255 - For Women's Reproductive Rights with Dr. Sophia Yen

May 15

255 - For Women's Reproductive Rights with Dr. Sophia Yen

Listeners, we're back this week with Dr. Sophia Yen

Sophia Yen, M.D. MPH CEO & Co-Founder of Pandia Health, birth control delivery. Pandia Health is the ONLY #DoctorFounded/Led, #WomenFounded/Led birth control delivery company.

Graduated from MIT, UCSF Medical School, and UC Berkeley’s MPH program. 20+ years in medicine, Clinical Associate Professor at Stanford Medical School, her passion is Women’s Reproductive Health and she co-founded 3 non-profit projects to improve the lives of women: The Silver Ribbon Campaign to Trust Women, SheHeroes.org, and fffl.co

Mother of 2 daughters, wife to feminist husband.

During our conversation, we talked about:

06:04 - Her parents story
09:06 - Choosing to be a doctor
09:40 - Don’t be a nurse
15:10 - Deciding her specialty
17:34 - It takes two to make a baby
24:23 - Start learning abut sex
27:12 - Sex ed doesn’t lead to sex
31:09 - Periods
40:56 - Starting her company
44:36 - Menopause

Hello everyone. This is Pam de Cafe con Pam, the bilingual podcast that features Latinas, Latinos, Latines, and people of the global majority who break barriers, change lives and make this world a better place. Welcome to episode 255 of Cafe con Pam. Today we have a conversation with Dr. Sophia Yen.
Sophia Yen is the CEO & Co-Founder of Pandia Health, birth control delivery. Pandia Health is the only doctor founded and led, women founded and led birth control delivery company.
Dr. Yen graduated from MIT, UCSF Medical School, and UC Berkeley’s MPH program. She's been in medicine for 20+ years, and is a Clinical Associate Professor at Stanford Medical School. Her passion is Women’s Reproductive Health and she co-founded 3 non-profit projects to improve the lives of women: The Silver Ribbon Campaign to Trust Women, SheHeroes.org, and fffl.co
She is also the mother of 2 daughters, and wife to feminist husband.
Listeners, I am excited for you to hear this episode, because I was so curious about how this conversation was going to go with Dr. Yen. If you know anything about me, you know, I love periods. So talking to someone who has a hashtag period optional, then I was like, oh, how is this going to go? And I am happy to report that he went well. I think Dr. Yen is amazing and her commitment to making sure that women have agency of their bodies is one thing that I'm 100% behind.
***
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***
This conversation is layered, this conversation I feel like we needed more time to go over a lot of things, perhaps. I don't know. Maybe we can bring it back and have a deeper dive into women's bodies and safety and all the things. However, I do hope that you enjoy all the things that we talked about and understand that while we may have different points of view, we both agree on the fact that women are to have agency of their own bodies. Women are human beings that can and should and must own the decisions to happen in our bodies. And for a long time. I mean, if you're listening to this in 2022, the conversation about Roe vs. Wade is still happening, like year 2022. And so I think the most important thing to highlight is that if you are a woman, I believe, we must make decisions of our bodies. And then we get into the intricacies of what it's like to be a woman, because women is kind of like the big umbrella, but then we have women with bigger bodies that also experience a lot of trauma, a lot of challenges when it comes to the medical field, because they have bigger bodies. We have also trans women that have a whole other set of challenges in the medical field. We have women of color. We have black women, we have Latinas, we have native women who have also, there's so many stories of how women's bodies have been controlled over time in the United States. And for all my international listeners, maybe that might be something that I could research and learn more of how women's bodies have or not been controlled outside of the US. But even like women in Puerto Rico, for example, they were like receiving hysterectomies without their consent. Latina women in California and black women in California were receiving also hysterectomies without their consent. Recently, women in migrant camps or migrant stations have also been reported to have received hysterectomies without their consent. And so this conversation is nuanced, this conversation is something that I'm obviously passionate about and I hope you enjoy. I'll stop my ramble. I'll do my rumble at the end, but here's my conversation with Dr. Sofia Yen.
***
Pam: Dr. Yen. So welcome to Cafe con Pam. How are you?
Sophia: Thank you so much for having me here.
Pam: Yes. I'm excited to dive into our conversation because it's super fun. So the question that I always ask is what is your heritage?
Sophia: My parents are both from Taiwan, so we're Taiwanese a hundred percent.
Pam: And you're first generation?
Sophia: I am the first generation born in Chicago. My dad was a PhD student and my mom was a nurse.
Pam: And they met here?
Sophia: They were in Taiwan and, um, she came from a very wealthy family. He came from a very indigent family. His mom died when he was eight. His dad died when he was 13, they had to give away their youngest sister. And in Taiwan luckily the whole system is a meritocracy. As long as you do well in school, then you get to go to the best college possible. And he and my mom met in their little hometown of Chiayi Taiwan, and then he's brilliantly smart, but she's wealthy. He's crazy poor. They had to give away their youngest sister. He's the first one of his generation to go to college. And then he was so loud politically, as you'll see that I am as well, that, um, there was a bad government at the time and they would have blacklisted him and he could have ended up dead. So my mom's like, let's go to the United States. And when they decided to get married, um, her parents disowned her and they came to the United States and she had to do everything, you know, while he was being the PhD student, she worked her butt off as a nurse. And even with my birth, she sat in the car til midnight with contractions. Cause they wanted to save money and wait until the next day.
Pam: Oh my god!
Sophia: And thank goodness. She was a nurse, the physician, literally African American comped us the doctor fee because they couldn't afford it. And so we've been grateful to him ever since.

Pam: Oh my gosh, what a story! I have so many questions. [laughs] Did he ever see a sister again?

Sophia: Yes. So later, um, my parents who also lived the American dream, came here, did not a startup the way startups are today, but bootstrapped from the garage. My mom was the sales person and he was the guy who made the technology. And um, when we got, luckily, you know, they got wealthy. The sister comes knocking on the door saying, hey, you like, left me. You owe me money, buy me something. He didn't do it. You know, the parents died, but my father has helped many of his siblings, um, through financially as well as their children through college, because he was blessed to go to college. And unfortunately his brothers and other siblings were not because financial and all that.

Pam: Wow. That's a whole book.

Sophia: It's the Horatio Alger story or just, yeah, I totally could see us like Crazy Rich Asians, but better. Like Joy Luck Club II.

Pam: Yeah. And so is it only you, are you an only child?

Sophia: No, I have two brothers and that's a fun story too. I was a kindergartener and I was like, mommy, mommy, I want a sister. I got a brother. I was like, mommy, mommy, I want a sister, brother. Then I was like, mommy, mommy, I want a sister. No more.

Pam: But you have two daughters. So you ended up giving birth to two little girls.

Sophia: Yes. Yes. Love it.

Pam: So back to your story. So your parents, like you have family in the medical field. And so did you always know that you wanted to be a doctor?

Sophia: You know, being an Asian American, your options are doctor, PhD, or engineer. And I like science and I like people. So medicine seemed the way to go because each person has their own story and there's so much hope and potential. And if we can give you comprehensive sex ed, if we can give you information to avoid catching diseases, or smoking, or drinking, to the best of our ability, then we can help. Right.

Pam: For sure. And so you were kind of like the expectation was--

Sophia: Firstborn. And my mom was a nurse, so she said, don't be a nurse, be a doctor. Cause all the nurses do all the scutwork and the doctors get the credit. And as a doctor, I totally get it, but as a physician, my new thing is don't be a doctor. If you just want to do general practice, family, medicine, pediatrics, be a nurse practitioner because they don't have to go through all the school and debt that we go through and they're unionized. And they actually, when I came into Stanford, they made more money than I did.

Pam: Wow.

Sophia: Because they're unionized and I wasn't. And as a woman, you come into the job and be like, oh, it's Stanford. You don't negotiate. You just like, whatever, just give me the job. Right.

Pam: Just let me in.

Sophia: And you find out the nurse practitioner. I did like probably eight years more training than her and I speak fluent Spanish, is getting paid more than me.

Pam: Wow. Okay. How was medical school for you?

Sophia: Medical school was easier for me than for some of my colleagues. I got a friend from Harvard and he was a classics major. So he studied Latin in undergrad. Whereas I was a biology major at MIT, so nothing bigger than the cell, molecular biology, biochemistry and whatnot. So the first two years of medical school are, you know, book learning, all those basic background to get us all to par. And I was like, ah, I already did this. I already know this. Whereas the Latin dudes were like "aaarrggg!".

Pam: Yeah, for sure.

Sophia: And then third year's your first time, you know, getting out there, seeing patients, having to get used to the on-call schedule every fourth night, and then fourth year you're practicing to be a resident. And that was intense.

Pam: Mm. Yeah. Like when you hear that medical students don't sleep, you know.

Sophia: Yes. Medical students, we would get up at 5:00 AM and we would finish at midnight. And if it went bad, you could go to two or 3:00 AM.

Pam: Whoa. How did you stay up? What was your fuel?

Sophia: Yes, I'm in high school, I went on a vibrant high, which is just caffeine pills. And I got so much done in that one week where I didn't get so much sleep, but at the end of the week, I was like, arrrgghh. I have always loved the smell of coffee, but not the taste of coffee, so I can do like coffee candy, coffee ice cream, Vietnamese coffee. I just can't do normal coffee. I think part of it is I'll do diet Coke. Yes. I think diet Coke was key and tea. And then also just sheer willpower. Like my thing is I won't go to bed until it's done. Whereas my husband, he'll like go to bed, wake up early and get it done. But I was like, how do you know? What's like, what if it goes extra? What if you can't finish it? I'm like, I can't go to sleep until it's done.

Pam: Ah, so interesting from a science perspective. Do you know why that is?

Sophia: I think it's just, you know, there, there's so many different people in this world. There's morning people, there's evening people. I'm a evening person. He's a morning person.

Pam: I'm a morning person.

Sophia: Ah, so we are opposites.

Pam: But it's interesting because in college, I am a designer by trade. And so in college I would pull all-nighters all the time because that was kind of like the norm in the art department was to literally arrive at like 10:00 AM with your snacks and your blanket. And then overnight, you know, like you would stay in the building the whole night, finish your projects and then leave the next morning.

Sophia: That's so crazy. That is like project runway. But I thought the show made you you do it that way. Right. Not because it's the way it's done.

Pam: It's a thing. It's a thing. And so I was like inherently trained by my peers to do that. But now that I work for myself, like for example, this morning, I got up at 5:00 AM and started working at like 6:30 and got so much done before 10:00 am. Like half my list was done before 10:00 am.

Sophia: That's five hours.

Pam: Right. But if I had started the day before, because I traveled, I started at 9:00 AM and then I was just dragging, like, I'm not productive around that time. I'm the most productive between 6:00 AM and 10:00 AM, which is like not the funnest. Cause I'm kind of like working against everyone's clock, you know, when everyone's asleep.

Sophia: That's actually the best time. Because when you send out email, nobody responds. It's a one way thing as opposed to back and forth.

Pam: I know, I know.

***

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***

Pam: Okay, so back to you. So you go to medical school and then when did you decide your specialty? When does one decide?

Sophia: You can decide your specialty, you really should decide it in med school. You don't have to decide it before med school, but I've always had a passion for women's rights, reproductive rights. And the main reason is because I was sexually active as a teenager. And if I were to get pregnant, I would like to one prevent pregnancy, but two, if anything came up, it'd be my body, my decision, and nobody better don't dare tell me what to do. And so I volunteered at Planned Parenthood and I was running pregnancy tests and I was a 15 year old pre-med running pregnancy tests and giving people results. I ran it for 13 year old. And it came back positive. And I'm like, okay, it's a positive test. Would you like to continue the pregnancy, give it up for adoption or terminate? And she didn't blink. And she just said, I'm going to continue the pregnancy. And I was like, oh! And you know, her body, her choice. But in my head, I'm like, oh my gosh, this is going to be such a difficult road. You know, for you, are you going to finish junior high, high school? Are you going to get to college? It's gonna be really hard, all in my head, you know, but her body, her choice, she went her way, but I would go on to MIT, UCSF, Children's Oakland and back to UCSF to specialize in teenagers, to prevent teenage pregnancy, and then down to Stanford, Clinical Associate Professor. And then just do my start-ups. So just personal interests to prevent unplanned pregnancies, and [inaudible] my rights. So I went into med school thinking OB-GYN, but then I did it like the baby delivering, every like delivery. I'd go into it and be like pushing with a woman for 12 hours and then she'd go to C-section and I was like, I don't want to do C-section. I don't like surgery. I don't like catching the baby. If I only I could do outpatient gynecology. And I found out adolescent medicine where I could do the pelvic exam, the pap smears, the STI, do the counseling on birth control, and prevent and start somebody on a good birth controls with no side effects and help them, so they could start their healthy future sexual life and have babies when they want to have babies and not have babies when they don't want to have babies, and make sure that those of us with uteri are having orgasms. Because if you're not, then why are you doing it? So improve your conversation and improve, you know, your communications skills.

Pam: So many questions. [laughs] Let's backtrack a little because you're fast. You're fast. You tell me the story too fast and I have questions. Would you say that this moment of giving the result to this 13 year old kind of like shifted the way that you see how sex-ed.

Sophia: It gave me a purpose and yes, it made me realize that it takes two to make a baby, but one could walk away. And this one with the uterus is adversely impacted and I am part of her world, and all of us with uteri have that problem, that risk. And as an adolescent medicine doctor, I tell young people, you know, he says, I'll stay with you, but once the baby comes, he can just walk away, you know? And I tell all those with penises, control your sperm. Cause once the sperm leaves your body, it's her choice. Whether she's going to terminate, continue, or make you a baby daddy. You know, so, and, and even if she and her mom like, oh, you don't have to be involved, we'll take care of it. This kid's going to turn 18, hunt you down and be like, where were you all my life? You know, be very angry that you were not around. So control your sperm, if you don't want to have babies. And if you have a uterus, you can have sex. Just know that there's lots of many different birth controls out there. So don't get pregnant unless you want to get pregnant. And then for both sides in a hetero relationship, you know, just assume everyone has every sexually transmitted infection under the sun, and always use condoms. So I have a condom bag, and I carry it around, and people like, you're married, why are you using condoms? Your husband, you don't, you, are you cheating on your husband? I'm like, no, I don't like to leak sperm for the next 24 hours. And if the other side had to leak my fluids for 24 hours, they would sure as heck made sure I wore something similar, but also just assume everybody has every sexually transmitted infection. Because as a physician, I can tell you, I can look at a penis and be like, that's the cleanest penis I've ever seen. And then you have sex with it. And then two weeks later, you got herpes, you got wards, you got HIV, you got gonorrhea, chlamydia, sorry. Cause with HIV and herpes and warts, we only call it what when we see it. It's running in the blood. We can't tell just by looking at a penis, it's there. And particularly also on the flip side for those penises that are listening. If I go into a woman's vagina with a speculum, we had these cool new speculums that are clear and you can light it up so you can see a little more, but it is a long dark cavernous thing. I can't check every nook and cranny and every wrinkle to make sure there weren't warts or herpes there. And again, even if I said, oh, this is good. And then you have your thing. And then two weeks later, whoops, sorry.

Pam: Yeah, that actually happened to a friend in college, where she was hanging out with somebody in a heterosexual relationship. And she called me crying one day and I was like, what's wrong? And she was like, I can't pee. And I'm like, what? She started just describing how like inflammation and, and she ended up having herpes.

Sophia: Cause it hurts so bad.

Pam: And so she was like, but you know, we had the conversation and he said he was clean and... And so I'm like, well, people can say whatever they want.

Sophia: Yes. And even there are apps where they'll be like "here are my results". But you gotta know it's only those results for those things they've tested. So if you come into my clinic, generally, we only screen for gonorrhea and chlamydia. We do not screen for herpes. We do not screen for warts. We ask you if you want HIV, but if that person didn't get a cheek swab or a blood test, they did not get an HIV test. And then the key with HIV is we test for the antibody. It takes six weeks for that to show up. So six weeks ago, this person didn't have HIV, but unless you've been with this person 24/7, watching them to make sure they don't have sex with anybody else, they could have HIV and they could be bringing into the relationship.

Pam: And HPV, it's another one.

Sophia: The number one sexually transmitted infection is HPV. 80% of us will have one of the four strains that are in the original HPV vaccine, if we have just two partners in our lives, which I don't think is unreasonable. Your first one and then maybe your final one, you know, like just two partners, quite, you know, reasonable. So please everybody go get your HPV shot, if you get it before you're 14 I think it's two shots. If you get it after 14, it's three shots. They used to only let you get it up to 26, but some people have gotten divorced. Come back in a game. There's also been STI, what is it, outbreaks in old folks homes because it's one old dude [inaudible]

Pam: What?!

Sophia: And so these women have been in monogamous relationships and their significant other died. They've never used a condom for like 40 years and this dude, and he likes on all of them.

Pam: Spread that, wow!

Sophia: Ghonorrea, syphilis in old folks homes.

Pam: That's so interesting. I mean, hey, everyone can have their fun, but take care of yourself.

Sophia: Condoms, condoms, condoms.

Pam: What about the people that don't like condoms?

Sophia: So the key to know is that-- these people should pay me, condomdepot.com. It h
as all the condoms and they rate it from the vagina perspective and from the penis perspective. So the person with a vagina gave it an A-, the person with the penis, gave it a B+, and they give their little rating and what. Bottom line is the thinnest condom that doesn't have breakage is what you want. Cause that's the best sensation. And if it's pretty thin, you almost don't feel it, with some lubricant it's kind of some good stuff. So I, at our clinic at Stanford, we always have one of the top three condoms. Cause I figured I'd give you a good condom, you're going to use it. I give you a crappy condom, you're not. And again, those of us with the uteruses, we bear the burden. We're more likely to catch an STD, STI in a heterosexual relationship than the dude is, because he just dips and out. But we're this giant receptacle, you know, we just receive everything and we get the abrasions and stuff like that. So I've never seen a guy not ejaculate with a condom, so protect yourself. And then the other caveat is some people won't do it for themselves. But a lot of people do stuff for their future baby, right? People quit smoking, quit drinking, et cetera for their future baby. So use a condom for your future baby, because if you have herpes or warts in your vagina and your baby comes out, then your baby gets covered with warts and then your baby will need a hole in their throat to breathe because there's so many warts. If we can't zap them all or cut them, or do you want your baby to have all these surgeries for me to cut all the wards off their throat, you know, so they can breathe, and speak because you didn't have, you had sex with a condom or the dude infected you, no, you don't want that. And then the herpes can infect your eye. And I was like, we all want a perfect baby. We don't want a baby that comes out with one eyes herped, or the other one. It can go to your brain. And herpes in the brain causes Swiss cheese and the brain does not heal. So, although actually there are babies who can live with just half a brain, but don't you want your baby to have full brain?

Pam: Wow. I didn't know you could live with half a brain.

Sophia: Yeah. It's very rare. But if you start as a baby, there's so much extra capacity that it can actually kind of do that.

Pam: Wow. So interesting. So what is a good age for humans to start learning about sex.

Sophia: So I love the Canadians. They start at kindergarten and every two years they have sex-ed. I'm from California.

One of the most liberal states in the nation. And before we recently passed the law, you would only have like an hour in high school now. And now I think we get an hour and like fourth or fifth grade about periods and then maybe an hour in seventh grade and then maybe an hour in ninth grade. And I was like all, that plus right before junior prom, right before just the senior prom, there should be a refresher and a bunch of condoms, but you can start with age appropriate sex-ed at like four or five years old. Cause as you know, a little boys are always touching their thing. And so you just, you know, name your private parts, the correct names. So penis, vagina, vulva's the new one for the outside, the vagina is really the tube. And like, my kids are like, oh, there's a baby in her tummy. And I was like, it's not in her tummy, it's in her abdomen or her uterus, because if it was in her stomach, it would be covered in acid and it would not live. So, yes, it's just science. It's just teaching them the correct terms and then they can all be pre-meds.

Pam: Well, and like talking about the Canadians and how they start in kindergarten. Has there been a difference in how kids that have sex education early versus kids that, you know, because one thing I read one time that the average age where kids, and I think it was in the US, I'm not sure, watch their first porn is eight years old. But they don't get their first sex ed until junior high.

Sophia: Yes, exactly. And that is, you know, a failing on our part as adults to control the internet, to block it. My husband works at Apple, so they do a pretty good job, but like he can't control all the web, you know? And the number one thing on the web for the longest time was porn. I don't know what it is now might still be porn, and porn just is so misogynistic. It sets up unreal expectations of body parts on both sides. They're always shaved and it's not because that's necessarily a good thing, but that decreases sexually transmitted infections, because you can actually get crabs if you have hair bumping up against each other. So I'm not a fan of porn, though there is some good porn. I think it's by Cindy Gallop, it's called Make Love, not Porn. It's real people, real bodies, mutual orgasm, so loving, caring, but also different body size and shapes and everything, you know, rather than unrealistic, expectations.

Pam: Ethical porn is cool. Erika Lust is another one that creates ethical porn.

Sophia: Okay. Um, thank you for sharing that, that's so important. It's ethical and people that aren't being forced, people that aren't being, you know, doing it cause they were sexually abused and this is the only way they can make money. People who are wanting to do it and wanting to share, you know, with the world and get off on it.

Pam: For sure.

Sophia: But you were saying that, research has shown that sex ed doesn't lead to sex. That is really important. There's a lot of people that push abstinence only, which is you can only talk about birth control with respect to its failures, and you have to abstain from sex until marriage, but I'm here as an adolescent medicine specialist to give you the reality. 10% of high school freshmen, one out of 10, three out of a room of 30 have had heterosexual relations. And by senior year, it's 50 or 60% throughout the United States. And you can imagine in the city, you're stressed out. You think you might die. So you might as well have sex and reproduce before you die. And then in the rural areas to see all the animals doing it, you got nothing to do. You got your hormones raging since you were 12. So let's just get it on. It's your body saying I want to make babies at 12 and it's really hard to fight it. And what I love is there was a writer comedian, and I could picture him. He's from Minnesota, Al Franken. He had a group of students at Harvard and they wrote the Republican leadership, saying, we know that you believe in abstinence until marriage, and it would be so inspirational to hear your personal story, to share with everyone. And crickets came back except for [inaudible] and good luck. And it was like, how dare you ask us to abstain until marriage? If you yourself, didn't pull it off, you total hypocrite. You know, and even then your body, your choice, my body, my choice. And you know, as long as you do it with a condom, with some hormonal contraception or a copper IUD, then you can minimize the risk of sexually transmitted infections. Minimize the risk of pregnancy. Right now with the way Roe V. Wade is going, if the condom breaks or there's other issues, if it breaks, emergency contraception, but if emergency contraception fails, then, um, 28 states are going to have limited options.

Pam: I know, that's like, that's a whole conversation. Okay. Let's take a quick coffee break and then we'll come back and talk about what you do now.

***

Pam: Dr. Yen, you said you don't drink coffee. What's your hot beverage of choice. If you have one.

Sophia: I think it's the like geek MIT in me, Star Trek, Earl Grayhot. And then I also like, you know, English tea with the whole tea set, you know, with the sandwiches and the dessert. I'm all about dessert. This is the secret to staying until 3:00 am, Vietnamese iced coffee. I do do that, but I treat it like dessert. I wouldn't drink more than one of it, cause it's a ton of sugar, a ton of caffeine. And definitely keep me up until 3:00 am.

Pam: Yeah. Vietnamese coffee is one of those that you drink at like 6:00 am and you'll stay up until like 9:00 pm.

Sophia: Oh, yeah.

Pam: Like it's a bomb, like a [inaudible].

Sophia: Yes, a very [inaudible] one. But delicious.

Pam: Yes indeed. 100%. And you live in the bay, so do you have any favorite local location that you visit for tea?

Sophia: Oh yeah, totally, Tea Time in Palo Alto. I love that place. If I can get in and sometimes they're booked up and that's disappointing, but given COVID that you could do take out, but I liked sitting in the stack and having tea with a friend and chatting, charla, you know. In Los Altos there Satura Cake, which is, um, Asian cake. That's just divine. Um, Manresa Bread has amazing pastries. As you can tell, I'm a dessert person. Or Kara's Cupcakes.

Pam: Yum! All the [inaudible]. We'll check them out. When we go to the bay. On my end, this is the afternoon. So I'm not drinking coffee anymore. I've had my tea and my coffee for the day. And I'm drinking water now. Yeah. I drink matcha in the afternoon.

Sophia: Ooh, matcha's intense.

Pam: You think so?

Sophia: It's green tea, isn't it? It's like, intense.

Pam: I love matcha, I love it so much. So, I drink coffee in the morning and then matcha in the afternoon. And then water the rest of the day. Cause I'm good after that. Okay. Let's go back to the show.

***

Pam: So, let's talk about periods.

Sophia: Yes. So in trying to get pregnant with my first baby, I realized that those of us who have uteruses, the only reason we bleed is we didn't get pregnant that month. And the reason why is I had been on the pill for like 10, 15 odd years before I had my baby. And so on the pill patch ring, your periods are like normally if it's five days, it's three days.

Normally if you use five pads, it's three pads is all just less because when you need to make a baby, that lining builds up to a level of 10. But when you're on the pill, patch rings just one. So there's far less buildup, far less blood to lose. And so I was trying to gain a girl and a boy in that order. But after two normal periods, so much blood, I was like, I don't care. Just get me pregnant in this cause I needed to get my baby's out, and I needed to pop out two babies and I just didn't want to deal with the blood. And so the realization, the only reason those of us with uteruses bleed as you build that lining every month, and you're like embryo? no embryo, bleed! And then you build it up again. Embryo? No embryo. Bleed! And we do that from 12 and a half to 50 every single month. But if we only want to pop out two babies and it only took me three months, each for each of those kids to pop, to get pregnant, I could have only bled for six times, but instead on average, first world countries, we believe 350 to 400 times in our lifetime, 350 to 400. And I want you to compare this to the Dogon Tribe in Mali Africa, Dr. Beverly Strassman studies of now, not like hundreds of years ago, and they die at 70 or 80, just like us, so we're comparing apples to apples. They only bleed a hundred times in their lives. So that is what is natural. We're bleeding 350 to 400. So we're having enough periods for three other women. And every time we build that lining, we risk cancer of the lining. Every time we pop out an egg, we risk cancer of the ovary. The only other way to decrease your risk of ovarian cancer is to take out those ovaries. But if you go on the pill patch ring for five years, you decrease your risk of ovarian cancer by 50%.

Pam: Why did the women in Africa only bleed like, so much less?

Sophia: Great question. So one is nutrition. So in the United States and anywhere, anywhere you hit a hundred pounds or 22% body fat, your body's like you have enough fat, let's make some babies. And so we start at 12, they start at 16, but more importantly, they have eight or nine babies. How many periods you have when you're pregnant?

Pam: Oh, they are pregnant more.

Sophia: Zero. They breastfeed 12 months. How many periods do you have when you exclusively breastfeed? Zero. We have two babies. We breastfeed for zero, so they spend 20 years of their lives pregnant or breastfeeding, we spend maybe two to four. So that's why we have so many more periods. And so we are incessantly menstruating, and they are not, they're pregnant or breastfeeding. Not saying that we should all have eight or nine babies. Totally. We should breastfeed as much as we can. But by going on the pill patch ring, or the IUD, the implant, the shot, you mimic pregnancy, you stop the eggs popping out for the pill patch ring, and you stopped the bleeding up and down, up and down with the IUD, the implant and the shot.

Pam: So, I was on the pill for years and I was going wild, nuts. It was not good for me. And so I went into deep depression. I was paranoid. I like, it was not okay. And so how do we recommend getting on the pill when synthetic hormones could also not be so good? Like for me, it just was not, then I switched, I switched like three or four times and it just wasn't. And I had PCOS actually.

Sophia: Oh, no. So you definitely need to turn things off because every time you pop, you risk it getting big and twisting and hurting and stuff like that. It's, you know, each person is different and some people have a very negative reaction to the hormones that are in birth control. But I would say that's like one out of a thousand. It's more likely to have some minor side effects and like 10 to 15%. And the key on the pill is to know that there's 40 different pills. There's at least eight different progesterones. So you, I don't know if you went through eight different pills, but there's 8 different progesterones. So you did 50%, but there might be new ones out there. In fact, there is a new one out there. This is what I want to tell you about my company Pandiahealth.com. I made it so that no one runs out of birth control on our watch, but more importantly, we are the only women founded, and women led, the only doctor led, the only academic doctor led. So I took my MIT, a UCSF trained, Stanford professor brain and applied this to birth control. I've only done birth control for the past six years. Just birth control. Your doctor does other stuff. They deliver babies. They do pap smears. I just do birth control and only birth control pills. And I realized what we were taught at UCSF Stanford works great for a Caucasian female that wants to bleed every month. But as an Asian, I had to go through three different pills until I found one that worked. And then every [inaudible] try that one, that we were taught it at UCSF Stanford, because this woman was telling everybody [inaudible], so it's gotta be good. I kept trying it. And every single time I tried it, I get breakthrough bleeding. And I was like, Ugh. And we forget that most of medicine is based on a 70 kilo, white male, and certainly not for birth control, but what works for them, doesn't work for us. So after studying it and putting all the progesterones in the list by the dose, because I'm all about Excel spreadsheets and science, I ranked it from most likely to give you zits to least likely to give zits, most likely to have breakthrough bleeding, to least likely to have breakthrough bleeding. I looked at the one that worked for me, and then I looked at a couple around it and we picked the best one. And so at Pandia Health, we put you on the that's most likely to give you the least amount of side effects. And then if you do have side effects, we have this chart and we know how to tweak it up. We know how to tweak it down and hopefully amongst 40 different options, we can find one that works for you. However, there are some special progesterones that are only available in the new ring, so that one might be better for you, but it might just be the estrogen. That's an issue. It might also be the dose of estrogen. And so I don't know if you've been pregnant. Have you been pregnant yet?

Pam: No. Um, I had a miscarriage.

Sophia: Okay. Cause I'm just thinking that the hormones, you know, might like when you're pregnant, you might be at higher risk of postpartum depression or something like that. I would check what your family history is with your aunt, your mom.

Pam: Yes. Yeah.

Sophia: So, so that's, I think you didn't like the pregnant hormones. Cause as I said, the pill, the patch, the ring is telling your body you're pregnant. And so if it kind of predicts, you know, the postpartum badness that could come, but hopefully not. And I don't want to put it in your head cause there's definitely a 30% placebo effect. So just go in, and you don't have it, but if you do have it, then you know what, because when you took the pill, it kind of brought it out. But there's also the IUD, the implant, which only has progesterone, but progesterone is the hormone of pregnancy. That's why it's called pro-gestation, progesterone. So, if it is the progesterone, then those might make you unhappy. But the good hormone that we found is in the implant. So you could try the implant and see if that works for you. Oh, and there's also a new progesterone, um, drospirenone which is really good for acne, it's Yaz or Yasmin.

Pam: I did Yaz. That was not okay. That's the one that made me go wild.

Sophia: Okay. Then you probably need the lowest progestational effect, which is actually the one that we were well, actually, no, that one has, we need to see which one we'll look at my chart and find you the lowest progestational effect one. And that might be the secret if you want it, to try it. But that the whole thing is just every person with a uterus is different. We have different genetics and at our company, we actually ask, what is your race? So that way we can correlate race with side-effects as a proxy for genetics and research going forward, not with your name, but totally anonymized to help women benefit from other women's experience. And then in the future, if you want to give us your 23 and me, then we can actually look at exact genetics and then the future, somebody else coming in. Oh, you have this genetics, the woman with those genetics like this pill, and it did well for her. Let's see how that goes with you. You know.

Pam: Kind of like the condom site that you mentioned.

Sophia: Yeah. These are the best, according to this and that.

Pam: I love it. And to backtrack a little, when you mentioned that this is a woman founded, because I read somewhere how there's a lot of companies that are masking "their founders" because they're male founded by saying we have a woman CEO. And so, but they're actually founded by men. So I love that you mentioned that you're a women founded, because it makes a difference.

Sophia: Thank you so much for bringing that up because two of our major competitors just did exactly that. We call it "woman washing". They had a male CEO cause that's who the founder and leader was and that's, who's going to get all the money as well. So we are also majority women owned, because we were women founded and women led, and they have women CEOs, which is great. But that's more trickled down. We are by women for women. And the other difference is having a doctor CEO. You know, I like to say as long as I'm CEO and as long as my values hold as the head of this company, we will always tell you what's best for your health. Even if it doesn't benefit our bottom line. And exact example is the IUD and implant are amazing. They totally beat the pill patch ring. We can only write you for the pill patch ring. Cause I can't put in the IUD or the implants, [inaudible] medicine. In the future I would love to drop a drone with a robot and be like spread up.

Pam: So, how did you decide to start this company?

Sophia: So I was giving a talk to a bunch of physicians because I teach other doctors how to prescribe birth control, how to take care of teenagers, how to kick the parent out of the room, have some private time and have private conversations. And one of the statistics that came up is one of the top reasons why women don't take their birth control is they didn't have it in their hand. And my friend and I, it was the beginning of Etsy. It was the beginning of E-bay. It was beginning of Amazon. Everything was coming in the mail and we're like, oh, we could solve this. We will just ship you birth control and keep shipping you birth control until you tell us a stop. Then we ran ads, free birth control delivery, and 70% of the women that responded didn't have a prescription. And it's like, don't you know [inaudible] the birth control pill, patch or ring. And luckily, I was a physician and thus Pandia health was born. If you have a prescription, your doctor can deal with your side effects. Your doctor can deal with all the up and down and all that stuff. We're just here to do the delivery. So no one runs out of birth control on our watch. Set it and forget it. Let us worry. So you don't have to, we call Pandia peace of mind. If you need a prescription, it is a total steal, because our doctors, if you came to see me at Stanford, it'd be $750 an hour. I think I don't even know what they're billing nowadays, because I never see that bill.

I only get paid what I get paid from Stanford when I'm there, but we charged $20 once a year to use our expert doctors. And we give unlimited follow-up questions about birth control. Not about anything else, because you've only paid us 20 bucks, is only about birth control. And so the person that wants the birth control fills out a questionnaire, gives us a selfie to prove you are who you are, a government ID, the front and back of your insurance card or your credit card if you don't have insurance. And then we send all that information, help 20 questions, the same questions I ask you if you came into my office, to our doctor, our doctors look at it. If they feel it's safe, they write the prescription. We send it to our partner pharmacy. We bill your insurance or your credit card for the medications and done. Don't have to see a doctor again for another year. We don't want to replace your primary care doctor. We just want to make sure no one runs out of birth control that doesn't want to run out.

Pam: And what are doctors, like the primary care doctor, what do they think about that?

Sophia: Yeah, so the new paradigm in medicine is doctors should work to the top of their license. So it is a waste of an OB-GYNs time and brain to be writing birth control pills, because they could be doing surgery. They could be delivering babies, they could be doing pap smears. These are far more lucrative and also mind using. And they've actually said the American college of obstetrics and gynecology, that birth control should be over the counter. And that if you do these 20 questions and say no to all of them, certainly don't lie because then you risk blood clots and whatnot, and you have a normal blood pressure. If you're generally 35 or under, and a non-smoker. Then you can totally just get birth control and it should be over the counter. So it is beneath them. They don't need to, and they have better things to do. And as long as we're not stealing their patients, and as a doctor, I'm not here to steal your patients. The profitability for us is owning that box, that goes to women's doors every month, every three months from age 14 and a half until 50. And then we're going to launch menopause, so 50 until you die. And then we're going to add PCOS, We're going to add yeast infection. We're going to add, uh, acne. So we want to be the online health brand women trust as the only women founded in women led the only doctor led company in this space. And we purposely chose Pandia, the Greek goddess of healing, light, full moon. And then mi español Pam is every DIA is day. So we're with you every day. And that is our goal.

Pam: So what happens with women in menopause? You mentioned menopause. Do they need pills?

Sophia: Yes. So what happened is a decade or two ago the women's health initiative, the largest study ever on menopause, was funded by the government, but the problem is there were some serious flaws in that study, the average age, they started them on the drugs with 63. Most women get menopause at 50. And so my view of the biology is we were supposed to crank out babies, help with the society and then die. So anything above 50 is gravy. And so at 50, your body's like bye bye, you need to go die. So let's just take away your estrogen. And that's when we, as women have our risk of heart attacks, just like men. Cause you took away our estrogen. And we turned into men with hard arteries and cholesterol and blood clot. And then if you wait 10 years, we've turned into men and then you throw estrogen, which could cause blood clots and heart attacks. Then yes, you're going to get blood clots and heart attacks. And so now in medicine, we know if you're going to start hormonal therapy, you want to start it before 60. And then the hormonal therapy is good for your bones as Asians, Latinas, a lot of us are lactose intolerant. We're not so good on the calcium. And so our bones are more fragile and could break. The key with estrogen is that it makes your bones bendy. And so we can't do a test for bendy. We do a, a test for hardness and the drugs work on hardness. But if we were to do a good test and we can't do it, cause we would have to take your bone and be like, how much pressure can I do until it brakes, you know? And so the estrogen works for that, but the estrogen also works for hot flashes, which is during the day, during the interview, all of a sudden it looks like you're drowning and water, but more importantly, it happens at night. So women are not sleeping through the night. Sometimes they're snoring cause a husband or self, because you're drenched and it's like, somebody dumped water on you. So you're waking up at three or five, not your normal waking up time and then having to go back to bed. And then the reality is dry vagina. So when you have sex, it's like sandpaper. And just like, so there's just, so there's like 40 symptoms of menopause. You can put the estrogen back in. There are some new technology to decrease your risk of breast cancer by only focusing on the vagina. Then I was like, does that help the bone? They have to study, you know, all of this, but definitely something to consider.

Pam: And that's something that you're gonna introduce?

Sophia: We're going to launch later this year. Cause I'm 50 and all my friends like menopause, menopause, menopause, and I'm like, yes, I need to know what is the best menopause treatment. And I'm going to use that for me. And I'm going to share it with all of you.
And certainly every woman has their choice, their body, their differences. I'm not going to push something on you, but yeah. I studied this and the best treatment is the patch. And if that doesn't work for you, then we can do the spray. We can do the local vaginal cream. And if you have a uterus, some people have had a hysterectomy, then you need progesterone. You could either do that through an IUD, or you can do that with a pill, 12 days a month, then you bleed. I don't like bleeding. Or you can do it with a pill every single day, but again, your choice. So when people come to our platform, we're like, do you want to bleed every month? Every three months, every six months or never? I haven't bled in the past 12 years. As long as I take my pills. My last baby is 12.

Pam: Wow! Oh my gosh. Tell us where we can find you.

Sophia: Yes. So pandiahealth.com. And we are on every platform. TikTok, Twitter, YouTube, Facebook, you name it. You can find pandiahealth.com. We have great blogs. We have great YouTube videos with like 300,000 views. Dr. Yen tips first time on birth control. These are my tips. Don't take it first thing in the morning on an empty stomach. That is like the worst possible thing to do. Take it either with your largest meal or right before you go to bed. And then the second Tuesday of every month at 5 o'clock Pacific in Español and at 5:30 in English, we have a Facebook live on different topics. So you can come and listen, or you can drop questions there, or you can always hit us up on any of our socials.

Pam: Awesome. Okay. I think this is where we differ because I do like periods because I read a study about how women's intuition gets more enhanced when women are bleeding. And there's actually a lot of cultures that do honor the periods. And you talk about the huts, the menstruation huts. And so I've read a lot on that and how women have connected through their bleed and they have connected through their blood and not only to the earth, but to the moon. And how, like when you end up actually menopause, when you no longer bleed it's because you've become one with the earth. And you have based on the ancient knowledge and wisdom that I've learned, it's when, when a woman has entered menopause is because she's earned her knowledge that she needs to, to have earned from the earth. And so I do like periods.

Sophia: I don't mean to diss periods. It's it's just simply as a tiger mom, pre-med, you know, with two daughters, I posited it to those people that have daughters out there. Is your daughter going to do better on the SAT, bleeding or not bleeding? Cause my daughter is going to crush your daughter. Cause my daughter won't have any chance of bleeding on the SAT, her choice. If she wants to bleed, she could totally bleed. If she feels she's more productive bleeding, all for it, but I was in the pre-med MIT, biochem final all of a sudden "bam!" And I'm like, do I run to the bathroom? Or do I finish the exam? And as a pre-med you finished the exam. And I looked to my left. I looked to my right. Two people without uteri. Not a care in the world. And so I want my daughters to be on equal playing ground. And the number one cause of miss school and work under the age of 25 is bad evil periods. So I'm not saying don't have any periods, but if you're having bad evil periods, even if it runs in your family, please see a doctor because it could be PCOS, it could be endometriosis. It could be fibroids. All of that runs more in people of color. So please get that checked out. Don't just suffer in silence or suck it up. It's really surprising how many professional women that I've met, 30 to 50 years old. And they're like, yeah, I have horrible periods. And I was like, please, why haven't you seen a doctor for 15 years in your life.

Pam: Yeah, that's it. I mean, that's another thing that I am behind is if you are constantly, I have two friends actually that literally for three days out of the month, they are in bed. And so I don't think we are meant to suffer. And so 100%, both of them have fibrates actually. And so one of them one time, which I was like, por qué are you doing this to yourself? Like, put a heating pad because it hurts so much. And she burned her skin, because the heating pad was so hot, you know? And so I am a proponent, like I do love science. And so if you are at a point where it's unbearable, where your day-to-day activities are just not happening because of it, totally go get checked. I mean, there's, that's why Western medicine exists, you know? So that could be taking care of. Another study that I found fascinating was, and I couldn't find it. I was going to pull it out before, but I couldn't find it. I've read that years ago. It talked about how women on birth control it changes the chemistry of your brain because you're on synthetic hormones. And so what they found is that once they got off birth control, they were no longer attracted to their partners.

Sophia: So I also have heard of that study, but I don't think it was like a hundred percent. It was probably, you know, like a 10 to 30% that, because everything's always 30, 30, 30. 30 found their husband repulsive, 30 didn't matter. And then 30 love their husbands still. And so that study, I recall, was like, when you are not on birth control, then there's the sexual attraction. And you're looking for like that alpha male. But then when you're on birth control, you're kind of being pregnant. And so you're looking for somebody that's nice and that will take care of you and stuff like that. My husband is a nice guy. I like the nice guy. I don't need the alpha male that might beat me, cheat on me, or do something like that. You know? I mean, my husband's still hot. That's why I went after him in high school, but he's my high school sweetheart. And I love him. And, but I'm still on birth control pills. I mean, that's why I love him when I come out. Maybe I won't love him, but that'll be, you know, 55, but I'll be on hormone therapy and I'll still love him. So yes, there is that theoretical risk, but that's one study and I would, you know, look at the numbers, but the, to me, the decreased risk of ovarian endometrial, colorectal cancer, the decreased risk of anemia, the quality of life, the green, we use 10,000 to 13,000 menstrual products in our lives. But mainly I just hate the random blood. I think those without uteruses, they don't know what it's like to be randomly hit with blood one week out of four for three to five days. It doesn't come Tuesday at 10:00 AM. It comes whenever it wants to come. And then the stress of like, am I pregnant? And the more stressed out you are, the farther your period goes because you're stressed. So it pushed it away. It just is cruel evil torture.

Pam: Uh, this is fun. Okay. So do you have aquote or mantra that you live by?

Sophia: I think, you know, the golden rule "do unto others as you would have done unto you". And one step further is "pay it forward". I've just been, you know, blessed with parents that have been so supportive and they've lived the American dream. And so if there's any way I can help people that's, you know, so much put out good karma and hopefully good karma will come back.

Pam: Yes. And what's your remedio? Your remedy?

Sophia: My naughty remedy? Or...? [laughs] I love listening to power music like Beyonce or Rihanna or Katy Perry or Megan Trainor and just dancing. Cause you know, get physical and release that tension and that energy. The power pose does work, you know? And then the naughty side is just trash TV, as well as desserts.

Pam: And you shared one with us, chicken noodle soup from Din Tai Fung.

Sophia: Oh, yes. Uh, Din Tai Fung is the best place for soup dumplings. If you've ever had soup dumplings are called that because they steam it. And when it steams you bite into it, you have to have a spoon to catch the soup. It's hot soup. And if they did it right, there should be soup. And they're not just juices, but soup. And I love vinegar and I love ginger and that goes with it. But in Din Tai Fung, which is one of the best soup dumpling places, they also have a chicken noodle soup there where you don't want to get the boneless chicken one. Cause I thought, oh, that's fancy. I get the boneless chicken one. No, you want the one with the bone because bone marrow and also they cook it so well the chicken just falls off the bone. So the bone is irrelevant, but that's so good. I just had it, like yesterday and I was like, this could heal anything.

Pam: So chicken soup is just good. Yes. And when it's done well, and ginger is really awesome.

Sophia: Yeah.

Pam: Okay. So tell us again where we can find you. You already shared a little bit, but you said you're an all the places and spaces, all the social medias.

Sophia: All the social medias, pandiahealth.com. And then if you want to review of #periodsoptional, go to pandiahealth.com/periodsoptional, at the bottom is my TEDx talk on the science and safety of not having to bleed every single month, so you can make #periodsoptional.

Pam: Okay. Thank you so much for being at Cafe con Pam. This is a fun conversation.

Sophia: Thank you for having me.

Pam: Yeah. Thank you for coming.

Sophia: Listeners, stay shining!

***

All right, listeners, what do you think. I do want to clarify and make sure that it's very clear that I understand that not everyone is meant to have birth control. During the interview you heard me talk about how birth control made my brain just go in directions that I did not need it to go. It made me make some decisions that now I could attribute it to me being on birth control, and maybe I could have tried all of the different options, but I didn't have the capacity to do it. And so in my case, in my personal case, I chose to not use birth control anymore. And now, me saying that does not mean that if you listening, you want to be on birth control and you want to make your period optional and you feel good about it. Go for it. That's the power of owning your body. That is the agency that I am passionate for you to have. To say, hey, if I want to be on this pill, because it makes my periods easier. Because if I want to skip one, I can, because I don't have pain anymore, because I can navigate the world in an easier way. Please go for it. And I want to make sure that it's clear that having the option it's what's important. While something might not be for me, and it is for you. I so respect that. And the, it becomes an issue when somebody else, call it the government, call it whoever, comes in to say "you can't do this". That's when it's, it's a problem for me because. Having agency and retaining the agency of our bodies is important. So I wanted to make sure that that was clear, that I don't want my opinions, my beliefs, my experience to sound like "I want you to believe that" because I don't, I want you to make your own decisions. So I wanted to make that clear. I am grateful for Dr. Yen to come to the show and share her story. And while we might not agree on the period conversation and making the periods optional, I do think it's having the option is already amazing.

And so bueno, if this is your first time here, I hope you come back. I hope you return, and a way, an easy way to make sure that that happens is to subscribe. So whatever platform you're listening, to hit that subscribe button. So you can be notified when the next episode drops. We drop episodes every Sunday. And my intention is to bring to Cafe con Pam people that are doing amazing things, to expand our options, to expand our opinions, to expand what we have been hearing all along. So I hope you subscribe, rate and review is also important. Not all the platforms allow you to rate and review. I'm aware of that now. If you are a Spotify listener, for example, you can't rate and review. If you are an Apple Podcast listener, you can rate and review. If you are a Goodpods listener, you can actually in Goodpods, you can rate and review each episode, which is super cool. No pressure, depending on what podcasting platform you use, if they don't let you review and rate, it's no problem. I know I've been getting, and I say this because I've been getting a lot of DMs from you like Pam, I'm listening on Spotify and I want to rate you, but I can't. No problem. It's because your podcast listening platform doesn't allow you to and it's totally fine. So I wanted to make that clear, but thank you so much to those of you who do leave ratings and reviews. I'm so grateful to read your comments. I'm grateful to, I think it's a gift, actually. I feel like it's a gift that you lended me your time and listened to the stories that I get to share on the show. It's, it's a privilege that I don't take for granted. So thank you for doing that. And for being here.

I would love to stay connected. You can follow me on all things social @cafeconpampodcast on Instagram and Facebook. You can also check out our online community. It's a Discord server, stayshining.club. Stay tuned for some upcoming news. You know, I can't keep my, I can't sit still. You know, my ADHD doesn't allow me to sit still. So have some fun things coming up and we are on Discord actually. I don't know if you are into NFTs but, stay tuned. Hint, hint, hint, hint. So join us there. Stayshining.club, join our discord server. We have awesome conversations. I love talking to you in there. It's super fun. The other way to find out about my work as a business owner, I am a business coach and I support first-generation entrepreneurs build, create, grow their businesses in ways that allow you to feel free and bring wealth while we dismantled the damages of Calladita Culture. If you resonate with that, and you're curious about what I do, cafeconpam.com. Check out all my offers in there and I love to stay connected with you. So whichever form you choose, we, we out there. Y bueno, ya se acabó. Se acabó el episodio. I feel like I did my rant in the beginning and kind of like towards the end. So I hope you enjoy this whatever choice you want to make. It's yours. I want to make sure that you know, that the choice is yours. And if you are not a woman, I hope that you support that women have choices because as women get choice and agency for the bodies, then non-binary folks will be too. And so it's this trickle effect of liberation that happens as other people get more agency.
Sending you so much love, so grateful again that you are here y pues, como siempre, stay shining!