Monday, Jan 31, 2022 • 45min

Elizabeth Ruzzo, adyn

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We’re in the business of talking to very impressive people who are working to solve incredibly tough problems— but Elizabeth Ruzzo, founder and CEO of adyn, may be one of the most impressive yet. Not only did she develop the only test for women to ensure they are prescribed the birth control that will be the least likely to have detrimental side effects, she also founded the company and fundraised as the sole employee of the company. She talks to Darrell and Jordan about the challenges she faced as a solo founder/employee raising money for a solution for birth control, why she decided to leave academia, and the complicated regulatory maze she had to navigate to get adyn off the ground.
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Speakers
(3)
Elizabeth Ruzzo
Darrell Etherington
Jordan Crook
Transcript
Verified
Darrell Etherington
00:00
Hello and welcome to Found. This is
TechCrunch's
weekly podcast where we tell you the stories behind the startups. It's the most important podcast on the internet. That's the title case, that's our slogan or tagline, as everyone knows. I'm your host, Darrell Etherington, and I'm here with the implant to my
birth control
pill.
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Jordan Crook
00:19
Oh, man. I'm Jordan Crook.
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Darrell Etherington
00:20
Listen, we have our mechanic, we have to do it.
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Jordan Crook
00:23
I know, but I'd rather be the
birth control
pill.
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Darrell Etherington
00:28
Okay.
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Jordan Crook
00:28
I don't wanna be an implant!
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Darrell Etherington
00:29
You don't need to get too into it. Don't think too much about it expressed as a physical reality. Let's just keep it light.
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Jordan Crook
00:37
Let's just say we are always protecting each other from unwanted financial and emotional cost.
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Darrell Etherington
00:44
Listen, this is dicey stuff that we're getting into here, but it's for good reason. Because what we're doing right now is destigmatizing, talking about this. We're enacting that currently.
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Jordan Crook
00:57
Totally, being open about it.
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Darrell Etherington
00:59
But we do a much better job on the podcast this week, the actual podcast. Because we're talking to Elizabeth Ruzzo from adyn. adyn is a company that helps women make the right health decisions for them based on their hormonal state and their genetics to find a
birth control
option that won't have negative side effect, hopefully. Or will have, you know, the least amount of negative side effects that they can manage, and that's like the immediate need and product servicing target.
Share
01:31
But also, Elizabeth is very passionate about just making scientific discoveries in general more inclusive, and creating datasets that are more representative of the actual population for scientific research, whereas most of the ones that exist today, overwhelmingly male, overwhelmingly white, not really representative of the actual human community, right?
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Jordan Crook
01:51
Yeah.
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Darrell Etherington
01:52
So let's go ahead and get right into the episode because she's much more impressive than us rambling here.
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Jordan Crook
01:58
For sure. Implant.
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Darrell Etherington
02:04
Hi, Elizabeth. Thanks for joining us.
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Elizabeth Ruzzo
02:07
Hi, thanks for having me.
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Darrell Etherington
02:09
Yeah, we were just talking about this before we start recording, but you're our first ever double Equity/Found podcast guest. We do a different thing here, sSo hopefully it's not too much retread versus what are equity pals did. We probably will cover some of the same ground.
Share
02:26
Like, for instance, we do want to hear what adyn is, and you're the best person to tell us. So if you can give us a very high level overview of what adyn is and does, that would be great.
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Elizabeth Ruzzo
02:36
So, adyn is a precision medicine company and we have created the first test that's designed to help prevent
birth control
side effects. So, I'm not sure how much you know about the
birth control
space, but there are nearly 200 options on the market, and the current way that it's prescribed is essentially trial and error. So we're basically bringing science into that selection process.
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Darrell Etherington
03:02
Yeah, I mean, I'm not personally super familiar, but I do know. My partner has changed depending on adverse reactions or whatever, or how her body reacts to the things, she's changed it a couple of times. And that that's what you're talking about, right? It was like you went and you prescribed a certain kind, and then like "oops! This one isn't good, I guess I'll try another one". Luck of the draw, let's see what happens.
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Elizabeth Ruzzo
03:22
Exactly.
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Jordan Crook
03:23
So what does that test mean? Like, what is that looking at, is it looking at our blood, or?
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Elizabeth Ruzzo
03:27
Yes, blood and saliva. So, it's an at home test. We collect a small finger prick of blood that we use to analyze hormone levels, and a saliva sample that we use to analyze DNA. And then we generate those
data
in a clear certified lab, and create a report that looks at your genetic risk for experiencing certain side effects.
Share
03:51
And then we also match you with a virtual care provider, so you're not just left on your own trying to understand your results. You can actually have a visit, ask questions and get a prescription, if you want, based on your preference, reproductive goals and obviously your unique biology.
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Jordan Crook
04:08
So your doctors can actually write scripts. So I don't have to take this to my PCP or my gynecologist or anything, I can just stay in the adyn network for
birth control
.
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Elizabeth Ruzzo
04:18
Yeah, exactly. We've built a full end to end precision medicine platform. So, from the testing all the way through to the delivery of prescriptions.
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Darrell Etherington
04:26
That's great.
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Jordan Crook
04:26
That's like a really hard business to build. Are you tired?
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Elizabeth Ruzzo
04:30
I'm tired. Very tired!
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Jordan Crook
04:33
I was like, as you were talking, I was like, and that's a regulatory thing.
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Elizabeth Ruzzo
04:37
I also hang out with lawyers a lot, no one warned me about that.
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Darrell Etherington
04:44
But how did you, what did you set out to want to do, and how did you come to that realization, like, to begin with?
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Elizabeth Ruzzo
04:50
I mean, in life I started out thinking I was going to become a professor of human genetics. So I was on that track, you know? Went to grad school, got my PhD in
genetics
and
genomics,
even did a postdoc at
UCLA
for a number of years, and then started imagining what life outside the ivory tower, you know, could look like.
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Darrell Etherington
05:12
Oh yeah, it's scary. It's scary. If you're inside there and you think you're going to stay inside there, it's safe. It's safe in there, safe and warm.
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Elizabeth Ruzzo
05:19
It's safe, it's warm. You feel like you're doing good no matter what. You're kind of like ingrained to think that any for profit corporation is the devil, just inherently,
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Darrell Etherington
05:30
I still think that. Even though I work for this one.
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Elizabeth Ruzzo
05:32
I mean, there's a lot of them that are bad, it's true. So, you know, I think a lot of it was me thinking about what was the problem I wanted to solve. And there were really throughout my, at that point, 10 + years of academia, I kept encountering a couple of health inequities that I knew I wanted to work on.
Share
05:51
One was because of working in
genetics
in particular, we had this huge bias, especially towards sequencing individuals of European descent. Which meant any time I did a project looking for risk variants in the non-European population, I just had less statistical power to make the same kinds of discoveries, and it was incredibly frustrating. And so I knew I wanted to work on that.
Share
06:12
And the other thing I encountered when working at
UCLA
on autism, autism has this 4 to 1 male to female sex bias. So four times as many males as females get diagnosed, and we're trying to understand the biological basis of that difference. And in doing that it was impossible to ignore the medical research gaps that exist with gender, partly because women weren't required to be included in clinical trials in the US until 1993.
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Jordan Crook
06:38
Ridiculous.
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Elizabeth Ruzzo
06:39
It's really insane. So, both of those were things I knew I wanted to work on and then I sort of came back to also another idea that I had which was a pain point that I had experienced, which was trying to find the right
birth control
.
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Darrell Etherington
06:55
So a lot of those things theme like things that are perhaps problems better solved from within academia, right? But how did you decide like, this isn't the way to do that work? Because I had a similar realization like, "oh there's not a lot of real world things happening in here. " It is an echo chamber in the degree that it's often portrayed in media, right? But like, coming to that realization is not easy, especially from within it, right?
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Elizabeth Ruzzo
07:19
Right. And so part of how I got there was sort of my lightbulb moment about the scientific approach we're taking. So basically, why I think of us as a precision medicine company? You know, precision medicine is the idea that not one size fits all, we need to be able to tailor diagnostics, treatments, medications. And to do that you need ideally not just genetics, but additional biomarkers.
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07:43
And so sort of the lightbulb moment I had was, if we could combine these large scale population genomic studies that I've been working on doing, with longitudinal hormone
data
. So not just looking at a snapshot in time, but trying to measure it over time, that that could make a really big difference. And let us look at a bunch of unmet needs, not just
birth control
.
Share
08:02
But what
birth control
let me think about doing is partnering with women throughout a very long longitudinal course. And so part of what made me think about leaving academia to do that was realizing that this direct to consumer model really lets you partner with people for potentially a long time.
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Darrell Etherington
08:19
Yeah, yeah, for sure. And and and doing practical good while you're in that process.
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Elizabeth Ruzzo
08:24
Right. Like the fact that we can offer something that adds value from the start is what made it feasible at all.
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Jordan Crook
08:30
So what's the price point? There's one question. Like, is that something that is also being democratized here, or it's a premium product because we're offering more precision, and you don't have to do the trial and error?
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Elizabeth Ruzzo
08:43
So, the honest answer is it's more expensive than I want it to be. So, right now it's about 350. But when you think about it, you're getting a genetic test, hormone test and virtual care visit. So it really is a high value product, plus you're saving yourself all that pain and trial and error.
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08:60
But my goal with adyn, our stated mission, is to make scientific discovery more inclusive, and I don't think we can really truly do that at that price point. So we're definitely working on figuring out, hopefully with scale and other things, how we can bring that price point dow, a and also partner with nonprofits to try to distribute the kit in a way that makes sense.
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Darrell Etherington
09:20
Like, what is the history of cost, and how has it come down, and how does it potentially... you mentioned scale, but what are the things that are contributing to that?
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Elizabeth Ruzzo
09:28
Yeah. So, the cost of genomic sequencing and
genotyping
in general has fallen consistently over the last 10 years. So part of what will happen with scale is we can buy the reagents we need in bulk, we can run more samples at a time in a high throughput way. So there's lots of things like that that can help bring down the cost.
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Jordan Crook
09:46
Is there a way to do something? I'm just brainstorming here.
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Elizabeth Ruzzo
09:49
Oh please, bring it on!
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Darrell Etherington
09:50
Are you going to offer product ideas?
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Jordan Crook
09:52
No, no, not, I'm not. I've actually never been on
birth control
, that's one of the benefits of being a lesbian. Well, I mean, there are plenty of lesbians on
birth control
, but anyway.
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Darrell Etherington
10:01
I thought you were going to say there were plenty of benefits to being a lesbian.
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Jordan Crook
10:04
There are also plenty of benefits to being lesbian, is a big part of it.
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Elizabeth Ruzzo
10:08
Good point, because
birth control
is medicine, so there's many other reasons to take it.
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Jordan Crook
10:13
This is a fun way to launch into my thought, by the way. So, you're talking about being able to decrease price by achieving more scale. Has anyone ever thought about what it would be like to pay back those early customers? Right? I like the way that you're talking about partnering with this community like, oh, we're doing this to partner with you. I get something, you get something. And not just your money, I get like this longitudinal
data
, right?
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10:37
Is there a way to say like, "hey, now, because we've achieved scale, we're bringing our price point down". Or even to telegraph, like, the more people you tell about this, the more quickly we can bring our price down and here's what we'd like to do for you, our early customers. I'm just literally thinking out loud, but-
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Elizabeth Ruzzo
10:52
I love that. I mean, our pilot customers are getting it for free. So they are definitely in on that ground floor. But yeah, I think you're totally right. I think that would be a very interesting model. I hope that there's a lot of people who really believe in our mission and what we're trying to do and because of that, they are motivated to spread the word. But you're probably also right that a financial incentive wouldn't hurt that process either.
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Jordan Crook
11:16
Well, who's your target demographically, or who's your core customers? Are these people that have been struggling to find the right
birth control
over and over and over again? Or are we talking about, you know, I'm a 14-year-old girl at home. Or are we talking about mothers talking to you about their kids? What does it look like? What's the breakdown?
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Elizabeth Ruzzo
11:32
Yeah, it's a really great question. Women use
birth control
in the
US
on average for 30 years. So there's potentially a very large segment that we are targeting, and you talked about two In particular. So one is thinking about, right now we're going to market 18 and over. But 7 in 10 teens use
birth control
for managing PMS.
Share
11:54
So it's a very common medication and it's also a very scary kind of thing to think about. So, it's interesting to think about working with moms or dads who want to make sure that their child gets on the right
birth control
, so that's definitely one segment. But I think you're also right in that, for now, the people who are the earliest adopters are going to be the people who have switched a bunch of times, right?
Share
12:16
So 52% of women have tried four or more methods. That doesn't even count multiple kinds of the pill. So I think it's those people who are in crisis and or just urgent need of
birth control
, who seem to understand that it's not a science when in fact it could be, are going to be the ones to be our earliest adopters.
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Darrell Etherington
12:35
I have a related question, that is maybe a dumb question and maybe a man question, but like-
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Elizabeth Ruzzo
12:42
Uh, I'm looking forward to this. Let's go!
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Darrell Etherington
12:42
Oh no. Please, go easy on me. Is there a challenge of even making your target audience aware of the problem? You mentioned a lot of people haven't even or have used many different kinds of
birth control
, but is there a sense, even among women, that like the pill is the pill and then maybe there's not even an awareness that there are different formulations that you can get?
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Elizabeth Ruzzo
13:03
I will be totally honest. I didn't even know how many options there were when I started working on this. I was truly, truly blown away. You know, my experience was I was prescribed to
birth control
in my early twenties to help manage another medical condition. There was no explanation given to me as to why that one was selected for me.
Share
13:22
I had no idea that there were so many choices they could have made and that they landed on one. And then I was gaslighted by my medical professional on the other end when I was honestly feeling suicidal and thought it was my
birth control
. And they said, "oh no no, that can't be. "
Share
13:37
And so a lot of it is education around the options, which is really the way you feel most empowered, is to understand what are your choices, what are the pros and cons of each of these. And then there's also education around the possible side effects and just what we're doing, like that there is a better solution out there.
Share
13:55
And I think one other point I should say when we think about accessibility and price is also, one thing that's different about adyn's tests compared to a lot of other direct to consumer tests is that it's medically actionable.
Share
14:07
So we've talked to a lot of doctors, obviously we have some of our own, who understand the value of this, right? They see that the way the standard of care is now is suboptimal, and that if they can have and leverage more information, then that's what they should do.
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Jordan Crook
14:21
Yeah. So I'm thinking about that a little bit, talking about the idea of it being actionable. There are people, and I'm probably one of them, right? Where like I've moved a lot as a kid, I moved a lot as an adult even and switched primary, care switched gynos, all of those things. And the process, that is terrible. I mean, it's like so so terrible, and they're asking you about things like, I have no clue. You know? Like what do you mean, I don't even know those words.
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Darrell Etherington
14:45
I still don't know my blood type. It came up the other day. I don't know what it is.
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Jordan Crook
14:48
But like, I shouldn't be responsible for that information. I don't understand it. I haven't been trained in it. I want someone else who I know and trust to be solely responsible for all of that information, which is why I'm super attached to the doctors that I have now, right?
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15:03
So when you offer me a virtual care visit, and I've been going to my gyno for whatever, six years. And we have a rapport, she knows what's up, I know what's up. And I don't want someone else prescribing me something, right? Like, I want your test and I want to take it to her and be like, what do you think? How does that work? And is there some sort of certification or what, you know, what does that mean?
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Elizabeth Ruzzo
15:24
Yeah. Honestly, that's next on the roadmap. We are launching with this full end-to-end solution for many reasons, including that we can have a tight line of communication with our providers to get automatic feedback on things like "hey, what question are you getting over and over about this report? How can we make it more clear to people? " I think there is inherently a big part of education in what we're doing.
Share
15:48
And so I think the way that adyn changes the standard of care is not by staying virtual, right? It's by truly going into clinics, hospital systems, your providers. And so step one will be what you're describing, where the consumer takes it on themselves to say "hey, I really would like to take this test and show it to my provider. How can I do that? " And we build a login for that provider to be able to go in and see your results in a secure way as well.
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Darrell Etherington
16:14
So, the other question I had about just that, our doctors depending on the network. Are they incentivized to prescribe certain ones, and does that become a complication? And another reason to go to own the whole banana, I guess?
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Elizabeth Ruzzo
16:26
I mean, there are kickback laws intentionally, because what you're saying is clearly a big concern. You don't want doctors prescribing stuff because they're paid to do so. It's also the reason why in academia we got free lunches a lot, because those pharma reps come and hold the lunch and it's an educational opportunity, but they're not exchanging money money.
Share
16:46
And so the way it works from, you know, interviewing dozens of doctors at this point, is there are criteria, it's not a complete shot in the dark, but it's mostly a shot in the dark. There's a table from the
CDC
called the MEC - medical eligibility criteria -, that kind of lists out some of the worst contra indications you could have, like if you're a smoker over 35, if you're on anti-seizure meds, things like that.
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Darrell Etherington
17:11
But it's basically just like in the, like, these things they cause death. So don't do that.
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Elizabeth Ruzzo
17:16
Yeah, it's a lot of the worst areas. So the way it works is, you know, a lot of doctors have their go-tos that have worked well in their experience, and they start with that, and that's the beginning of the trial and error process, right? And the burden is on the patient to come back and say, hey, I'm experiencing this and I recognized it as being able to like be attributed to my
birth control
because of the timing, x, y, and Z.
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Darrell Etherington
17:43
And I recognize that that's also not the way that it should be. Because a bunch of people are really just like, well I'm experiencing this thing and I guess that's just cost of doing business, so I'm going wield with it.
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Jordan Crook
17:52
I think that's a lot of female things, right? Like, how common is the
endometriosis
, right?
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Elizabeth Ruzzo
17:58
One in ten.
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Jordan Crook
17:59
Yeah. I remember going to my gynecologist, and she was like, "How much pain you experience during the period? ". And I was like, just the normal amount, you know? And she was like, "What is the normal amount? "
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Darrell Etherington
18:08
Normal amount is my favorite. An answer to a medical professional and also the one that is consistently like-
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Jordan Crook
18:15
Yeah, they're like, what does that mean?
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Darrell Etherington
18:17
I love saying that to my GP, the normal amount because, and then she's like "Darrell, how much is that? Let's put it on a scale of whatever. " And then I say, and she's like, that's not how anyone-
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Elizabeth Ruzzo
18:26
That's not the normal.
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Darrell Etherington
18:28
You're not normal at all. Yeah.
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Elizabeth Ruzzo
18:29
Right, right.
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Jordan Crook
18:30
You know, she's like, don't say that. Yeah, exactly. So I mean there's a bunch of stuff, I feel like, when it comes to women's health that is like, you just expected, price of business, right?
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Darrell Etherington
18:40
Well, especially if it's not discussed. It probably comes up more in women's health because the things are discussed more generally, or historically they've been kind of like, well that's a taboo topic or that's something that people shouldn't discuss in public.
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Jordan Crook
18:51
And there's also, there are taboo topics for men too. But there are men who are like, hey other men, give me money and I'll go fix those taboo things because I'm a man, I'm your bro, right? They go fix it. And that's a different story for women.
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Elizabeth Ruzzo
19:05
And I think
birth control
in particular is interesting there too, because you know,
birth control
is freedom, right? It's changed our ability to get education and be in the workplace and was, you know, it's almost anti-feminist to talk badly about it. So I think it's only recently that there's been more vocal uprising about, hey maybe we shouldn't have to deal with this as the status quo.
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Jordan Crook
19:27
So one of the other questions that I had was around, we were talking about like the next phase, right? Like getting into clinicians, getting into doctors' offices, etcetera. What about into pharmaceutical companies in general? This feels like
data
if it were at scale that would be highly, highly valuable to them, right?
Share
19:45
Because if you're thinking in a dollars and sense framework, then the best way to be the most competitive with one of the 200
birth control
products is to try to eliminate as many side effects as possible, right? And understand why are they happening, and to what people, and how can I make sure that the right person always gets my medicine?
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Elizabeth Ruzzo
20:04
And yet here we are. I mean, that does not seem to have been the incentives by which they're operating, right? And why is that? Because we're talking right now about highly effective methods of
contraception
, that metric is meaning they prevent pregnancy. So they meet those criteria. The rest, you know, you look at that list of side effects, it is sometimes quite shocking.
Share
20:29
They're not optimizing for that, they're optimizing for enough of a different variation that is patentable. So the incentives are different. But to your point about thinking about partnering, you know, I have no interest in developing drugs, I don't want to be a pharmaceutical company, I want to stick to what I love, which is precision medicine and helping people.
Share
20:47
We are actively working on thinking about our
data
sharing policy. You know, we're not in the business of selling
data
. But if there were an opportunity to partner for sure with an academic institution or someone else who I felt really could use aggregated and anonymized
data
in a way that would truly help move the needle on women's health, we would consider doing that. And of course every customer would have the ability to opt in or opt out of that process.
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Jordan Crook
21:14
I'm really disappointed to hear you say that you're not going to develop any pharmaceuticals, 'cause I was thinking, and I need you to answer this question, why isn't there
birth control
for men?
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Elizabeth Ruzzo
21:23
They're working on it. But the most depressing part is there have been multiple clinical trials that have quit because the men complained of, guess what? Acne, weight gain and depression.
Share
21:36
Oh, is it tough on them? Own!
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Darrell Etherington
21:36
Yeah, pretty bad. But if I'm thinking that the pharmaceutical companies are, if I'm doing like the most nefarious case, right? It's like well, if you shared all this
data
with them directly, they would probably use it to lock up a patent and then just shelve the thing. Because we've already spent all the R&D in making this thing that already works fine. It works fine by our definition.
Share
21:58
You can't see my request as an audio podcast, but I did that. Right? It's like they're much more incentivized to just defend their existing spend and investment, if they think they can get away with that.
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Elizabeth Ruzzo
22:08
It's a horrifying point that I had not honestly fully thought through, but is exactly why I'm very, very wary about who we would partner with in that scenario, right? They need to truly have it baked into any agreement that they're not going to do that. I mean, that would be horrible.
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Jordan Crook
22:26
Without defending big pharma, I do feel like it's important to say that my partner works for big pharma and as a doctor of pharmacology. So I'll just put it out there, before we get too rough and tumble.
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Darrell Etherington
22:38
That was just like if, you're being overly cautious, this is something to keep in mind.
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Jordan Crook
22:42
They could, you know.
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Darrell Etherington
22:45
I'm sure Elizabeth's many lawyer friends will appreciate.
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Break
Darrell Etherington
23:42
But I want to talk more, because you keep talking about you know, adyn is a precision medicine company, and it sounds like you have more general kind of ambitions beyond this, or perhaps there are other areas you want to explore. And when you were talking about that too and like, I had a conversation, it was actually a disrupt, but I talked to
Uğur Şahin
from
Biontech
and he was talking about the same thing, right?
Share
24:03
Biontech
was originally designed as a precision medicine company. What they wanted to do is tailor medicines to the patient and take into account environmental as well as genetic predispositions. And so that is literally like when you get a medicine, is the medicine for you, the individual patient, right? And that seems like a big, big area of investment and interest. So what are your broader ambitions there and what kind of excites you about that field?
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Elizabeth Ruzzo
24:28
I mean, I think what excites me about it is how much green space there is, because there's not been enough research dollars going into a lot of these areas. So there's a ton of different direction we could see this going, right? There are some things that are almost very parallel to what we're doing with adyn, like when you think about menopause and hormone replacement therapy.
Share
24:51
But I get really excited when I think about things like early diagnostics for disorders like PCOS,
endometriosis
, uterine fibroids is another one where it's incredibly common, more common than it's even diagnosed, and the later it's diagnosed, the more invasive the treatment and surgery and the less likely that surgery is to work. And so the earlier you can get it, the more it has a difference.
Share
25:15
So basically, I'm interested in studying anything where I think we're going to be able to generate a medically actionable outcome, meaning you're actually going to change somebody's life and health.
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Darrell Etherington
25:25
And is that something you talk about when you're talking to investors? Or how do you describe when you're going out and having those conversations about fundraising?
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Elizabeth Ruzzo
25:33
I mean, I definitely try to pitch the bigger vision, right? And I think at this point now we've at least proven out that we can build, we have built, that first platform and have a product to go to market. And it's almost tying back my own ambition from running wild and doing all the other products I want to do too before we fully have product market fit with the
birth control
test.
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Darrell Etherington
25:55
And we should mention actually just that adyn is in early access, right? For anybody listening. So you can go up and you can request early access, but you can't like immediately just sign right up.
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Elizabeth Ruzzo
26:05
Right, right. You can't purchase quite yet.
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Jordan Crook
26:07
How did you come up with the name adyn?
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Elizabeth Ruzzo
26:08
So it is from the greek, monadiki dyname, which means unique strength.
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Jordan Crook
26:14
Totally familiar with what did you say?
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Elizabeth Ruzzo
26:18
Monadiki, so I took the A D, from that. And dyname, so the Y N from the second word.
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Jordan Crook
26:26
I like it.
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Darrell Etherington
26:27
it's cool.
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Jordan Crook
26:27
It's like also like the name of many kindergartners right now too.
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Darrell Etherington
26:31
It is, I was going to say. I think I suggested it to my sister who is pregnant right now, actually.
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Elizabeth Ruzzo
26:39
I like it. I mean that 's not the spelling normally, which is probably "Aiden", I think that's more common.
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Darrell Etherington
26:45
How has it been for you, like, the fundraising? Because you know, your background was academia, and then you got out of school and then you did a startup, right? Is that basically how it went? Yeah.
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Elizabeth Ruzzo
26:56
Yeah, basically.
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Darrell Etherington
26:57
So how has that been for you? Like, first of all, I mean fundraising to start I guess, but also like building a company, right? And build it being a founder there.
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Elizabeth Ruzzo
27:07
I mean, I think I was a little bit unique in my academic background in that human genetics projects are very collaborative, right? You need many clinical sites, many people involved. So I'd sort of managed projects and teams before, which is not always the case coming out of academia. But in terms of fundraising, you know, it was hard.
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27:27
I think it was obviously good that I had deep technical expertise. I definitely also got a lot of almost this is too good to be true, and somebody else would have done this already. And it's like, well, nobody else has my exact background and precision medicine and actually experienced this pain point, right?
Share
27:44
And you know, I had a question that I wrote my template for taking notes in these meetings. At the top of it always said: did they understand the problem? And that was the number one predictor of if they wanted to invest or not. And if it was a male investor, they would tell me, oh, I get this, my wife had that, my sister had that, my partner had that, my mom told me about that.
Share
28:04
But if they hadn't seen it firsthand, meaning somebody they trusted had told them that that was a pain point for them, they were like, "hmm, I think this is fine. I think doctors know what they're doing and people just figure it out that way".
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Darrell Etherington
28:16
Yeah. I mean, I can see how that would be the default. It's one of those things you always see in television movies, whenever somebody like, well, yeah, this is an important issue, I realized once I had a daughter or whatever. I realized like, oh, it's important. And you're like, I wish that didn't have to be the thing that's the realization point.
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28:34
I mean, I'm guilty of this at this sort of the thing. I mean, you would have been on the podcast regardless of whether my partner had that issue or not. But I can see how that would be like a very frustrating kind of blocker to come across, right? Because it's not true, I doubt it's true in the opposite direction. I mean, I don't have the numbers in front of me, but I bet not, right?
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Elizabeth Ruzzo
28:53
And you know, it is what it is. There's lots of investors out there, there's lots of good company ideas. You want the investors who get it and believe in you and see why it's the right thing to bet on.
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Darrell Etherington
29:04
So how many meetings you have to get? Like, what was your hit rate like?
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Elizabeth Ruzzo
29:07
Oh boy, I don't even know if I ever went back and counted all of that. I mean, I went through YCombinator, which helped accelerate, obviously, create that FOMO. I do know that the first couple of checks were really painful, and then it was oversubscribed landslide pretty quickly. So that was good, but getting those first people on board was, was a lot. A blur.
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Darrell Etherington
29:30
Was it facilitated from those first people, like once those first people in there making introductions, or was it more like you still have to do all the legwork to get it in?
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Elizabeth Ruzzo
29:38
I still had to do a lot of legwork and luckily we had a lot of interest from demo day, so there were a lot of people to respond to and it was more about just like sequencing and following up with everyone. And then once I had my lead investors,
Lux Capital
and M13, you know, they really helped to make other introductions, especially for like strategic angels and things like that.
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Darrell Etherington
29:57
Lux Capital
, we should mention, I don't think we have to disclaim, but Danny Crichton is now in
Lux Capital
, who was on our team.
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Elizabeth Ruzzo
30:04
Oh, cool.
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Darrell Etherington
30:05
Disclaimer, Jordan. I don't think it's necessary, but it's just a shoutout., That's more of a shoutout.
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Jordan Crook
30:10
Big shoutout to the squad!
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Darrell Etherington
30:12
So how about on the other side, I'm like being a leader and forming the team. Like, what was that like for you? What was kind of your major challenges you had to overcome with that and what else? You mentioned that some of it came naturally because you were already used to working collaboratively, but what kind didn't come naturally? And did you have to go acquire the skills?
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Elizabeth Ruzzo
30:28
What didn't come naturally in leading for me was setting really ambitious targets and hitting that balance between setting ambitious targets where people feel disappointed because you're not making them and keeping the sense of urgency, and we're going to be big, and we have to move quickly. We did have really incredible luck because of the mission with interest. We have literally hundreds of applicants. It's been pretty wild.
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30:55
And so the hard part is honestly figuring out what's the dream team who fits together, and I think we've done a really good job. I'm so happy with the team right now. Everyone gets along, they're collaborative, there are no big egos. It's a really magical time where I know we're going to keep growing and hiring more soon, but this super seven right now is pretty great.
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Darrell Etherington
31:15
Did you do it all during the pandemic?
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Elizabeth Ruzzo
31:17
Yes, it's been all during the pandemic. So when I fundraised, I was the only full time employee. So it's been since that raise to grow to the team of seven. Obviously we've had some contractors and things like that, but-
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Darrell Etherington
31:30
That's something we don't hear that often. Not only solo founder, but solo person at the company when you're out doing your fundraisers.
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Elizabeth Ruzzo
31:36
What kind of questions did you get about that? Did many people were like, well, why don't you have a co-founder? Like, why we hired a team yet? Or like, was that a thing?
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31:46
Yes, definitely. I mean, I knew it was going to be a thing, even when I applied to
YCombinator
, to the point where I only applied because I had done this summer school thing they had, where you could get $15,000 equity free, but you had to apply to the whole thing.
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32:01
And I was like, oh, well they won't let me, and I'm a solo founder, but let me get this $15,000. That sounds good. And then instead I got in and was like, okay, I guess I'm like leaving this postdoc and I'm going, I'm doing it. So that was a good push off the cliff.
Share
32:15
And yeah, there were lots of questions and I think skepticism just because it was a big ambitious vision and one person. But I obviously also had the network and the people in mind. So I would talk about that and advisors and you know, who I wanted to bring on, and how I was thinking about growing the team, things like that.
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Jordan Crook
32:32
What did you feel like was your key thing and fundraising that really tipped investors over the edge, like, had them on the edge of their seat. Is that your experience in
genetics
and
genomics
? Was it that those advisers you were naming and that network? What did you feel like was the clincher?
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Elizabeth Ruzzo
32:47
I think it was probably mostly my deep expertise, like literally right then as evidenced by me being the only person they were betting on me, but it was also the ability to get that pain point storytelling right. Helping whoever it was understand it, and the market size. Like when they're like, what's your market size? And I'm like: half the population for 30 years, you know?
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Jordan Crook
33:11
Yeah, market size is a fun one, right? You're like, listen to my tamp. But it's generally hard to fundraise for products that the demographic is women, because men tend to be investors, and they just don't get it, or don't care, or don't understand. But the
birth control
seems even more difficult, I don't know why I feel that way.
Share
33:31
Just something in my gut is like: they understand it even less, right? Like it's just this thing and like I hope you're on the pill, or get off the pill, let's have a baby, and like that's about it. Maybe I'm underselling dudes, but like, no.
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Elizabeth Ruzzo
33:44
Yeah, I mean, I think because even the complexity isn't clear, right? The fact that there are 200, and there's a bunch of different types, and then there's generic and brand, and like, you know, all synthetic hormones, and it's just complicated. And so getting in typically a very short amount of time for them to understand the complexity and why you need a complex approach to solve it, all of that is complicated.
Share
34:07
I would be super curious, and I'm wondering if you two in particular, now I'm giving you product ideas. I am curious to, if even once people were interested, if the kind of level of diligence that I was subjected to is the same as male founders or people not working in like a women's health space?
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Jordan Crook
34:26
My expectation would be that you, as a health tech company that's doing actual testing, genetic testing, taking people's blood. There's like such a huge regulatory framework that generally a health tech company should get more due diligence in my mind. So that feels like one step.
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Darrell Etherington
34:44
And the
Theranos
caused a whole bunch of caution, right? Like, among the casualists in the group, right?
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Jordan Crook
34:50
Yeah, we're like, let's not take their word for it necessarily.
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Elizabeth Ruzzo
34:54
My first name doesn't help.
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Jordan Crook
34:57
But I mean, I wouldn't be surprised at all, unfortunately. It's the stage we're at and whatever movement is happening right? Where it's like, I think there are many traditional VCs who are older, older men, older white men, generally, who are trying to learn something new and people struggle to learn things that are new when they're older, right?
Share
35:23
And it's not something that is obvious either. It's not like, hey, learn science, right? Which would be difficult enough, but it's learn about yourself. I think it's a difficult thing to do. So I think that there's effort being made, I don't want to like shit on everyone, right? I think there's effort being made out of kind of the wrong intentions, which is like, hey, it's really important to LPs now, I'll get bad media attention, blah, blah, blah, right?
Share
35:48
Like, I have to do this. And I think there's also some good intention there too, which is like the terrible like, I'm a father of daughters! Oh, I sure hope my daughter, you know, like just a moment of empathy that triggers something as well, which isn't great, but it's something, right? So I would say we're in some weird, almost middle ground to progress
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Darrell Etherington
36:09
And I think like, to agree with Jordan, we're at that stage where their door is opening, but there's still so many like inbuilt biases and things that I can confidently say, again, without real proof, to hand that you are scrutinized more closely than an equivalent male founder, right?
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36:27
I think it's also this is maybe reading too much into it, but I don't think so. Like
birth control
was, even its original creation, it was a moment of like taking power away from men, right? And it's like a thing that, especially, I think, for older generation, like it's just, it's something that they probably don't even realize is there, but at base they're going to have a reaction to it that is probably negative, like I don't want to touch that and I don't know why.
Share
36:54
And if they really analyze themselves and really went in to investigate why, it's like maybe has something to do with their inbuilt misogyny and how it threatens it or whatever, right? I'm just thrilled that you were able to get the attention at the stage you were. And as a solo founder, like, it's a terrific story, given how much it's kind of stacked against you even still, I think, right?
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Jordan Crook
37:13
Yeah, yeah. You don't need us to tell you to be proud of it, but that it is a really astounding achievement. To raise as a solo founder and healthtech for
birth control
, it's just like a stacked on, stacked on, stacked, right? And the business you've built as well, incredibly complicated.
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Elizabeth Ruzzo
37:30
Well, thanks. It doesn't hurt to hear it because I don't have time to remind myself. So thank you.
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Darrell Etherington
37:35
That's why you should come on TechCrunch podcasts more often.
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Elizabeth Ruzzo
37:40
I will try.
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Jordan Crook
37:41
Maybe that's one way we could, one final question we could ask. Is how do you balance your life out as a founder? I mean, you're in like, proper medicine health, but like, mental health is a big issue for a lot of founders and entrepreneur. How are you dealing with that?
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Elizabeth Ruzzo
37:58
I am trying to make time to meditate and go for walks, both of which are the first to go out the window when something hits the fan. But it's very important, and do yoga, and have therapist and all that good stuff. Because you're right, if you're not taking care of yourself. I think it's very clear how easy it is to burn out.
Share
38:20
So trying hard to stay balanced and make time for family and friends too. But that also goes, actually that goes out the window before the meditation.
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Darrell Etherington
38:33
At least it's there to go out the window as opposed to already gone.
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Elizabeth Ruzzo
38:38
Exactly, exactly!
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Darrell Etherington
38:39
All right, thanks very much, Elizabeth. It's been great talking to you and yeah, you had to participate in our little weird therapy hour here too. So I think accounts towards treating yourself.
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Elizabeth Ruzzo
38:51
Definitely. This was fun. It was such a pleasure. Thank you both.
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Darrell Etherington
38:57
So that was our episode with Elizabeth and adyn.
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Jordan Crook
39:05
I really liked Elizabeth. The topic and the company and the mission, is all super great, and I'm for it, behind it. But I just like also really like Elizabeth, and I think I like her attitude every time that we "oh I have a weird question" or "I have a really off the wall thought" she's like, yeah let's do this, right?
Share
39:24
Like, very hands on, ready to go, ready for anything, which I appreciate. I also think it's so impressive that she fundraised as herself as the company, right? Like, not even with a team. Solo founder scientist lady, like super cool.
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Darrell Etherington
39:41
We regularly have, I mean, basically every episode of this feature is a person who it's more impressive than us in just about every possible way, but this one really takes the kick for that, I feel like.
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Jordan Crook
39:52
I mean, they keep getting better, these founders. They, come on-
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Darrell Etherington
39:55
Or do we keep getting worse?
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Jordan Crook
39:56
Wow, I didn't even think about that, but it probably is both. It probably is both, now that you bring it up. I'm getting worse. Face palming as we speak about how much worse I'm getting.
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Darrell Etherington
40:07
Yeah, I'm just so impressed. We didn't really talk about this that much, but imagine just like, oh, okay school's done, what am I going to do with my life? This problem needs solving, I'm just going to go do it. I'm going to build a company to do it, and I'm going to go get the money to build that company, and I'm going to do it all on my own. I'm going to get into YC and like, all these things, right? It's just like an unimaginable level of ambition that I think is really, really honorable.
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Jordan Crook
40:31
Well, the business itself too, right? I mean, it's not even like she was in academia and was like, I'm really smart, you know, I know some people, maybe, maybe not. I'm going to just go start this company that like, I don't know, says yo to people when you push a button right?
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40:46
She's like, I'm going to go create a precision medicine company that helps sort out 200 different kinds of
birth control
, and I'm going to hire out like a virtual visit business as well, so that there are actual doctors who are prescribing things so my customers can take action right then and there, and you know it was really hard to build and it takes a lot of balls. Good for her.
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Darrell Etherington
41:10
Yeah, super hard business, but then also a problem that is something else that like came across and that is totally sympathetic, is just how obvious this problem is to the people who encounter it, and how frustrating it must be to just not have anybody attempting to do anything to kind of improve that situation.
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41:29
You know, she had her story about having suicidal thoughts that were a direct result of like an interaction with the
birth control
medicine she was on, and then being gaslitghetd by her position, right?
Share
41:39
And like, you know, our producer Maggie has a note that a friend had a similar kind of experience, right? And then I also talked to my partner and she had the exact same experience, where like her physician ended up saying like no, these things that you're imagining, you're imagining effectively right?
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Jordan Crook
41:55
It's not a big deal, whatever it is, get over it.
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Darrell Etherington
41:58
Yeah, she described that and then we were able to find like three supporting examples of it immediately with a zero effort.
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Jordan Crook
42:04
No, organically we were like, hey, by the way, there's this thing that happens with
birth control,
where you're going-
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Darrell Etherington
42:10
Not even that, it was just like, oh this is the person I had on, this is the topic we discussed and then that was like volunteered.
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Jordan Crook
42:16
Yeah, exactly, it's very organic, the kind of collective agreement on how this goes. And I think we talked about it a little bit on the podcast and it makes me sad but also hopeful that Elizabeth building what she is. But it's like my women have been told "That the cost of doing business, baby". You know? There's so many things, it's not just
birth control
or women 's health, there's a million things where you're just like, that's how life is, good luck.
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Darrell Etherington
42:40
Yeah. it's like, deal with it, that thing is unchangeable or whatever, right?
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Jordan Crook
42:43
Yeah and she was like, I don't think it should be unchangeable. Like, what if I changed it, right? And that's awesome. We need more people like that in general.
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Darrell Etherington
42:52
Yeah. And I think, I mean, the other larger mission too, like talk about having a startup that has terrific, just like mission alignment and double bottom line mechanics. Oh, we're also going to solve this disparity in terms of datasets for scientific research, like, available information, right? It's like that is so good, to be able to do that and then to be able to do it while providing a valuable service at the same time, right? That kind of alignment doesn't come along too often, so it must be great for adyn in terms of recruitment.
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Jordan Crook
43:24
And I just like the wave of not just women's health, but like health tech businesses that are kind of breaking down the stigma barriers around what we talk about and what we don't. Because if you can't have the first step, you know, of having, I mean, I made a joke in the intro about like, you know, pregnancy. But
birth control
is used for treating all kinds of things.
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Darrell Etherington
43:44
Right.
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Jordan Crook
43:45
Like, it is a very common... when we talk about tam, talk about a massive tam. It's like you or someone, you know, right? For sure like one out of two people probably, you know, is on
birth control
. The massive tam and yet like it's not something that we're talking about very regularly or with any compassion, maybe. Step one, right? And stuff can change from there.
Share
44:08
So I appreciate what Elizabeth is doing, but also just in general like how healthtech is kind of, started talking about things, put them into a colorful brand, put a commercial on TV, put it, you know, like have a social media presence and let it be part of the conversation.
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Darrell Etherington
44:21
Yeah, we talked previously with founders who are like kind of like building new communities around this, where communities didn't exist before, right? So it is a great and promising trend.
Share
44:30
But yeah, that was our episode with Elizabeth. I recommend everybody go check out adyn and find out more about that. And I also recommend everybody say that we're the best on all all internet platforms, wherever you're on, no one knows, no one knows how many stars there are in the review system.
Share
44:49
It's an unknowable fact, but what you can do is just like sort of movement, maybe a groundswell movement around conversation around Found the podcast. That's probably a good idea.
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Jordan Crook
44:58
We should stop talking about Found with so much stigma, you know?
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Darrell Etherington
45:01
Yeah, well, dicey again, dicey intro, dicey out.
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