

[00:03:24] other people through their pheromones which is changing our biochemistry. And people are actually

[00:03:30] attracted to one another when their immune system genes are very different. So you can think about it

[00:03:35] like you want an organ transplant from your sister but you do not want to marry your sister right.

[00:03:42] And so when you get an organ transplant it's about similar immune system genes. When it's about

[00:03:47] physical chemistry and attraction it's actually about opposite immune system genes. So that's

[00:03:52] kind of the quick 4-1-1 on what is a DNA based dating app. It's tapping into the biology of attraction

[00:04:01] and putting that into the technical world. So if our listers haven't figured out already these

[00:04:07] are two very creative smart and innovative women. And so it doesn't you know it shouldn't surprise anybody

[00:04:18] that they're also very outspoken in terms of being advocates for women's health and I've really

[00:04:23] enjoyed getting to know you guys over the last couple of years but you know in many societies

[00:04:30] including ours women's health issues are still considered to boo and we in the United States

[00:04:35] still find resistance to talking about certain issues. Though I think things are changing because

[00:04:40] I just read that the vagina museum in London is opening up again so there is some hope but why can

[00:04:47] we all collectively work towards normalizing that conversation right. It's all like you get started.

[00:04:53] There's so many factors but like the way we think about women's health is a good model for how

[00:04:58] we think about moving the category along. It really is about the intersection of physical

[00:05:06] conditions, emotional situations, hormonal social behavioral contextual aging and we're really

[00:05:15] starting to talk much more about how complex so many of these issues are that women face. They

[00:05:23] either face them uniquely because they have they were born with the organs, they face them differently

[00:05:28] because men and women respond differently or they face them primarily in terms of they affect

[00:05:33] women a lot more than men. And when we look at the progress that we've made it really is

[00:05:39] a combination of all those factors. We have lots of entrepreneurs who are building companies

[00:05:45] who invest in companies. There are a lot more women who have excess capital to invest. We have

[00:05:53] creative sources of capital. We have celebrities aging which makes a big difference when Oprah talks

[00:05:59] about menopause versus you know Joan at the corner talking about menopause. We have organizations

[00:06:06] who now have part of their mandate investing in and supporting female entrepreneurs. And we have

[00:06:13] the media who's now come along with the conversation. Everyone has noted that The New York Times has

[00:06:20] done quite a number of articles on menopause and the last piece. And this has been discovered 25

[00:06:25] years ago for fertility and reproduction and only more recently with menopause. We know that if we're

[00:06:31] not dealing with women's health conditions situations experiences, we are at risk of losing

[00:06:39] a lot of talent. So when Apple and Google came out with fertility and reproductive and egg freezing

[00:06:45] benefits, you know is it because it was nice to do? Yes but didn't also make sense from a business

[00:06:53] perspective. Yes people left less frequently. We reduced turnover. We increased productivity and

[00:07:01] we're seeing the exact same thing in menopause right now because at any one point 20% of the workforce

[00:07:07] is in menopause. So it's a long answer but it is so many factors coming together at the same time.

[00:07:15] You know I joke, I have a talk that I give that's called in a hot flash women's health and overnight

[00:07:20] sensation centuries in the making. And these factors have come together at this moment or the last two

[00:07:27] years of moments because of all these factors coming together and coalescing at the same time.

[00:07:34] You know I really resonate with that I've been doing women's health. They are practicing women's

[00:07:39] health for very long time and I was going back through some of my papers and things like that. A lot

[00:07:46] of the topics that we are talking about now, we were talking about back then but we didn't have

[00:07:51] this confluence of kind of the perfect storm of women in leadership, women in science, more

[00:07:58] women in clinical and business as well as the technology. So it's all about the timing and so I'm

[00:08:05] so glad to go to be seeing that. And just to underline what you were just talking about with respect

[00:08:11] to menopause, Mayo Clinic study came out that showed that businesses lose an estimated one billion

[00:08:18] dollars in lost work time per year and 26.6 billion annually when medical expenses are added due

[00:08:26] to menopause and parimenopausal symptoms that are experienced by their workers in the workplace.

[00:08:31] So you know that should give us pause.

[00:08:36] Having numbers from the Mayo Clinic or having numbers from you know the menopause foundation,

[00:08:42] that speaks volumes and one of the other factors that is the result of all these this confluence

[00:08:49] is a vocabulary. You can have a conversation unless you have the words to speak about it

[00:08:55] and whether that's body parts, whether it's human conditions, whether it's emotional experiences,

[00:09:01] you need the vocabulary which also has been being built and developed and used most importantly

[00:09:07] alongside all the other changes. Brittany what comes to my mind is that recently you were at a large

[00:09:13] conference and saw a need and dealt with that in a very public way so that you did a service

[00:09:21] and you also then called attention to the issue. Talk a little bit about that.

[00:09:26] Yeah sure so there's a conference called Health Spelt HLTH and it's to date like the largest

[00:09:32] health tech conference in the world and I attended it last year and it was on the Las Vegas trip

[00:09:37] and several women approached me knowing who I am and what I do saying I just got my period

[00:09:43] and I have to leave because there's no menstrual products in the bathroom. There wasn't even coin

[00:09:49] operated ones and so not only did these women have to interrupt their day, not attend a meeting,

[00:09:54] not attend a talk but they could have just even go down the hallway. They had to walk and I looked

[00:09:59] it up .7 miles to the closest pharmacy to get menstrual products for themselves and you know these

[00:10:06] are women who may have only needed two tampons or a pad to get them through the day maybe they had

[00:10:11] some in their hotel room but instead we're asking them to spend $20 on a box of 20 tampons and then

[00:10:17] they have to keep in their purse or throw away right because what are you carrying at the conference

[00:10:22] and just seem to be so logistically nonsensical and to something that you know we're providing water

[00:10:28] and toilet paper. We should probably provide menstrual products and looking at that being 10,000

[00:10:34] people there let's assume 40% of the attendees were female let's assume even 10% of that 4,000

[00:10:42] women were actively menstruating that's 400 menstruators right 400 menstruators that

[00:10:48] regardless of breakthrough bleeding let's just say on on their period they knew it they ran

[00:10:53] out of product or forgot it in the hotel had to do something about it and so yeah I bought I purchased

[00:10:58] a thousand menstrual products brought it to the conference put them in little baskets in the

[00:11:04] restrooms put up little signs that said when all you think about is women's health you see opportunity

[00:11:08] where others don't had a little QR code for my podcast and my consulting firm and it was the best

[00:11:13] $120 I've ever spent because we've gotten a ton of business out of it and next year hopefully

[00:11:19] we'll have a whole femtek booth with lots of products available for everybody not just in the

[00:11:23] women's health bathrooms people forget that menstruators are part of the workforce menstruators are

[00:11:29] part of your attendees at your conference and you know it's kind of fun women's health it is a

[00:11:35] lot of low hanging fruit which makes it a great business opportunity right now. Sure you know it's

[00:11:40] interesting my daughter attended a lot of hackathons when she was in high school and the first time

[00:11:46] I went to one in the in the girls bathroom was some products and I think it might have been

[00:11:51] sponsored by ant flow and it was like I'd never seen that before I never really thought about it

[00:11:58] because we're so used to trying to find that quarter if you need it or or stuffing you know toilet

[00:12:04] paper or whatever it is I just want to kind of expand that a little bit just to make the point

[00:12:09] that not only again do we maybe not think about that it's expensive and there's even taxes on it

[00:12:16] in certain municipalities so we call it the luxury tax and so what we know for example is that

[00:12:23] there are girls that don't go to school in the United States because they can't afford period

[00:12:28] products and they don't go to school so you know we think about this as kind of a minor issue but

[00:12:36] it's really not and for all the reasons that you stated in terms of again being inconvenient

[00:12:42] and all of that but even more than that expensive and having to miss opportunities you know

[00:12:49] all the way to just not even being able to go and do what you need to do to graduate high school

[00:12:55] so I'll get off my my soap box but I wanted to make that point. But it speaks to the rise of

[00:13:00] women's health right we're finally acknowledging that there are administrators at school in the work

[00:13:05] place at your conference right and so we're also not only admitting to there being administrators but

[00:13:11] the administrators are standing up saying I deserve service. I deserve to be accommodated this is a

[00:13:18] biological process that is not in not weird not taboo shouldn't even begin community this should

[00:13:23] be a natural human process that you should acknowledge and respect and so speaking to kind of your

[00:13:28] first question mitsy about this rise of women's health we're finally starting to call things what

[00:13:33] they are it's your vagina this is your vulva right there's a cervix we're starting to get rid of

[00:13:39] you know myths like breaking your hymen right we're starting to actually talk about the facts

[00:13:46] the biology and we're learning about the biology of menstruation right we're learning about the

[00:13:53] windows of fertility and the more that we learn about these things we're more able to talk about

[00:13:58] it as Rachel was mentioning right we can't raise awareness for something if we don't even know

[00:14:01] the words that we're supposed to use for it and the thing that excites me the most of what we

[00:14:06] see in our research is that there's a rise of women in STEM science technology engineering

[00:14:11] and medicine and the more women we have in STEM we're seeing the more solutions coming out

[00:14:16] specifically for women's health and so it's a really exciting time Gen Z gives me a lot of hope

[00:14:22] they're just questioning every paradigm that's ever been built and we we're truly starting to

[00:14:27] make women's health mainstream so we're talking earlier about the fact that we have more

[00:14:35] women in life sciences and research and business and investment and clinical practice obviously

[00:14:43] can always use more but the burden the responsibility is on women where are the men in all this what do

[00:14:50] you think Rachel? We can't do it without the men it affects everybody and I'll just go back to

[00:14:58] to Brittany's example with walking point seven miles to the bathroom if you are working with a woman

[00:15:04] who has to walk one point four miles to go to the bathroom and she was meeting with you that

[00:15:09] affects your productivity so it has a lot of implications really practical day-to-day implications

[00:15:14] in the workplace women make 80% of the healthcare decisions and in their family they're the chief medical

[00:15:20] officers often of their family if there is a woman in the family so her understanding her knowledge

[00:15:27] her ability to put together pieces of information affects everybody they should not be a women's

[00:15:33] health issue healthier women lead to healthier more productive societies so we have a lot of

[00:15:41] advocates and men supporting it should not be and us versus them we must do this together

[00:15:47] to make the change and to build the companies that we want to see that can change the world

[00:15:52] you're here Brittany do you have anything dad? The tagline of our podcast is women's health is

[00:15:58] everyone's health you know we are 51% of the population and responsible for the other 49

[00:16:04] even if that's just burling them and so when you improve a woman's health you truly improve

[00:16:09] the health of her partners her childrens her families her community her business

[00:16:14] and unfortunately we haven't seen capitalism care too much about women's health but now that we're

[00:16:21] more than 50% of the workforce our health does matter to your bottom line. Going back to your

[00:16:28] point Rachel in terms of the challenging parts of sex and issues the DOBS decision focused

[00:16:38] attention on women's reproductive rights and that was the overturning of Roe v Wade it also

[00:16:43] with obviously highlighted how politics and policies can impact on our health so talk a little bit

[00:16:52] about your view on the key takeaways from this decision and others like it and its impact on women's

[00:16:59] health well after the overturning of Roe v Wade we saw a deep self reflection I think by individuals

[00:17:07] governments and companies to ask themselves where do I stand on this issue we've had companies

[00:17:13] ask themselves where do they stand on it we've had investors ask themselves where do they stand

[00:17:17] on it are they going to put money into reproductive health we've seen what we call row rounds which is

[00:17:22] startups and venture funds having a very significant uptick in the amount of funding they were able to

[00:17:28] raise because investors were self-reflecting on themselves and where they stood on the issue and

[00:17:33] you know the ones that said I wanted to put my money where my heart is and they invested in

[00:17:37] these reproductive health companies something I'm really excited about is I actually just got back

[00:17:42] from the national contraception meeting last week ironically took place in Texas where abortion

[00:17:49] is illegal um they saw a significant increase in male interest in birth control so I actually called

[00:17:57] my mother um yesterday and was telling her about the conference and and I was telling her oh mom

[00:18:03] and there's like oh there's a three three drugs in phase one clinical trials right now for a male

[00:18:08] contraception of male birth control and she said oh well it's too bad that men won't take it you know

[00:18:13] she's like men would never do it they won't even get the sector means and I said ma that's your

[00:18:17] generation I said you know and she what is she she's almost 60 right and so for her she had this

[00:18:23] paradigm that men would refuse to take birth control and I said ma the men and my the males if I

[00:18:28] if I am more correct the males in my generation and younger are absolutely open to taking on

[00:18:35] the responsibility of reproductive rights and they want to participate in that and she was like

[00:18:40] are you serious that's incredible that's huge right and so I wouldn't and that was a specifically

[00:18:47] in the research they showed it was they redid the surveys after Roe v Wade was overturned

[00:18:51] and that's when the jump took place right and so although it's like a horrible in my opinion horrible

[00:18:57] thing that happened to women's rights I also think it kind of made us dust off some you know

[00:19:02] cobwebs and say damn we need to make some decisions we need to step up and do something about this

[00:19:07] whether that be policies in your company investment decisions or even personal choices about

[00:19:13] the drugs that you or your partner are taking and you know I'm cheering uh if we could be cheering

[00:19:20] during a webinar you know I agree wholeheartedly with everything Brit says I'll take it in a slightly

[00:19:26] different direction you know the expression necessity as the mother of invention we luckily

[00:19:32] seen more innovative solutions COVID trained us just in time to understand telehealth which has made

[00:19:39] medication abortion a much bigger option one of the things that's really challenging for companies

[00:19:45] is this is a this is an issue that is never easy there's never consensus it makes lots of people

[00:19:53] uncomfortable and I was on a panel with a person who is in the benefits area and I heard the

[00:19:59] most fascinating thing that I want to share because I hadn't heard it before since if you want to

[00:20:05] enable employees to travel across state lines for miscarriage management for abortion

[00:20:13] why should they have to go to their boss to their HR department and say raise their hand and say

[00:20:19] I'm going to terminate a pregnancy so what this company has decided to do is we now pay for people

[00:20:25] to cross state lines to get to the best care they can get for whatever it is that else them

[00:20:31] so if you need a double-hyper placement and you're in a state uh that's next door to where the

[00:20:36] greatest orthopedic surgeon on the planet is they are paying for you to go there so and that's

[00:20:41] a really important concept that we don't want to make women's health or my personal health I

[00:20:49] certainly don't I want to be the one who gets to share what people know about my health and so

[00:20:53] putting the onus on women to say you know here I am here I am I'm doing this thing which you

[00:20:59] may or may not approve of there you can create policies that make it so everybody can get the best

[00:21:05] health that they need while moving on to the other end of the spectrum and we talked a little bit

[00:21:11] about menopause but specifically menopause in the workplace and again we talked about the bottom line

[00:21:19] what are you seeing in terms of actual programs initiatives that you think are not just

[00:21:28] superficial but really meaningful and Rachel you're nodding your heads I'll let you start

[00:21:35] okay so uh and I'm it's more personal for me than Brit given our respective ages

[00:21:43] so we're seeing that one of the biggest things we hear over and over again with the menopausal

[00:21:49] community is that they feel so alone they don't expect it you know your trained as a physician

[00:21:54] you might not have been expecting it there are dozens and dozens of symptoms you know

[00:21:59] high flashes might get center stage but there are many many others that are quite problematic like

[00:22:04] brain fog like increased anxiety like the impact on sleep some of which is caused by hot flashes but

[00:22:10] not all increased anxiety and depression lethargy so these are huge issues every single one of

[00:22:18] which affects productivity in a workplace so we are seeing many startups going in and educating

[00:22:26] you know providing the language helping them understand the signs helping them do what they can to

[00:22:31] manage any of the symptoms giving them access to collect data your lot of amazing devices in

[00:22:36] menopause that are collecting data that will help you make more informed decisions so the first

[00:22:41] piece is education and awareness and the second we're not quite there yet but we're making a lot

[00:22:47] of progress is products and services that offer solutions or relief of some of these symptoms that

[00:22:54] are so intrusive. Brittany how about yourself? Well there was a survey in 2022 that said

[00:23:03] four out of every ten women so 40% of women have experienced menopausal symptoms that interfere

[00:23:09] directly with their work performance or productivity on a weekly basis so 40% weekly basis symptoms

[00:23:16] are interfering with their work and 17 so 1 7% have quit their job or considered quitting due to

[00:23:24] menopausal symptoms this is actually a recent revelation for me I you know obviously this is all

[00:23:30] like eat breath sleep roll around in is women's health and I have been hearing more and more

[00:23:38] and more about women in dropping out of the workforce because of their menopausal symptoms as a female

[00:23:44] founder as a female scientist as a feminist in general I've been fighting the DEI fight we need

[00:23:50] women at the table we need women on boards we need women leadership and I can't help but think

[00:23:56] have we missed a major talking point or by talking I mean hopefully actionable point that menopause

[00:24:05] may actually be part of the leaky pipeline that people been saying I think there's been a giant

[00:24:10] gaping leak in our pipe which is even if women did make it to leadership their brain fog or fatigue

[00:24:18] or hot sweats at night that leads them to not be well rested and they're they're just pure like

[00:24:26] dissociation from their body may actually be causing one of the biggest fit pitfalls

[00:24:33] and having females in leadership we've worked so hard to get females in leadership how do we keep

[00:24:38] them there and keep them there in a healthy way and I think that is so important because of the way

[00:24:44] we talked earlier about keeping young childbearing women in the workplace by offering benefits and

[00:24:52] enable them to build families in the way that they want how they want when they want we are now seeing

[00:24:58] the response to that for the first time companies offering menopause support and that takes many

[00:25:04] different forms it could be a telehealth visit with the doctor it could be education it could be

[00:25:10] access to products but we are now seeing why would we want okay there'll be oldest and say maybe

[00:25:18] the wisest also why would we want to lose people who will be but they're not that old I mean

[00:25:26] but I'm talking you could start 40 years old so and we have executives that are in their 70s

[00:25:33] and so male executives for the most part so I think that's another piece of it it's it's not just a

[00:25:40] disease of old people it's not even a disease let's put it that way it's not a disease but there

[00:25:45] is a jizum you know if I never I would never want to be in a room where I would want to raise my

[00:25:51] hand and say excuse me my brain synapses aren't connecting right now can we take a 20 minute break

[00:25:58] while I have an unbearable high-flash and go to the ladies room that's not what the goal is

[00:26:05] but could we have a high-flash standing in front of a room which I have and many many people I know

[00:26:10] have and say excuse me I need to step out for five minutes that's different we're not you know

[00:26:17] I think one of the things we have to be clear about is I don't think most women want to be sharing

[00:26:24] their personal details of their health in the workplace what I think they want is an ability to work

[00:26:31] with them in the context you know of the workplace and again I'm a broken record because I go back

[00:26:38] to the economic argument we'll assume that people who are entering Manipause have more work

[00:26:45] experience than people who are 20 years younger why would we want to lose the people who are

[00:26:50] elevating or making decisions who are giving us a seat at the table our listeners out here are

[00:26:56] probably saying okay that's great but I don't want to be the person that brings this issue up so

[00:27:02] how would you suggest that they could successfully advocate and what are they advocating specifically for

[00:27:09] I would say a workplace that supports women in general right so I think work has been

[00:27:15] it's only recently that women have had a major stake holder place in the workplace right that this

[00:27:21] is a recent thing in the in the long generations of working but to answer your question and like

[00:27:28] instead of you know your listeners going to HR and being like you need to rethink how workplaces

[00:27:33] are philosophically here's actual something they can do they can go to their HR department and say hey

[00:27:39] can you bring in a speaker to educate the workplace about ovulation in the office or

[00:27:44] menstruation or metapause in the office HR departments bring in DEI speakers all the time put it

[00:27:50] under that budget put in a women's health talk right and then you as they employee don't have to bear

[00:27:55] that burden of educating your bro or male leadership about what's going on in your body you can

[00:28:03] bring in an external person like Rachel or myself or you know if you want to list I'm sure we

[00:28:08] have a list of experts I would love to come in and talk to your business about this we'll do the heavy

[00:28:13] lifting for you in the meantime I would say that you can also advocate for little signs that the

[00:28:19] company is pro women so you can advocate for going to HR and saying hey can we get free menstrual

[00:28:25] products in the bathroom so I think it's about for me as of right now it's an H it's a talk about

[00:28:31] with leadership in HR's about you know putting it under DEI is typically what I find to be most

[00:28:37] successful and by the way going back to men and women and if you're experiencing hot flashes from

[00:28:44] your prostate cancer treatment we care about that also very good the other piece that I would

[00:28:49] mention is COVID as horrible as it was had a few silver linings one of them was we understood

[00:28:57] the complexity in the full range of people's lives and I could say as someone who has been working

[00:29:02] since the day my children were born 25 years ago I would never say I have to go and leave for

[00:29:10] my daughter's squash match but now a kid is running behind you a baby is crying the dog jumps on

[00:29:16] you someone poops on the desk it became a reality when everybody's on zoom that people had to

[00:29:23] understand a broader view of someone's life the same thing when schools were closed then we saw

[00:29:29] literally and still have a crisis in child care you know I don't know anybody male or female

[00:29:36] anymore who has a nine to five job that you know that is like a vacation compared to how most

[00:29:41] people are asked to work overtime becomes just something that's expected so we need to be supporting

[00:29:49] our workforce in a way that doesn't require you know all the blocks to be put together and the

[00:29:55] puzzle to be fitting together perfectly this isn't new people have been struggling with child care

[00:30:00] and figuring out how to take care of their children and work this is going to be a challenge forever

[00:30:06] because you cannot be in two places at the same time so I think really we're seeing when we talk

[00:30:13] about these cataclysmic changes changes some of them we are catalyzing and some of them we need to

[00:30:20] be responding to you know I entered investment in women's health because the light bulb went off

[00:30:26] for me when I was being consulted for my clinical expertise by these women who could not find

[00:30:32] solutions for their medical issues in the marketplace or in the healthcare system and so for me

[00:30:37] I literally wanted to be invested to support these innovations and these innovators so talk to

[00:30:43] me a little bit about what you see as the way that these innovations can play a pivotal role in

[00:30:50] women's health Brittany what do you say sometimes I think innovation could be seen as an improvement

[00:30:58] on solutions and so often I find that in women's health it's the first ever right like we're making

[00:31:04] the first ever diagnostic for endometriosis which affects one in 10 women not a better test

[00:31:10] not a faster test on a more specific one a first ever right or if we are innovating on something

[00:31:16] that exists it we're innovating on something that's been around for 300 years right like it was

[00:31:22] invented 300 years ago and we really haven't touched the product design of it and so some of the

[00:31:27] things that I'm really excited about are um I'll give you an example of one of those like dramatic

[00:31:33] improvements the 300 year timeline one um to get an IUD in place into the uterus you have to

[00:31:40] bypass the cervix I like to think of the uterus as like a balloon and the cervix is the not on the

[00:31:46] bottom of the balloon holding holding the air in right now that's not actually how the cervix works

[00:31:51] but just go with me here in terms of the analogy you have to bypass that nut and it's actually very

[00:31:58] painful to do so it's actually very painful to do so but most of that pain actually does not come

[00:32:03] from the crossing of the cervix the pain comes from the stabilization of the cervix and what I

[00:32:08] mean by that is the holding it steady and currently the way that gynecologist hold your cervix steady

[00:32:15] in order to put an IUD into your uterus or do things like implant an embryo into your uterus if you're

[00:32:22] doing fertility you know treatments or get a um a uterine biopsy if you're getting a test on any

[00:32:28] of those things that need to cross that cervix cross that knot what they're currently using is a

[00:32:32] thing called a uh tenaculum a tenaculum is like these little pincher things and it's actually the

[00:32:39] same tool that they use to take a bullet out of a hole right I think we've all seen enough action

[00:32:44] movies like they're they're in the war zone or whatever and they need to take the bullet out

[00:32:49] and there's this these like kind of um metal clampy looking things are going in there and they're

[00:32:54] taking the bullet out that is what they are using the clamp down onto the cervix and that's what

[00:33:00] they're using to stabilize it okay for those who can't see me I'm quote-unquoteing it stabilizing it

[00:33:05] right the most of the pain is coming from that pinch there is now a new medical device by the

[00:33:10] company called a spivix and a spivix created a suction based the device that essentially it's like

[00:33:18] a little smiley face a little half circle and it goes to the bottom of the cervix and it you pull

[00:33:23] on the bottom and it sucks and it sucks a little bit of the cervix skin into this little med

[00:33:29] device and that's what's actually holding it and in their clinical trials they showed a 70%

[00:33:34] decrease in pain now what gets me just really riled up is that pain is considered normal in

[00:33:40] women's health if your symptom is pain it's not considered a symptom because pain is just part

[00:33:45] of the female experience supposedly and so what they are innovating on is not that the tenaculum

[00:33:52] isn't good at stabilizing the cervix but it is incredibly painful and when you're trying to get

[00:33:58] women to do things like be diagnosed for disease or have an IUD place you would like it to not be

[00:34:04] a traumatic injury and so I'm really excited about innovations like spivix which are dramatically

[00:34:10] decreasing the pain of that experience so that hopefully we can dramatically increase the conversion

[00:34:16] of female patients saying okay yeah I'll have an IUD placed none of my friends said it was that

[00:34:22] bad and we're talking about Roe v Wade we're living in a world where 21 states abortion is illegal

[00:34:27] when you have a procedure that could potentially guarantee your you know contraception through not

[00:34:33] having to take a pill every day through an IUD you want that that procedure to be attractive

[00:34:39] you want that to be something that women say yeah I'll participate in this and so those are

[00:34:44] the types of things I am excited about and you know femtic is so often the lowest hanging fruit

[00:34:50] literally the lowest hanging fruit we're we're the innovation is we're no longer using a

[00:34:55] bullet remover to clamp on your internal organs one last example as to how bad this is

[00:35:02] I saw a spivix at a conference and I did a demo follow me on tiktok to see the demo dr.

[00:35:08] Brittany burrito and I did a demo they had little cervix and the little the section cup thing

[00:35:12] and I'm doing it and I asked the founder I said oh do you have a tenaculum on you let me show them

[00:35:17] what that one looks like and she said oh it's on the TSA's band list I'm not allowed to fly with it

[00:35:23] I said well dear god if that's not the epitome of women's health that you you were not allowed

[00:35:29] to fly with the medical device because you might actually kill someone on the plane with it

[00:35:33] it's that dangerous that I mean if you're not allowed to bring it on TSA we probably shouldn't be

[00:35:38] clamping your organs with it so I'll end with that I'm really excited about what is becoming

[00:35:44] sort of a deafening roar around women's health and you know even 12 months ago we were hearing

[00:35:50] conversations where VCs would say oh I looked at a menopause company I'm good I'm covered

[00:35:56] which if you know about menopause or you know about women's health is a very narrow relatively

[00:36:01] uneducated view of the implications and the impact of menopause so I like that there are companies

[00:36:08] where I spend my time is as the connective tissue between venture back startups and larger companies

[00:36:13] whether they're sources of capital whether they're distribution partners whether they're access points

[00:36:19] whether they're mouthpieces and you and you uh they're the wind beneath your wings so to speak

[00:36:26] I'm really excited that there are more people who are interested in this it's been very clear

[00:36:32] one of the things that concerns me which wasn't part of your question but I'll just

[00:36:35] throw that in anyway is we have lots of effort in patches and we still have big gaps on the

[00:36:42] plane field where no one isn't starting no leadership so we're going to see a lot of consolidation

[00:36:48] a lot of collaboration in areas where you know quite frankly there might be more companies than we

[00:36:54] need and we still have to really work at what are these huge gaps like endometriosis like PCOS

[00:37:02] diseases that take seven to ten years to diagnose that often come or not a person is not even aware

[00:37:09] that there's anything wrong until they start getting trying to get pregnant and then they've

[00:37:14] potentially had a seven to ten year impact on their fertility window so I want to make sure we're

[00:37:20] coming up with solutions for the big big big stuff because there's still a lot of big stuff

[00:37:26] and to do that what we're learning is you have to break down the problems into pieces

[00:37:30] there's no warmins health condition where there's you know how many times you hear in this space we

[00:37:36] need the female viagra the female sexual response system does not work that way so there is no

[00:37:43] one hit wonder for women's sexual response or desire or satisfaction or orgasm so we really have

[00:37:49] to be breaking down an understanding of women's health and figuring out places where we can make a

[00:37:54] difference in a very complex process and to that and I know that you know we you and I and Brittany

[00:38:01] talked about this and that is different from the viagra where my kids knew what ED was before they

[00:38:08] knew what a vagina was because they saw it on TV at five p.m. on channel CBS during the Super Bowl

[00:38:15] absolutely you know there are companies that aren't even in the sexual health space but certainly

[00:38:22] including it those that can even get their products advertised talk a little bit about that

[00:38:29] how much time do you have 30 seconds you can this is this is an old story as long as I've been

[00:38:36] in the space which is over 15 years at this point there have been limitations on channels media

[00:38:44] channels where women's health businesses can get their ads and big things like now meta but they

[00:38:51] were doing it when they were still Facebook some TikTok every every website every cable station

[00:38:58] every network what you are approaching them when I was running my first business in the space we

[00:39:03] went to a hundred media outlets and that was radio website TV cable and network 95 said no

[00:39:10] what was your product at that point it was a product that improved a ralphal desire and satisfaction

[00:39:15] for women so if you can't get your product out there to educate people how to Brit's point do

[00:39:21] actually know about a solution so we do still face despite huge efforts and huge progress big headwinds

[00:39:27] because someone some algorithm some company decides that breastfeeding is too sexual in nature

[00:39:34] you know my favorite story ever in this space is company called pulse that I've had the pleasure

[00:39:39] of working with they have a device and consumable for lubrication and massage oil for intimate wellness

[00:39:47] and their ad got rejected because vaginal dryness was considered too sexual in nature so you know

[00:39:55] I always put it out to people name a hundred things that sound sexual or sexually appealing or

[00:40:01] sexually motivating I don't think vaginal dryness would make even the longest list so there's education

[00:40:09] that is sometimes being stymied by the actual places where we want to put the education

[00:40:15] it goes back I think to what you had said earlier we really need to be upstream talking to kids

[00:40:20] about body part language and making the body you know neutral as opposed to normal safe something

[00:40:28] we talk about something we're comfortable with not something that if I never hear the taboo taboo

[00:40:33] again for the rest of my life you know that would be great absolutely and Brittany talk a little bit

[00:40:40] because I don't think that you know the I know I didn't until I got involved the process of getting

[00:40:47] a product developed into market especially if it's a medical device or need some kind of regulatory

[00:40:55] approval well we have a lot of you know well essentially we have a lot of struggles and creating

[00:41:05] really fantastic diagnostics and medical devices because of the lack of history of work being done

[00:41:12] so our backdrop to scientific discovery has been based on a male paradigm and so we have to

[00:41:18] actually rewrite the books in terms of you know sometimes I wonder what basic scientific things have

[00:41:24] I learned about that are literally based on a male that we've never actually studied a female

[00:41:28] cell or a female animal model and then you jump into human clinical trials and you have issues like

[00:41:35] well women were not allowed to participate in clinical trials until 1993 and that was just

[00:41:42] the permission to participate not even the requirement to participate was the it was just the

[00:41:47] permission to it wasn't until 2016 2016 y'all that we actually had a bill pass that said you have

[00:41:57] to consider sex in your data so before that if you even included females in your clinical trial

[00:42:04] you are allowed to summarize that data with the male participant data and say here's how it's

[00:42:09] working well here's an example as to why that is terrible science well the drug called ambian

[00:42:16] ambian is a drug for helping you sleep the female metabolism metabolizes it dramatically slower

[00:42:22] than males do and so for 20 years women were getting into car accidents in the mornings because they

[00:42:27] were still high on ambian they were still half asleep and so it was the first and only drug to be

[00:42:33] removed from the market and then re-approved with sex specific dosages I cannot imagine how many

[00:42:39] women out there are being overdosed because the dosage is based on a male's body type right and so

[00:42:45] when you actually require clinical trials to say well here's the results for the male participants

[00:42:51] and here's the results for the female participants now we can actually start to say huh this drug does

[00:42:56] work in both but actually needs to be higher in females or get this what if we considered her menstrual

[00:43:02] cycle so you know we're technically able to give women a 28 day hormone regimen for her birth

[00:43:08] control pill why are we not doing that for her prozac why are we not doing that for her Crohn's disease

[00:43:14] medication her Parkinson's disease medication we have so many women patient advocacy groups now coming

[00:43:21] out saying we know our symptoms are worth when worse when we menstruate and we want pharma to kind of

[00:43:27] consider that can you please figure out why my symptoms are worse do I need a higher dosage of

[00:43:32] my drug when I'm menstruating what about if I'm post metapause does it change how my metabolism

[00:43:37] works with these pharmaceutical drugs do we need to consider that the the it is required for female

[00:43:44] participants in clinical trials to be on birth control to date you do now have drugs that have been

[00:43:50] approved that have been on a woman not on hormones every woman in clinical trials in order to prevent her

[00:43:55] from getting pregnant during the trial she has to be on birth control and so this I've even lost

[00:44:01] track of what your original question oh the track how do you get the medical device the product at

[00:44:05] market essentially essentially the first thing we do is ask how sex and gender is being considered

[00:44:13] throughout that product development through the safety protocols through the evaluations of its

[00:44:18] efficacy i.e. how well it works and then don't even get me started on actually getting it

[00:44:23] reimbursed by insurance or getting it approved by the FDA and what what I think the conversation

[00:44:30] really demonstrates is some of the just basic fundamental things are wrong you know the average drug

[00:44:35] was determined and dose done a hundred sixty pound white man 40 percent of america is overweight or

[00:44:41] obese so we're doing we're making a lot of mistakes because our clinical study population

[00:44:48] is not reflecting our population in terms of you know how people show up and you know what

[00:44:56] what they bring with them what what is their genetic history what is their familial history so

[00:45:02] again in women's health i mean if there's one theme you know it's complicated but making a little

[00:45:08] bit of progress in any of these things has a huge implication for you name it you know I just

[00:45:16] wanted to add one more thing about the other silver lining of covid you know we had conversations

[00:45:22] about the impact of vaccines on menstrual cycles because millions of people were getting vaccines at

[00:45:28] the same time and they were seeing changes that wasn't studied but that mistake or whatever you

[00:45:35] want to call it gave rise to a conversation and awareness that hadn't existed before

[00:45:41] let's talk about the consumer itself because we all had a conversation about

[00:45:47] the fact that women's health can also be a place where women can be exploited and so

[00:45:55] Brittany talk a little bit about how consumers can really evaluate some of the

[00:46:05] products that we're seeing in services yeah well unfortunately a lot of marketing has been

[00:46:11] going into women's health to try to tell us to have our vagina smell like flowers and we've lost

[00:46:17] track of what our vagina is really supposed to smell like and unfortunately I think that these types

[00:46:24] of marketing things have played on societal expectations of women that are outside of our natural

[00:46:30] biology and so one thing to do is to you know you can listen to podcasts like this one or femtic

[00:46:37] focus or business of the V if you're if you're inclined to kind of listen while you do the dishes

[00:46:43] or take the dog for a walk and learn about products and learn about your own biology and you're

[00:46:48] the bacteria in your vulva and what it's actually supposed to smell like and start to question

[00:46:53] what products am I using and why am I using them another way to do research is simply by going

[00:46:58] on the company's website and asking if they have research behind the products that they are doing

[00:47:05] if you do not have the time or desire to do so and I can totally appreciate as a consumer myself

[00:47:10] I don't necessarily always have the time or desire to do my own research you can go to marketplaces

[00:47:15] that have already done the research for you so actually just this morning how to call with the

[00:47:19] founder of a company called unfaibled unfaibled and they actually do the research for you and it's

[00:47:27] a marketplace e-commerce website that has all these women's health brands and companies that

[00:47:32] they've already did the research they did it for you to make sure that this was you know good

[00:47:37] for your health based from a good company that actually cares about your you know health and not

[00:47:43] just how your vagina smells Rachel what are your thoughts it is very hard for the average consumer

[00:47:50] to understand how to read or interpret clinical studies but it is to a certain extent you know

[00:47:58] caveat answer let the buyer be where your responsibility to find a way to get the information

[00:48:04] of just as we know just because it's on the internet doesn't mean it's true and just because

[00:48:09] someone has doctor in front of their name with all due respect to two doctors on the phone who

[00:48:14] I'm sure minister's back for doesn't mean they've looked at the science so you really have to be

[00:48:21] an advocate you have to read the science or figure out how to help someone understand the science

[00:48:26] before used to these claims from you know from skincare and hair care and is it actually saying

[00:48:34] improves X by 10% or doesn't say in a trial 90% of women reported X that's what's called a marketing

[00:48:43] study which just means which doesn't mean it's not valid but it doesn't also mean it doesn't

[00:48:50] necessarily mean it's scientific so like we don't have enough to do there's there's one more

[00:48:55] thing but to me before you're putting something in your body that has the or on your body that

[00:49:00] has the ability to have you know implications for a lot of systems and quality of life you need

[00:49:06] to get educated so as we're wrapping up my questions are what excites you about the next five

[00:49:14] years with respect to women's health how about yourself Brittany I am excited to see red liquid

[00:49:21] in menstruation commercials which essentially is for in bigger terms a normalization of women's

[00:49:29] health and media it's what I'm really excited about it's almost kind of like the blue is as normal

[00:49:36] I mean if you have a smart liquid coming out of your vagina I recommend you see a doctor

[00:49:45] there I'm some really excited to see the normalization of women's health and media I'm excited

[00:49:50] for people to say these words like vagina or vulva not only correctly you know I'm wearing

[00:49:58] uterus earrings for those who can't see these are female reproductive organs I have ovaries

[00:50:03] fallopian tube butyurus cervix vagina and people will literally say like oh you have vaginas

[00:50:09] on your earrings and like oh here's a teaching moment that's the vagina right like there's so

[00:50:13] many other words so just learning about the basic anatomy of the female reproductive track in

[00:50:20] our bodies and how things are supposed to work because the more we learn and normalize it

[00:50:25] the less stigmatized or unique will feel so I think like there's women who are so hard on

[00:50:30] themselves for quote unquote not being able to breastfeed and yet if they knew the actual statistics

[00:50:36] of breastfeeding success they would say oh wow I'm actually in the norm or miscarriage you know there's

[00:50:42] this thing that's like don't tell anyone you're pregnant till the second trimester and it's like well

[00:50:46] who's on whose behalf are we telling these women not to talk about that I would love for them to

[00:50:51] tell me and then therefore if they did lose the pregnancy I could support them in that right

[00:50:56] but we continue to tell women to keep their health to themselves keep their bodies to themselves

[00:51:00] and only tell us when it's going great um and so I think that uh I'm really excited for the normalization

[00:51:07] of the regular female health experience and I'm excited to see some big exits and some big money

[00:51:13] come in from women's health you know and by exits I mean acquisitions where bigger companies

[00:51:19] buy other companies or even IPOs the more big successes will get the less questions will get about

[00:51:25] this being a big enough market to make money in and uh I'm also really excited because the people

[00:51:30] who are gonna make the money I know where their their next round of funding is going to go it's

[00:51:34] gonna go back into women's health they knew it was a good investment decision they made their

[00:51:39] money from it and I'm excited for them to further engage in in funding our industry great Rachel

[00:51:46] I'm excited for the changes to actually really change the conversation so that more money goes in

[00:51:53] I'm excited for the day when um a women's health unicorn isn't a unicorn isn't so unusual when it

[00:52:01] just becomes um par for the chorus I'm excited for when you no longer see all male panels which

[00:52:09] they call mammals which I think is very funny talking about uh women's health I'm excited to see

[00:52:15] collaboration between small companies and large companies I'm excited to see consolidation

[00:52:21] and I'm excited to sort of wake up one day and have this not be so much work to even get this

[00:52:30] on the table you know a lot of the hard work has been done but lots of people and I also want to

[00:52:37] make sure that we're celebrating the wins and it just strikes me when Brittany was talking about

[00:52:43] you know actually showing the color of menstrual fluid that did we spend enough time talking about

[00:52:49] the fact that Wimbledon changed the all-white dress code partially in response to the fact that

[00:52:56] women it's not the most comfortable thing to wear white certainly not on TV certainly while you're

[00:53:00] playing tennis when you're menstruating I mean that in the world of women's health that's a sea change

[00:53:08] you know that's unbelievable and we really have to celebrate so that we can keep up our energy

[00:53:14] because this is a long haul absolutely and what would you say to the listeners who want to get

[00:53:21] involved or want to make a difference Rachel you're smiling solid. I'm the answer is so different now

[00:53:29] than it was before there are podcasts there are communities like Femtec focus like Femtec inside

[00:53:35] or like women of wearables there's a lot of information so I'm sure and I know this Femtec I've

[00:53:40] talked about this week at calls every week I'm interested in women's health that's a hard

[00:53:45] conversation to have because that is so broad and so big so really start using the resources

[00:53:52] that are available and the information that's available in the case studies that are available

[00:53:56] to figure out what your focus is you can't just do women's health there's no such thing there's

[00:54:03] there's too many pieces of it so I encourage people who are interested in the space find people

[00:54:09] you like in any other business find people you admire see if you could talk to them read about

[00:54:13] interesting companies read about big failures talk to people who have been successful in other

[00:54:19] spaces and find out what it would take you know from a P&L standpoint to be successful there's so

[00:54:25] many sources of education now then when I started it was like you know you felt a little bit

[00:54:32] years ago like you were shouting into the void now you're shouting and a lot of people are shouting

[00:54:37] back and I think that in a productive way there's a lot of conversation there are thousands and

[00:54:43] thousands of not billions of people who are talking about it building companies raising money

[00:54:49] investing money great how about you Brittany building on that because that was my first

[00:54:55] first suggestion get involved educate through podcasts newsletters articles you know linked in post

[00:55:00] etc but also start to participate there are crowdfunding platforms like WeFunder or Kickstarter

[00:55:06] that you can put a hundred dollars in start to put your money into the products that you want to

[00:55:11] see come to market and so that one you don't have to be a very rich person to put your money where

[00:55:17] your desire is in terms of products coming to market and then also it's just talk about women's

[00:55:23] health normalize the conversation and I'm not just talking about but yes in addition to your

[00:55:29] girlfriends your female family members your female co-workers but men as well Metsi I don't know

[00:55:35] that your gender sex demographics of your listeners but if there anything like my show it mine is

[00:55:40] 96% female listeners right and I'm talking about women's health innovation it's not just for women

[00:55:45] but that's just my listener base we need to include men in this conversation and the more that I think

[00:55:51] that we can educate men on it they have questions they have a lot of questions and if you could be

[00:55:56] someone that they know they can ask answer questions to you're actually empowering the women in their

[00:56:01] workforce and their jobs and their other circles because they may not feel comfortable to ask them.

[00:56:08] You know it's funny that you say that because I have a cadre of men who do listen to the podcast

[00:56:13] yeah Dr. Brittany Barreto and Rachel Braunchirl thank you so much my friends for coming on this was

[00:56:20] really great thank you great to be with you and great to see you Brittany

[00:56:25] same here

[00:56:32] thank you for joining me as we discuss the challenges and opportunities in the field of

[00:56:36] innovation in women's health I really hope this discussion opened your eyes to some of the

[00:56:41] challenges as well as the opportunities that women and women's health innovators face.

[00:56:47] In fact if you're looking to make an impact investing starting a business in women's health or

[00:56:51] working for one can provide many opportunities and as you heard while there are still challenges

[00:56:58] such as obtaining funding and barriers to marketing one can really make a difference

[00:57:03] and as consumers and advocates we all need to be aware of the science behind health products

[00:57:09] in order to make better choices and to support credible companies.

[00:57:14] If you enjoyed the program do rate us on your favorite platform and subscribe so you won't miss

[00:57:20] an episode I also invite you to follow us on Instagram YouTube and Facebook and go to our website

[00:57:26] at beyondthepapergown.com there you'll find articles podcast a marketplace as well as information

[00:57:33] on nonprofits focused on women's health and while you're there you can also subscribe to our newsletter

[00:57:39] so you can keep up to date on our podcast women's health news and ways to participate in advocacy

[00:57:45] and studies. Thanks again for joining us and take good care

[00:58:01] our podcast was produced by Patrick Shambayati and me and our associate producer is Kyla McMillan