Pandia’s Dr. Sophia Yen On The Right To – And Need For

On the morning of June 5, 2024, an inflatable intrauterine device (IUD) met the commuters going in and out of Union Station in Washington D.C. An IUD is a quarter-sized, T-shaped piece of plastic that is inserted into a women’s uterus as a form of contraception. The one in Washington D.C, in contrast, was 20 feet tall and aimed not to prevent pregnancy but to bring awareness and support for the Right to Contraception Act, which was facing a critical vote in the Senate later that day.

The June 2024 vote on the Right to Contraception Act was the third time that this Act has faced a test of support. In 2022, Senators Patty Murray (D-WA) and Ed Markey (D-MA) first introduced the bill, which aims to protect the right of individuals to obtain and use contraception and the right of healthcare providers to distribute contraception. It would also prevent any impediments to accessing “contraceptives, contraception, and contraceptive-related information. (“Contraception” refers to all birth control, including “contraceptives”, which in turn, are specifically used to prevent sperm from reaching an egg).

In other words, the Right to Contraception Act would take the right to access contraception – which the Supreme Court established for married couples in Griswold v. Connecticut in 1965 and for unmarried people in Eisenstadt v. Baird in 1972 – and enshrine it into federal law. Birth control is currently legal in all states and is required by law to be offered with no copay or deductible by health insurers. However, as of April 2024, 53% of voters believe access to contraception is at risk in their state – especially after Dobbs v. Jackson Women’s Health Organization overturned Roe vs. Wade and limited access to abortions: another reproductive health right defined by the Supreme Court.

The Democratic-led House passed the Right to Contraception Act when it was first introduced in 2022, but the bill didn’t receive a vote in the Senate due to the lack of necessary votes needed to end a filibuster. In June 2023, about a year later, the Right to Contraception Act was reintroduced to Congress but didn’t have sufficient support to pass in the House or to end the filibuster in the Senate. It fell short once again in June 2024; it needed 60 votes to move forward and received only 51.

“As a woman, as a mother, as a physician, it is inconceivable to take away birth control” says Dr. Sophia Yen MD, MPH, co-founder and Chief Medical Officer of Pandia Health. The Sunnyvale, California-headquartered company was founded in 2016 with the original goal of preventing women from running out of birth control. “I conceptualized the idea for this company after realizing that the constant pain points various family members and friends were experiencing were identical to my personal experience”, Dr. Yen shares. One of those pain points was visiting the pharmacy; as Dr. Yen explains, “One of the main reasons that women don’t take birth control is that they don’t have time to get to the pharmacy every month”. Pandia delivers contraception directly to its customers’ doors, eliminating this need for a monthly stop at the pharmacy – and the subsequent barriers to access that women may otherwise face. For example, they may be at the pharmacy ready to pay before learning insurance no longer covers their contraception or they might not have the time to reach the pharmacy before they run out of birth control pills (which are most effective when taken at the same time every day).

Around 30% of all reproductive age women in the United States may not even have a pharmacy or a health clinic that they can access in the first place. More than 19 million women of reproductive age in the United States live in a contraception desert, meaning that they lack reasonable access in their county to a health center that provides the full range of birth control methods.

If women can overcome those barriers and access contraception, though, the benefits are numerous and wide-ranging. Economically, every dollar spent on contraceptive services saves almost $6 of public spending through reducing unwanted pregnancies alone. In terms of education, access to contraception before the age 21 has been found to be the most influential factor in enabling women in college to stay in college. Or, as Dr. Yen asks, “How many women would’ve graduated high school, college, or higher education without birth control?”

Contraception can have a positive effect on personal healthcare as well. Birth control is often the first-line treatment for endometriosis (which affects one out of every 10 women) polycystic ovarian syndrome or PCOS (which affects one out of every five to 25 women), and heavy bleeding (also known as menorrhagia, which affects one out of every five women). All in all, as of 2022, 90% of women between 18 to 64 years old in the United States reported using contraception at some point in their reproductive years.

Accessible contraception also has public support. In a 2022 poll, 89% of Americans said condoms and birth control pills should be legal in all or most cases. In a 2024 poll, 91% of registered voters believed that birth control should be legal. Another poll from 2024 found 79% of voters believed having contraception widely available in the United States would be “very or somewhat good” for society.

Dr. Yen herself has spent eight years focused on birth control. She ranked all 40 different birth control pills based on their side effects – such as whether they were more or less likely to cause heavy bleeding, acne, or cravings – and how those side effects vary among women of color. For example, Black women who take oral contraceptives may see an increase in markers that signify an increased risk for developing heart disease or diabetes. White women do not see that same increase.

Like their side effects, the efficacy of these different options can vary. Prescription birth control can be effective for women with a BMI of up to 35 while over the counter birth control can be effective for women with a BMI of up to 26. Opill, the new over-the-counter birth control pill, has a three-hour window for maximum effectiveness while combination pills – those that contain both estrogen and progestin – have a 24 to 48 hour window. In short, as Dr. Yen summarizes, “Not all birth control pills are the same”. To help Pandia customers, 45% of whom are women of color, she used her ranking and data to create an algorithm that helps them find their best fit among these options. As a result, Pandia has an 82% retention rate at Year 1 – compared to a 30-55% retention rate for primary care and telemedicine companies over the same time frame – due to this personalized and data-driven approach to care for patients who are new to birth control.

“I made the company for me – so I don’t have to go to the pharmacy every month – now it’s for my daughters,” Dr. Yen, a woman of color herself and mother to women of color, says but adds that, after the Dobbs decision, her daughters now have fewer rights than she had at their age. “The Dobbs decision set us back half a century,” she explains, noting that outlawing abortion doesn’t stop abortions but, instead, can delay care and/or force women into the “back alley” days where they pursued unsafe abortion solutions out of desperation. Rather, the “most effective” way to reduce unintended pregnancies and, subsequently, abortions, is by improving access to “consistent, effective, and affordable contraception”, according to the American College of Obstetricians and Gynecologists. Or, as Dr. Yen puts it, “If you’re anti-abortion, then support birth control”.

For individuals who want to show that support – for contraception specifically or access to women’s healthcare generally – including contraception, Dr. Yen recommends using their voices: as voters, as constituents, and as leaders themselves. Beyond voting in November, they can write to their current representatives or potential future representatives now to ask for those politicians’ stances on accessible birth control, comprehensive sexual education in schools, and the Equal Rights Amendment (ERA). The ERA guarantees “equality of rights under the law for all persons”, regardless of their sex, gender identity, and sexual orientation. Since – as former Supreme Court Justice Ruth Bader Ginsberg said – full and equal citizenship “is intimately connected to a person’s ability to control their reproductive lives”, passing the ERA could help protect abortion and birth control solutions. Dr. Yen adds, “Let [your representatives] know that you care and that you’re watching”. Women can also run for political office or other leadership positions themselves. “Things should always be getting better,” says Dr. Yen, “and they will – with more women. We need 50% in government, in leadership positions, and on boards.”

Finally, Dr. Yen says that society should hold those without uteruses responsible, whether they are in politics, in leadership positions, on boards, or otherwise. After all, it takes two people to make birth control a want, a need, or both.

Pandia itself continues to support women’s healthcare – and to grow as well. It currently offers emergency contraception, acne solutions, and menopause solutions alongside its original birth control products. Dr. Yen is also leading a research study based on genetic markers, which can influence a women’s response to a certain contraception method; patients submit their genetics profile and Pandia leverages artificial intelligence and its existing database to determine which birth control pill is the best match for a patient’s genetic profile. Pandia, and companies like it, can thus help fill the needs of women looking for the type of accessible and affordable birth control that could be protected by the Right to Contraception Act, which may be brought to the floor again in the future. The 20-foot IUD that drew attention to the Act, meanwhile, was last seen in mid-June in Miami, Florida, and will continue to travel throughout the election – and to bring attention to the right to and need for contraception, wherever it appears next.