The Art of Being Human

Medical device marketing has long been formal and risk-averse. But if you're not human, you're not heard.

We talk with two leaders at Axena Health — Mandy Pulliam and Christina Reita — to explore how the team behind the groundbreaking Leva Pelvic Health System addresses clinical correctness and approachability in their messaging. We discuss the importance of tone and language choices, empowering women through education and accessible solutions, and collaboration among teams to ensure that messaging is both clinically credible and approachable. We also touch on the changing dynamics in patient-provider conversations and the impact of generational differences on health discussions.

Product Context: Leva Pelvic Health System by Axena Health.
This discussion is for informational purposes only and does not constitute medical or investment advice.

A Perimenopositive™ podcast, powered by GrayMatter Agency, Inc.
©2025 GrayMatter Agency, Inc. (www.graymatter.agency)

See below for full list of series episodes.

Guests:
Dr. Samantha (Mandy) Pulliam, CEO, Axena Health
Christina Reita, Vice President of Sales and Marketing, Axena Health

Company & Product Links:
• Axena Health
• Leva Pelvic Health System

Creator Link:
• GrayMatter Agency: https://graymatter.agency/

Show Resources:
• It's Time for FemTech to Step Up — marketing insights, strategies, and tactics for women's health brands
• Episode Webpage: link t/k

Extras:
• Episode Mocktail Poster! Nojito: link t/k

Chapters:
00:00 Cold Open and Intro
01:56 Introducing Mandy Pulliam and Christina Reita
04:57  Making the Medically Important Approachable
07:23 Designing For Clarity and Real Life
10:49 The Impact of Simple Language Changes
14:49 Collaborating With Trust
17:34 Making Data Meaningful
21:50 Shifting From Funnels to Care Journeys
27:40 Results of a Successful Approach
29:37 A Cultural Shift in Women’s Health Conversations
34:14 The Best Therapy? One That She’ll Do
38:00 Follow Your North Star
39:52 Thank You and Outro

Series Episodes:
• Ep.1 Let’s Set the Record Straight
TOPIC: Unlocking opportunities in a world of misinformation for credible, emotionally intelligent marketing.
GUEST: DR. C (THE VAG DOC) https://www.tiktok.com/@thevagdoc

• Ep.2 Feminine by Design
TOPIC: Harnessing the powers of empathy, listening, and community to shape brand relevance.
GUEST: IKRAM GUERD, Aspivix

• Ep.3 Leading the Shift
TOPIC: Changing the conversation to open minds, spark dialogue, and move markets.
GUEST: TRACY MACNEAL, Materna Medical

• Ep.4 The Art of Being Human
TOPIC: Transitioning your voice from clinical to conversational for authentic, relatable connection.
GUESTS: DR. MANDY PULLIAM and CHRISTINA REITA, Axena Health

• Ep.5 The Power (and Pitfalls) of Influence
TOPIC: Working with creators, ambassadors, and UGC to build trust and amplify impact.
GUEST: ERICA GATLIN, CEG Agency

• Ep.6 The FemTech Social Media Playbook
TOPIC: Platform strategies to make your message stick and spread.
GUEST: DR. ANJALI MALIK, BRCA Strong  https://www.tiktok.com/@anjalimalikmd

• Ep.7 What Investors Really Want
TOPIC: Insider perspectives on winning attention and securing funding in women’s health.
GUEST: AMY MILLMAN, StageNext LLC

• Ep.8 Empowering a FemTech Sales Force
TOPIC: Modern sales enablement strategies that drive connection, confidence, and results.
GUEST: DEBBIE GARNER, FemSelect Ltd.

• Ep.9 Trends That Could Change Everything
TOPIC: Innovations and ideas shaping the next era of FemTech marketing.
GUESTS: CAROLYN RUSH, Koto and DR. JENNY YU

Creators and Guests

Host

Gabrielle Svenning

V.P., Account Director, GrayMatter Agency | The creator of the term Perimenopositive™ and a strategic leader in healthcare marketing. Passionate about big ideas, equality, and kindness, she brings a wealth of experience from 16 years in the medical device and life science marketing sector. With her enthusiasm for transformative technologies and improving women's health outcomes, she provides a fresh, insightful take on navigating perimenopause and beyond.

Host

Karen Flynn

Content Partner, GrayMatter Agency | An advocate of FemTech’s role in advancing women’s health, with 25 years in content creation. She recently authored “It’s Time for FemTech to Step Up,” roadmapping how brands can (and should) use social media to educate, combat misinformation, and establish brand leadership. She brings a research-driven, deeply empathetic perspective, focusing on reclaiming the narrative around women’s health and wellness.

Guest

Christina Reita

V.P. Sales and Marketing, Axena Health | Christina is passionate about advancing treatments and improving patient outcomes, and has a track record of building and executing winning strategies for some of the world's most valuable brands in diagnostics, digital healthcare, medical devices, biotechnology, and precision medicine.

Guest

Dr. Samantha (Mandy) Pulliam, MD, FACOG

Chief Medical Officer and Interim CEO, Axena Health | Mandy is a senior executive and healthcare services professional with extensive leadership experience across industry and academic medical centers. Valued as a strategic thinker, she leads cross-functional teams and inspires team members at all levels of the organization.

What is Two Uteruses Walk Into a Bar?

Real talk. Smart strategy. Women’s health marketing, served straight up.

If you're a brand leader, marketer, founder, or investor in women’s health or FemTech, pull up a stool — this is your podcast.

Hosted by Gabrielle Svenning and Karen Flynn of GrayMatter Agency, this Perimenopositive™ podcast explores the brand strategies driving success, featuring candid conversations with founders, brand strategists, healthcare professionals, and industry disruptors about what it really takes to market products and experiences built for women today.

Gain insight in how to:

• Position your health brand with authenticity and impact

• Build trust in the age of influencers and misinformation

• Design marketing that resonates with the women driving care decisions

• Elevate your voice while staying regulatory-smart

• Future-proof your brand for what’s next in women’s health

9 episodes. Zero fluff.
Mocktails included.
Follow & be notified when episodes drop!

Gabrielle (00:00)
medical device marketing has a reputation for being formal, clinical, and careful to a fault. But the problem is, if you don't sound human, you're not going be heard.

Karen (00:09)
Because when the topic is personal, the words you choose can either build trust or build a wall.

Gabrielle (00:34)
Welcome back to Two Uteruses Walk Into a Bar. I'm Gabrielle Svenning.

Karen (00:37)
and I'm Karen Flynn. Today we're talking about something many healthcare brands struggle with, balancing authority and accuracy with approachability.

Gabrielle (00:45)
It's so important. And it isn't about being less serious, it's about being more human. Clear, compassionate, and real enough so that the people who are listening can relate to the stories that you're telling.

Karen (00:56)
Yeah. In women's health, transitioning your voice from clinical to conversational and making your messages relatable isn't just a marketing preference or a marketer's preference. It's vital. If women can't connect with what you say, they won't recognize the value of your solution no matter how strong the clinical data is.

Gabrielle (01:14)
Today's guests know this firsthand. Dr. Samantha Pulliam and Christina Rehta of Azina Health are helping translate reliable, evidence-based data into clear, approachable, and empowering communications.

Karen (01:27)
It's gonna be a great conversation. To get ready for it, it's time to introduce our mocktail of the day. Our mocktail of the day is a nojito. Muddle some mint, put it in a glass with some ice, add some ginger ale or fresca, little lime juice, put in some maple syrup if you'd like. It's light and it's bright, and it's proof that the right combination can create a delicious experience.

Gabrielle (01:32)
What is it?

So raise your glass, let's get into it. Cheers.

Karen (01:54)
Let's get into it. Cheers.

Karen (01:57)
Our guests today are two incredible leaders from Axena Health, Dr. Samantha Mandy Pulliam and Christina Reita Thank you both for being here and we're gonna raise a glass and toast to you. Thank you for being here. Cheers.

Gabrielle (02:08)
Cheers. Cheers. Thank you.

Mandy Pulliam, MD (02:09)
Thank you. Cheers.

Gabrielle (02:11)
Yeah, to get us started, and again, thank you. we know who you are, but for our listeners, could you please introduce yourselves and talk a little bit about your respective roles at Axena Health.

Mandy Pulliam, MD (02:21)
Sure, so maybe I'll start. I'm Mandy Pulliam. I'm a urogynecologist by training and I still practice clinically as well as I'm the chief medical officer for Axena Health. So what that means is I spend the bulk of my time in ⁓ research, presentation of data, thinking through information really about how our products work and their effectiveness. And then I spend a little bit of time doing a lot of other things ranging from

investor relations to payer relations, sales training, and some other ways in which I sort of pop around really a lot of the company translating medical speak into other speak depending upon the audience.

Karen (02:59)
Okay.

Wow, that's great. Gabrielle, perfect guests. ⁓ Christina, tell us about you.

Gabrielle (03:02)
Perfect guest. I know, I know. I know how to find him.

Christina Reita (03:08)
Christina Reita and I'm the vice president of sales and marketing here at Axena Health. And what that means is, of course, my team and I, we're responsible for delivering results for the organization. But all of that is really based in ensuring that our commercial strategy, our communications, our marketing, that everything is really aligned to the mission that we have in the market. We work really

closely with all of our cross-functional partners to ensure that everyone from patients to providers to payers and of course to investors that we're able to tell our story and and show how we are able to help women with urinary and fecal incontinence.

Karen (03:55)
Again, another perfect alignment. for those of our listeners who may not be as familiar with Axena Health, your work centers on an issue that impacts so many women.

and often goes unspoken, which is urinary incontinence. And before we kind of dive into your brand voice, can you paint the picture of what are some of the unique needs of the women that you serve and how those needs shape your communications?

Mandy Pulliam, MD (04:17)
Sure, I'm happy to talk about urinary incontinence and incontinence more broadly as So urinary incontinence is ⁓ involuntary leakage of urine. It happens in a couple of different situations. One would be with coughing and sneezing. Another would be with urgency, so rushing to the bathroom, not being able to get there in time. And then there's a mixture of both.

Karen (04:18)
Great. Great.

Gabrielle (04:20)
Yes. Mm-hmm. Mm-hmm.

Mandy Pulliam, MD (04:38)
mixed incontinence. And Axena and our Leva product, which we'll talk about more specifically, I think, is also indicated for chronic fecal incontinence, so loss of stool and voluntarily as well. we cover both of those pelvic floor disorders, which is really sort of our major focus is caring for women with pelvic floor disorders.

Gabrielle (04:57)
it may be easy for you to say, but I don't think a lot of people find it easy to talk about urinary incontinence or, God forbid, fecal incontinence. I think in my own world,

Mandy Pulliam, MD (05:00)
Ha

Gabrielle (05:09)
my friends and I are just starting to get comfortable with you know joking about oh my gosh I just peed my pants you know when we laugh or we dance. So I think when it's a particularly it's probably a question you have all the time is like how do you approach messaging in a way that is relatable or or doesn't at least induce fear or stigma?

Karen (05:15)
you

Christina Reita (05:32)
Yeah, that is a great question and it's funny I've spent.

really the vast majority of my career in the medical space dealing with everything from breast cancer to cervical cancer to various sexually transmitted diseases. And it was really only when I started working at a Axena or considering coming to a Axena and talking to people in my personal life about the company that I was going to that I realized even I paused for a second before saying urinary incontinence.

And that is something that I've really brought into like the role and the messaging is, is understanding how do we take something that is a medically relevant and medically important condition that women are dealing with actively? And how do we make that more, more approachable? And for us, it really comes down to rooting it in the fact that one, it is medically relevant.

Two, there are proven solutions to help these women. And then three, just coming at it from a perspective of we're not here to make fun of you. We're not here to make a joke out of you. We are here to empower you.

to take this into your own hands, to have open conversations with your clinician about this, because the average woman waits six and a half years before ever talking to her clinician about this.

Karen (07:04)
Yep,

I can believe that.

Gabrielle (07:06)
Mandy you talked about the Leva Health System and so before we go any further because we're talking about tone and how let's be clear what you're selling and what you're offering and providing women which is a new approach to ⁓ a common problem it sounds like.

Mandy Pulliam, MD (07:23)
So urinary incontinence has a very clear treatment pathway. In other words, most medical professionals recognize the steps in treatment in a sequential order. And the first one is pelvic floor muscle training. Sometimes it gets called Kegels. I hesitate to use that word because it implies something that everybody knows about. And I actually think it's more complicated than that.

But we offer.

to that need of pelvic floor muscle training, the Leva pelvic health system. And really the offering is because of a couple things. One is that someone who's told, go home and do Kegel exercises, I if you think about it, you can't see those muscles, right? They're in your pelvis. So if I went and told you to go home and exercise your biceps, you might have a reasonable chance of knowing how to do that and being able to see if you're doing it properly. But women can't see their pelvic floor muscles. And studies have shown that women also think they're doing

pelvic floor muscle training properly, but they can't. So there's a real need for teaching women what to do and how to really feel empowered to do those training correctly. One of the challenges is that we often send women to see a pelvic floor physical therapist, an excellent way to learn about pelvic floor muscle training, but not one that works for many women, right? You need a day off of work once or twice a week. You have to park. You need to figure out what to do with your work or your children or some other obligation in order to do.

Gabrielle (08:15)
right.

Karen (08:16)
Right.

Mandy Pulliam, MD (08:43)
So the need to be able to do that sort of training on your own time, in your own place, and in the privacy of your home if possible, really is what sort of generate the need for the LEVA pelvic health system. LEVA is ⁓ a combination really of four different sort of pieces. One, it is a wand. It's placed in the vagina. It's very small, like the size of a small tampon, so it's comfortable for most women, not intimidating.

Once it's placed, it connects wirelessly to an app that can show a woman how well and how properly she's lifting and squeezing the muscles in the pelvis. Those types of devices called biofeedback...

in some way aren't new, but Leva's a unique type of biofeedback that lets you actually see kind of how those muscles are lifting upward, which is really what you need to do. So the app also contains amazing educational material developed by pelvic floor physical therapists. We've recently incorporated some patient education material from the Mayo Clinic, so it's robust and full of the kind of information you need to know to figure out not only how to train those muscles, but then how to use those successfully trained muscles to treat your urinary incontinence or fecal incontinence.

Karen (09:25)
Mm.

Mandy Pulliam, MD (09:49)
Also embedded in the app are surveys and other kinds of questionnaires that will allow you to provide information about how your symptoms are. You can kind of track how things have improved. That information is all collected wirelessly and then it's formulated into a report that's provided back to the clinician. Leva's a prescription product. So the clinician who prescribed the product receives a

Karen (10:08)
Okay.

Gabrielle (10:08)
Mm-hmm.

Mandy Pulliam, MD (10:11)
report on a monthly basis about a woman as she goes through this 12-week program. ⁓ The use of LEVA is two and half minutes twice a day. ⁓

Gabrielle (10:17)
Mm-hmm.

sound.

Mandy Pulliam, MD (10:23)
And sort of that's the whole cycle. And the intent there is just that a woman who has initiated care with her clinician can follow up. ⁓ First line care works for many, many women and helps them avoid things like surgery or medications. For some women, they need to go on and have additional care. Many of those women could be lost to follow up unless they're sort of tracked by their clinician and connected to them to move on through care. So that's really the continuum that we want to contribute to.

Karen (10:30)
Right.

Gabrielle (10:41)
Mm-hmm.

Karen (10:48)
Yeah, right,

right. There's, know, as we've talked with our other guests as well, there's so much education is such a big part of really what you're doing, you know, and ⁓ as well as the opportunity for easy communications between the patient and her care provider. So you're definitely, you know, you're definitely in a clinical space and

Christina, we were just talking about this a little bit before, but how do you navigate that tension between being clinically credible and approachable? You've got two audiences, I would imagine, that you're talking to when you're marketing.

Christina Reita (11:28)
Yeah, I think, you know, we talk about this a lot in marketing is how, like you said, how do you navigate that space between getting the right

level of clinical information out there so that the audience that is the clinician feels like, okay, this product, whatever it is, is based in science. I see outcome information. I can see that it's safe, that it's effective, that there's durability. And so that is a very clinical audience and they deserve clinical messaging.

And at the same time, while we do not go directly to consumers, our information is getting to patients via their clinicians and then once they come into us through our our leave a women's center. And so we work really hard to take that clinically relevant information and and talk about it in a way that is incredibly accessible.

for patients. So let me give you a quick example of where we've had those conversations even directly in the field. And I'll pick on myself again so that we keep any patient information private as we should. But I even had a conversation with my clinician I shared like...

Gabrielle (12:45)
You

Christina Reita (12:54)
Wow, I actually haven't talked to you for 12 years about the fact that I have had this issue because when I come in and I fill out the form before my annual every year, I'm asked if I have urinary incontinence.

Urinary incontinence is a very medical term that for a lot of people will elicit the idea of the 80 or 90 year old woman who has no control over her bladder at all.

So I and others didn't see myself in that terminology. So even making small tweaks, and you'll hear Mandy even use the term bladder leakage, just little things like that. It's still clinical. It's still relevant. But it's much more accessible for the patient that's on the other side of that message.

Karen (13:42)
Mm-hmm.

Yeah, yeah. There's a theme as well with some of our guests about language. And that's kind of my bag is language stuff and word choice and how important that is because there's so much that gets wrapped up into a terminology. know, so like I'm much more comfortable with bladder leakage, for instance, than the concept of incontinence because I'm like, I'm not that bad. know, like I'm not that bad. Yeah.

Christina Reita (14:11)
Right.

Mandy Pulliam, MD (14:13)
I think if we're not careful, we can end up in our own echo chamber where everyone else around us understands what we're talking about. We think so, right? At least in our little worlds. And so I think it's really an important challenge to understand that even something as...

Karen (14:20)
Mm.

Right.

Mandy Pulliam, MD (14:28)
complex potentially as clinical data. It doesn't really have a lot of value unless it can be presented in such a way that it has meaning for the women who need to understand it. So I think that's a really critically important piece about what we do. We need to develop the data. need women deserve products that work and have been proven to work. And they also...

deserve to be able to have the information given to them in a way that's meaningful that they can understand. And I think those are the challenges really before us in this area and in many others.

Karen (14:58)
I think, Gabrielle, do you mind if I keep going? Because I think that that just made a perfect segue into our next question, is, tell us about how that developed on your end, the collaboration then between your medical teams and your marketing teams. I imagine that we're talking about a lot of inside thinking and collaborative

Gabrielle (15:00)
No, keep going, I'll ask, yeah.

negotiations.

Karen (15:22)
Yeah, or just

or just you know how I'm trying I'm trying to imagine walking through, you know, a mind, the mindset of we're going to take this clinical data and we want to make sure that it is accessible and relevant. And as a company, what does that mean for us? How are we making sure that that we're on that journey, that we're kind of going in that direction? And then, you know, probably wrapped up into this is do

Do you have a real world application or an example of a campaign that you think really worked well to sort of reflect that evolution of a brand voice that way? And if it's too big of a question, we can break it up into little ones.

Christina Reita (15:59)
Yeah, yeah,

we could we should probably break we can break it up into little little little bits on our on our own. think Mandy and I could both probably share examples of.

Karen (16:04)
Okay, yeah.

Christina Reita (16:12)
what you're probably getting at, right? Because I can hear you even kind of tiptoeing through the questions. So we've all worked and it doesn't matter if it's clinical, if it's medical, if it's sales, it's, you know, it doesn't matter what organization or what function you're in.

Karen (16:18)
Hahaha

Christina Reita (16:28)
there can be challenges, but I think what's most important and what I really appreciate about Axena Health and Mandy and Mandy's team is I've had the opportunity to partner with some amazing medical partners over my career and I would put Mandy and her team in that same upper echelon because at the end of the day,

Every single person at Axena Health is so tied to our mission and vision that we all know what we're playing for. And so we don't get into those, what I think oftentimes are ego-driven or territorial conversations. I that is, I will be honest, like the most important thing any people leader does is hire great people. I think that's a special.

Karen (16:58)
Yeah.

Okay.

Christina Reita (17:20)
true when you're a startup or when you're new in the femtech space, whatever your audience happens to be experiencing and getting those people who are missionaries, the people who are really tuned to that vision and that mission and bringing that to life makes a huge amount of difference.

Karen (17:41)
Yeah, I would

imagine. here's what I'm thinking. A company, let's say it's a startup, it's not a Zena Health, but it's somebody who's like a startup. And they know that they need to make their communications, their messaging much more accessible.

to people much more relevant. They're an engineer driven company or whatever. So the internal speak and the way people have been talking for a long time might have been really clinical and they want to make that transition and everybody's on board. Like there's no egos or anything, has to happen? have either of you been involved at a time in the company where you're kind of.

working on tone of voice transitions and things like that? Is that something that's relevant to your experiences or has it always been well-focused and sort of developed since you've been in there?

Mandy Pulliam, MD (18:29)
So I think I can give you an example of a time when we were working to make that transition. So to set the stage a bit, we did what we've called our pivotal randomized controlled trial that showed that LEVA is superior to pelvic floor muscle training alone for the treatment of ⁓ two different types of bladder leakage. And one of the data points was a data point about something called a bladder diary where

Karen (18:44)
Okay.

Mandy Pulliam, MD (18:55)
every three days how many leaks she's had in real time as she's reported them and that was that's one of that kind of major outcomes of the study. But the outcome was computed in a using a statistical analysis called a median right so and the improvement went from five episodes to three episodes of urinary incontinence or basically one and a half leaks.

day to, I'm sorry, five weeks a day to one and half weeks a day, right? So the layperson might say, that's an 80 % change, right? Please don't do the math because I'm probably not actually. But in the statistical world, medians are not.

Karen (19:23)
Okay.

Gabrielle (19:23)
Mmm.

Mmm. Yeah, it's very intricate.

Karen (19:30)
That's alright.

Mandy Pulliam, MD (19:36)
Like if you're a statistician, you're very uncomfortable applying a percentage to a median, right? So here we were having this debate, right? Because every time I looked at this thing, I would say, no, you can't use percentages. This is not the statistics that would allow that. But the marketing person would say,

Gabrielle (19:38)
Yes. Mm-hmm.

Yes.

Karen (19:51)
Okay.

Mandy Pulliam, MD (19:54)
I need to be able to explain this to women in a way they understand and a median means nothing to them, right? And so we came together and we talked about it and I said to them, I'm gonna send out an email to five of my statistical advisors and see what they say, right? And I got everything from a treatise on statistics to a couple of people who said, well, this is how we can solve this problem, right? And my email to all of them was, here are the statistics. We need to say this in a way that it's easily understood.

Karen (20:12)
You

Mandy Pulliam, MD (20:21)
working with them, we arrived at a kind of analysis that we could do that would give me peace of mind about being able to use this percentage. And then we were able to go ahead with it based on really expert opinion in my field, but with the goal of bringing the information to patients in a way that is meaningful to them. And we arrived on that just through that kind of negotiation was painful. I'm sure the marketing folks were like, good grief, you know, how long are we going to think about this? And what is the

Karen (20:39)
That's.

Mandy Pulliam, MD (20:48)
serious repercussion, for me, I was relieved. And I felt and I understood the call, right? We needed to be able to explain this to women in a way that was meaningful to them, because it was a meaningful finding and a meaningful bit of information.

Karen (20:51)
Yeah.

Right? Yeah.

That

was a perfect example, thank you. That was exactly what I was looking for, like how people work together for that type of stuff. And as I'm kind of nerdy myself, I mean, not saying that you're nerdy, but I am. Okay, good. So I'm all about accuracy. You wanna make sure that you're not saying something that you don't mean. And there's always that kind of tug of war a little bit between accuracy and.

Mandy Pulliam, MD (21:12)
I am. I own Nerdy.

Gabrielle (21:16)
Got the corner

Karen (21:28)
approachability, I think.

Mandy Pulliam, MD (21:30)
And

can I say one thing about approachability is that I think, and we've talked about this, approachability is critically important, but so is sort of fact-based data. And my guiding light in this work is that women deserve products that have been proven to work, right? So I want to have the data, and it also needs to be approachable. And you can't have one without the other. Data without approachability, not very compelling. Approachability without data, what do

Karen (21:32)
Say what?

Gabrielle (21:33)
Yeah.

Karen (21:40)
Yeah, absolutely.

Yeah.

Mandy Pulliam, MD (21:56)
I mean, it's important to have both.

Gabrielle (21:59)
This is actually interesting because so we're talking about how we talk about these very clinical things in ways that, you know, resonate with women and, but also now we're having conversations or you're empowering conversations in the clinical setting between patient and doctor about the LEVA

has it been like to get in your commercialization journey, those talk tracks or that guidance, how did that evolve? And was it sort of an easy thing or what were some of the things that you learned along the way? Because I think a lot of our listeners will be in a similar situation where they have these two audiences that they have to speak to and they recognize they need to talk to them differently, but then all of a sudden they're in the same place. And now...

having conversations that weren't necessarily... they weren't having them before because quite honestly the doctor could say, go you know you can talk to your PT. I'm going to recommend you for pelvic floor therapy and then leave the conversation to that person. This is sort of... it's changing the dynamic. Can you go into that a little bit more and how... what has been the response in the field, Christina?

Christina Reita (23:07)
Yeah, so I think it's here in commercial land, if we want to call it that, it's very easy to get sucked into talking about sales funnels. It's easy to get sucked into talking about our sales process or marketing campaigns. And any time we talk or think about things in that way, it's very us centric.

Gabrielle (23:12)
Yep.

Mm-hmm.

Karen (23:34)
All

Christina Reita (23:34)
So

I would say one of the highest priorities for me any time that I'm coming into a commercial organization is really looking at it more from the care journey that the patient is on and the care journey that the provider is delivering. Because that really helps get

Gabrielle (23:56)
Mm-hmm.

Christina Reita (24:00)
everyone in the organization thinking about things from a more, and I'll use a fluffy word, a more empathetic perspective, where you really are trying to understand what is this patient or what is this provider trying to like fix or accomplish or avoid and.

And what does care look like early in the journey versus as they move through that journey? so anchoring a lot of what we're doing, so anchoring our messaging, anchoring our strategy, anchoring our promotions, all into different stages of that journey really helps to be able to then go in and say, OK.

If this is our messaging today, for example, and we want to evolve it to a new place because we see that something isn't working, if it's coming from that place of your audience on the other side versus what am I trying to fix, accomplish or avoid, ⁓ it makes it a lot easier to make those adjustments and to then roll it out into the field.

Karen (25:05)
Okay.

Christina Reita (25:13)
maybe what I can do is give a little example. So as we then roll that out into the field, you've got our salespeople. And our salespeople are focused on calling on the OBGYNs.

urogynecologists, and we know that there is a certain amount of like clinical messaging that we need and want to be able to deliver. And again, oftentimes, I think sales reps can get stuck in a world of

Well, show up and throw up, right? Like, let me tell you, like, I learned all this great stuff from our clinical team. I know it. I know it inside, outside, backwards, and forwards. And I can give you my elevator pitch in 90 seconds or less. ⁓ And yeah, that's right. And it's like, well, but there's a reason clinicians don't want to talk to us. And it's because when we...

Gabrielle (25:51)
Yeah, yeah.

Karen (25:51)
You

Mandy Pulliam, MD (26:04)
If you don't breathe. ⁓

Gabrielle (26:06)
Yeah.

Christina Reita (26:15)
come across in that way, in a very formulaic way, with let me tell you all of the things that I know, or let me say the message and the exact right words, that's not bringing the clinician value. So one of the things that we're very much focused on is helping our sales teams to go in and actually, before talking at someone, asking really good questions so that they can start to understand

ah, when I talk to this clinician over here, if I'm talking to Dr. Pulliam, for example, I know that she is proactive, because I've asked good questions, I know she's proactively asking her patients if they are suffering from urinary incontinence. And so how I talk to her is gonna be a little bit different than let's say I'm talking to...

Dr. Reita over here and she's just coming from the perspective of if they don't bring up a problem, like I just going through my emotion and that's a different than conversation that I'm going to have. really empowering the sales team to get curious, to ask good questions, to understand where somebody is on their care journey, to understand where they currently see and how they currently are treating incontinence.

That's all really critical information for them to then be able to say, OK, well, here's why I'm here. And let me share how I can help your patients, because I understand now how you look and understand and treat your patients.

Karen (27:49)
Well, I think that's and that's a really good application of not only your corporate tone, you know, but but also your your sort of mission driven focus that you have. And I think and I think it's a it's a nice marrying of the two. And I think that's why spending the time and doing the work that it takes to really work on your corporate tone, your messaging tone, it has so many implications on so many other

areas of the business, know, not just the quote unquote marketing, right? It really comes to play into all of that stuff. Have you seen results during your time here of like an evolving, your evolving tone? Whether it's, you know, whether it's, they're your sales team saying, great, great idea, that was great, or patient engagement, or the data, the data side of things, are you seeing?

Christina Reita (28:20)
Absolutely.

Mandy Pulliam, MD (28:37)
So

I think I can talk a little bit about some of the results that we've seen. So we are a digital health company. We collect a lot of information in terms of women's progress and how they're doing on their using LEVA to treat their incontinence. And we provide most of that back to clinicians. But we're also able to look at how our patients are doing. How much do they adhere to the two and a half minute, twice a day regimen?

Karen (28:39)
Good.

Mandy Pulliam, MD (28:59)
what results are they seeing? And then also is the base of both prescribers and the number of women who are receiving LEVA growing. So the part that's in my realm is really the data part. We can look and see how women are doing. And in fact, we've been able to publish on that to say, you know what? Women who receive LEVA.

by their clinician actually are doing just as well as the women in our clinical trial did, right? So they're getting clinical trial level results from their experience using LEVA and we've seen that happen and grow really over time as more and more women are using LEVA. Our results are compelling. We're able to publish that which is great for clinicians to hear about and I think it's also useful for women to feel confident that what they're going to embark upon is actually going to help them.

Gabrielle (29:48)
How much, I guess, when we're talking about moving clinical to conversational, how much are you seeing in the last couple of years talk about out there in the non-clinical world about these issues? And I guess what I'm getting at is, your customers, are your clinicians, your providers, are they

Have their changes, let me start over, have their requests for information from you, from your reps, from the company itself, has that changed in any way over the last couple years? I guess I'm curious because from my own perspective, as I mentioned earlier, I'm hearing more, maybe it's just as I age, I'm hearing more, but I feel like in the ethos right now, there's much more conversation about these things, whether you call it bladder leakage.

or incontinence or just, you know, I wet my pants or whatever, there's more conversation. So I back to what you as a company are finding, what are the requests? How is this, are you noticing any change in the field when it comes to these conversations between your salespeople, your doctors and the patients?

Christina Reita (31:02)
Yeah, so a couple of things. One, you're not imagining things just based on the media monitoring that we do. Based on the social media monitoring that we do, we absolutely see an increase in these conversations. We are working to tie as much of that to additional data as we possibly can. So I will say I'm a little bit in front of it, but as you can

Gabrielle (31:07)
Okay, yeah.

Christina Reita (31:29)
imagine there there is definitely a generational difference how much we can attribute to the generational difference I can't tell you that just yet but there absolutely is a difference between baby boomers gen xers and then when you get into millennials and gen z so for example when gen xers were having their babies then you would go home but now more often

Gabrielle (31:29)
Yeah.

course, right.

Christina Reita (31:55)
pelvic floor physical therapy, pelvic floor muscle training, Kegel, something is being recommended to women more often, even postpartum. Yeah, it's, yeah. It's not too late for you, I absolutely promise. We have, that's, yes.

Gabrielle (32:00)
Mmm. ⁓

That's great. I didn't know that. mean, I know. We're fine. mean, just to, yeah, keep going. That's great.

Karen (32:06)
I know, I'm very excited to hear that. Too late for me, but yeah.

Mandy Pulliam, MD (32:12)
It's not too late.

Karen (32:13)
I know.

Gabrielle (32:14)
Yeah

There we go, combating misinformation in real time.

Karen (32:18)
misinformation right there. Thank

Gabrielle (32:20)
Yeah,

Karen (32:20)
you.

Gabrielle (32:21)
yeah.

Christina Reita (32:21)
Yeah,

and so as you can imagine, and this is getting you have teed up very nicely where I was going. ⁓ So there is a lot more talk. There is also a lot more either misinformation or at worst, right, misinformation at worst.

Gabrielle (32:26)
you

Karen (32:26)
Ha ha

ha ha!

Gabrielle (32:37)
Yeah.

Christina Reita (32:38)
At best, there still is a lack of information, right? There are still holes where what you see is people going out and asking questions, but not necessarily finding all of the answers they're looking for. And then there's kind of like in between those two things, there's either a confusion of information or information that's not as, you know, rooted clinically as it should be. Because like Mandy has already said, we like to provide

solutions that actually work for women. Not just solutions, but solutions that actually work.

Gabrielle (33:07)
Right, Yeah,

yeah. Thank you. That's really interesting. I remember, ⁓ so my son is 15, so 15, 16 years ago, I was reading a lot about delivery and all, and just what was happening to my body. And I remember reading about France, or is it the French who have, yes, man, those French know how to do it. They have, they drink their wine and...

Christina Reita (33:26)
It is French, the French.

Gabrielle (33:32)
Not at the same time, but they drink their wine and they do their pelvic floor therapy. And it's very part of the just the standard of care for women. And that just, I remember thinking this is insane among the many other things that I feel we are somewhat backward in as far as it comes to maternal health or care or the way that we as a society support parents. In any case, I digress. The point is that I'm glad to hear that those standards are changing and that it's almost sounding too like

The audience is pushing for the, the people are pushing for change. And I can certainly see how a Gen Z-er was gonna go in just from the Gen Z-ers I know. Expecting and wanting a lot more information and transparency from their clinician than previous generations. I mean, I know that I necessarily wasn't challenging my doctor when I would go in. And I'm not saying that challenge is the right thing, but having that conversation, know, like question.

⁓ So, and again, pelvic health is such a sensitive area.

Christina Reita (34:28)
Well, and...

Yeah, and you know, it's not just the information that people are requesting. They're also requesting solutions that work.

Gabrielle (34:38)
Yeah.

Christina Reita (34:39)
for

them in their lifestyle. And so that's where a product like the LEVA system comes in. Because as you can imagine, if you're postpartum, let's think back to when we had our children. If you had told me that for the next 12 weeks, I needed to physically get myself to the physical therapy office, and it was going to be a half hour appointment three times a week, but I had

Karen (34:40)
Yeah.

Gabrielle (34:51)
Yeah.

Right.

Christina Reita (35:06)
to drive 30 minutes each way to get there versus you're providing me the flexibility and the opportunity to do it in the comfort of my own home. Wow. It's a game changer. Yeah.

Karen (35:17)
Yeah, no, yeah, yeah.

Gabrielle (35:17)
It's a game changer. It's a game changer. It completely and personally again,

at my experience only, I have discounted, I have been prescribed pelvic floor therapy and I have not done it. And so I think that talking about convenience, talking about inconvenience, talking about stigma, talking about what kind of conversations, what are they gonna do? I don't know. To have all of that.

taken off the table and just to have a conversation with my healthcare provider that something that I can do at home, you've taken so many objections off the table and empowered women, which is really important and I think the name of the game these days in advancing women's health. You have to empower the woman, the patient.

Mandy Pulliam, MD (36:02)
You know that...

Christina Reita (36:02)
And Mandy says

this, Mandy, no, sorry. Mandy says this a lot, like the best therapy is the therapy that somebody does. And ⁓ so it's not to say that there's not a place in the world for pelvic floor physical therapy. There absolutely is. ⁓ And what we're trying to do is make therapy much more accessible for every woman.

Karen (36:10)
Right, yeah.

Gabrielle (36:18)
Absolutely.

Mandy Pulliam, MD (36:27)
do think that when you think about, and maybe we're still a little bit off topic, but when you think about getting women care that's useful to ⁓ them, there's a of a known list of things that actually help women complete pelvic floor muscle training successfully. And some of it's the things we've talked about, like accessibility, so being able to do the training in your own home.

Karen (36:43)
Yeah.

Mandy Pulliam, MD (36:50)
clarity in terms of the instructions and empowerment by information about how the body works and also accountability. And I think that's another thing that LEVA offers in two ways. I mentioned that the prescribing doctor gets a...

Gabrielle (36:54)
Yes.

Mandy Pulliam, MD (37:03)
actually not just doctors can prescribe, lots of clinicians can, but in addition to that, we have a coaching team and every woman who comes through who receives a LEVA receives a coach and they can communicate with that coach in any way they think is useful, whether it's by text messages or phone calls or not at all if they choose, ⁓ but that actually helps support women through the use of LEVA and through the program and that's important.

Karen (37:20)
Mm-hmm.

Gabrielle (37:26)
I love that.

That is so important because you're empowering women by, what am trying say, you are respecting women and how they want to communicate and talk and giving them options about whether they want that coach or not and how do they want it. I love that because again, it's all about putting the controls back in the woman's hands and yes.

Karen (37:28)
It's really important.

but with accountability, which is really

good, because I would be that guy. I would be the guy, you know, be like, I'll do it like twice, yeah, and then I don't. But if I know my doctor's waiting for the report, let's say at the end of the month or whatever, I've signed on to that. No one's forcing me into this situation, but because I have agreed to do this therapy in this way, that that makes me, you know.

Gabrielle (37:54)
Yeah.

Mandy Pulliam, MD (37:54)
You

Karen (38:12)
I don't want to be the kid who doesn't get the homework done, right? So I just want to get it done. Hi, reformer.

Mandy Pulliam, MD (38:14)
High performer.

Christina Reita (38:17)
Ha ha ha!

Gabrielle (38:17)
Yeah, yes, yeah.

Well, I want to be respectful of our time. We could talk and talk and talk, but this has been really helpful. I want to thank both of you for coming. ⁓ I think that, you know, if just before we part, if there are any last words, again, for our listener and for the marketer, the chief medical officer.

Karen (38:21)
Yeah.

Yeah.

Gabrielle (38:37)
People who are in your shoes at other companies, what kind of advice? Do you have any advice for how you balance this and how you shift and make sure that your messaging is getting, it's reaching your audiences, plural, in the right way?

Mandy Pulliam, MD (38:49)
⁓

So I think I'll jump in with a word about messaging. I think the key is what the North Star is for the company, right? We certainly need to sell Levas and become a viable company financially. And I would never say that's not important. But I think maybe more important, or at least as important, is what is our North Star? What are we doing here? Are we caring for women? Do we have a problem we're looking to solve? And how well are we doing that together? And I think that unifies a lot of potential silos

in a company and allows for a great product for women.

Christina Reita (39:22)
Yeah, I'll underscore what Mandy

just said about the North Star and that last bit is what I'll kind of like underline in bold as well. And that is it really is about collaborative problem solving. So there there are no problems that we can't talk about that we can't figure out a creative solution for. And it's just just like we are trying to empower women and be more

provide more transparency for women and have more authenticity in the market. That's exactly how we approach collaborative problem solving internally as It really is just about like trusting intent and understanding that we are all trying to achieve the exact same thing, being able to lay out that problem from each of our perspectives and then finding that creative solution.

Gabrielle (40:14)
Thank you. Thank you both for coming. Yeah.

Karen (40:15)
This has been a

really valuable and interesting conversation. Thank you so much for your time.

Gabrielle (40:20)
Yeah, so thank you, I think for all of our listeners, if they've heard this and want to learn more about Axena Health, we'll have all of the information about the company, Leva pelvic floor system. that will be in the show notes with links to it. And yeah, best of luck and thank you for sharing your experiences and for all you're doing to advance women's health.

Mandy Pulliam, MD (40:21)
Thank you.

Karen (40:39)
Thank you. Bye bye.

Christina Reita (40:40)
Thanks for having us.