← unPAUSED with Dr. Mary Claire Haver
unPAUSED with Dr. Mary Claire Haver
Female Libido in Menopause: Desire Loss, Biology & Solutions with Cindy Eckert
01:07:10
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- [00:00]
Dr. Mary Claire Haver
No one really owns this part. For women, they do. For men, it's urology.
- [00:04]
Cindy Eckert
Absolutely right. That's right. Yes.
- [00:07]
Dr. Mary Claire Haver
But usually it falls under psychiatry.
- [00:10]
Cindy Eckert
I know I can't even. I mean, that is like. That is the biggest misconception, though, that everything that goes wrong for women as it relates to sex is rooted in emotion and everything that goes wrong for men is rooted in biology. And that is the big dissatisfaction.
- [00:36]
Dr. Mary Claire Haver
The views and opinions expressed on Unpaused are those of the talent and guests alone and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment. I first met today's guest, Cindy Eckert, many years ago, long before the Galveston diet or menopause education was even on my radar. At the time, I was a practicing general academic obgyn. My world was pregnancies, deliveries, emergency surgeries, and the day to day rhythm of patient care. Cindy was speaking at a women's conference in Phoenix about her company, Sprout Pharmaceuticals, and the female low libido drug she had developed and brought to market called Addi. But what struck me that day wasn't the drug.
- [01:22]
Cindy Eckert
It.
- [01:23]
Dr. Mary Claire Haver
It was her conviction that female sexual health was real, important and worthy of science, funding and conversation. In four years of residency, I'd been trained to handle nearly every kind of pregnancy emergency, every surgical complication, every crisis that could walk through the door. But we had never covered female sexual health in any meaningful way. I didn't know that there were FDA approved options that might even help. I didn't even know how to start the conversation. Up until then, when my patients wanted to talk about sexual function, I was completely unprepared. About a quarter of my patients, 20 to 25%, would pause just as I reached the door after an annual exam, take a deep breath, and say, doctor, there's one more thing I need to talk to you about. And there I was, rushed, overwhelmed, another patient in labor, a surgery waiting, frozen in place while this woman gathered the courage to tell me she was struggling with sexual dysfunction and I had no idea how to help her. The best I had been taught to say was something vague and dismissive like, try to relax or have a glass of wine. It'll get better with time. Sex was treated as something women give their partners, not something they deserve to enjoy. So when I sat in that audience listening to Cindy Eckert discussing women's sexual function with calm, clarity and absolute purpose, it was groundbreaking. I felt a rush of recognition and honestly shame for what I hadn't been taught. I had tears in my eyes thinking, how did I not know this? How did an entire generation of physicians miss this? That day changed the way I thought about my field, my patients, and women's health as a whole. And it's why I am so honored to have Cindy here today to remind us that women's pleasure, desire and agency are as valid and as worthy of care as any other aspect of our health. I'm Dr. Mary Claire Haver, a board certified obstetrician and gynecologist and certified menopause practitioner. I'm also an adjunct professor of obstetrics and gynecology at the University of Texas Medical Branch. Welcome to Unpaused, the podcast where we cut through the silence and talk about what it really takes for women to thrive in the second half of life. If your skin or your nervous system feels a little overwhelmed lately, this may be your sign to simplify. Primally Pure's Blue Tansy products are designed to calm stressed skin using real biocompatible ingredients that work with your body, not against it. Blue Tansy is a calming blue antioxidant that helps soothe inflammation, redness and irritation, which is especially beneficial for sensitive skin or for those people whose products tend to overwhelm rather than help their skin. Primally Pure's soothing collection incorporates this ingredient across face and body, from their effective deodorant to the soothing serum and body oil, creating a cohesive and calming routine. They've become go tos for our team with Simplicity Matters most. Use Code unpaused to get 15% off your primally pure purchase. That's www.p r I-M-A-L-L-Y-P-U-R e.com and use code unpaused at checkout for 15% off your order. So welcome to Unpaused.
- [04:44]
Cindy Eckert
Thanks for having me.
- [04:46]
Dr. Mary Claire Haver
Where did you grow up?
- [04:47]
Cindy Eckert
Okay, let's start. Rochester. Fiji. Rome. D.C. i was totally nomadic. My dad may have a sick sense of humor, so we moved every year from the fourth grade through senior year of high school. Oh my God.
- [04:59]
Dr. Mary Claire Haver
Your dad was a diplomat?
- [05:00]
Cindy Eckert
Yes, State Department. And just truly like an adventurer to his core. So I'm grateful for that childhood. It was hard during it, but in, you know, retrospect, wonderful.
- [05:10]
Dr. Mary Claire Haver
We were expats for a couple years, Venezuela. And so we hung out with a lot of State Department families and kids, and it was a really interesting learning of their lives and their lifestyles and this kind of moving every couple of years. But their kids Were also resilient and had had these amazing adventures all over the world. So it was an experience I really enjoyed.
- [05:31]
Cindy Eckert
Good for your kiddos.
- [05:31]
Dr. Mary Claire Haver
So good for my kids.
- [05:32]
Cindy Eckert
Yes.
- [05:33]
Dr. Mary Claire Haver
Incredible. They're citizens of the world now.
- [05:35]
Cindy Eckert
Yes. I say to my dad all the time, were you, like, secretly training me to be an entrepreneur? Was this your master plan?
- [05:41]
Dr. Mary Claire Haver
So was that your plan? What'd you go to college for?
- [05:44]
Cindy Eckert
College business. Like, always a bit of a nerd. Like, loved what makes one thing great versus another. And I was lucky enough to have a female professor who, like, recognized that weird ambition. Ambition of it. I don't know if it was ambition. It was a bit of, like, relentless curiosity. Like, she knew. So she would give me extra assignments, like, go read this magazine and tell me why this company is doing this thing. And she really cultivated that in me as a strength as opposed to, like, an odd, you know, quirk.
- [06:13]
Dr. Mary Claire Haver
Where did you do your undergrad?
- [06:15]
Cindy Eckert
In D.C. i actually moved back to D.C. my senior year of high school. How fun. A new kid, your senior year. And, like, my single criteria is, I will not leave this area. So I only applied to schools in the D.C. area. I didn't want to move again. I went immediate. Because of this professor, I made, like, a unilateral decision. I will work for Fortune's most admired company. And at the time, it happened to be Merck. It happened to be a pharmaceutical company, like, I think all the time. You know, the concept of sliding doors. Like, what if it had been aerospace and this time it was Merck? And I told her, I'm going to work for Merck. And I think she then got a little bit nervous. Like, you should apply a number of places. But as luck would have it, Merck was hiring, and I went there to learn from the best.
- [06:57]
Dr. Mary Claire Haver
And what did you do there?
- [06:58]
Cindy Eckert
Sales. Okay. So started, like, first, you know, rung of the ladder, you have to move up. It's like a very big corporate. Like, you have to do this, and you do this. And what was funny is, while I was like. I felt like I'd won the lottery, I was working for, like, the most admired. I got in there, and I realized very quickly, Cindy, you do not fit in big. You have a want for people to listen to what you have to say. And when you're like, Employee 4472, they're like, just sit in the corner and do the thing you're hired to do.
- [07:27]
Dr. Mary Claire Haver
How long till you jumped ship?
- [07:29]
Cindy Eckert
Took me almost four years. So I'm very grateful for the training. Like, Foundationally, it was so good for me also in, like, what I didn't want to do, it taught me that as much as what I wanted to. And I went. My brother, I have two big brothers, very influential in my life. And one of them worked for a startup. And I was like, what's a startup? He worked for a dot com company back in that day and he was given equity. And I'm like, equity. And so I started chasing, like, how do I go to places where I also have a bit of skin in the game for the value I create? So I jumped ship four years later and never looked back.
- [08:04]
Dr. Mary Claire Haver
But you went back into pharmaceutical.
- [08:06]
Cindy Eckert
Yeah, I was. I went to progressively smaller pharma companies where I was getting closer and closer to innovation. You know, I was getting into the places where they would hand you a job you'd never done before, and they're like, you'll figure it out. And I loved it because that was. That's what I loved about the industry. Like, what Merck did awaken in me is my love of science and the impact you can have in people's lives. And so the closer I could get to that innovation that was groundbreaking or new, you know, I chased it relentlessly.
- [08:35]
Dr. Mary Claire Haver
When did you start your first company of your own?
- [08:38]
Cindy Eckert
2007. What kind of company was it? Pharma.
- [08:41]
Dr. Mary Claire Haver
Okay.
- [08:42]
Cindy Eckert
Which is, you know, very like pharma startup. Feels like it doesn't fit in the same sentence. Pharma's so capital intensive, so difficult, like, and yet I had this, you know, now a track record in the industry where I met all of these folks that were, you know, uninspired in big environments. I thought, well, what if we could put a collection of them together against a product? Like, what could we do? That was really the thesis. I called the first company Slate. It was like truly clean slate.
- [09:09]
Dr. Mary Claire Haver
And did you have a, like a product in mind or.
- [09:12]
Cindy Eckert
I was gonna go find a product and we found at the time the only FDA approved long acting testosterone treatment. And that's how I landed in sexual health. So I was finding a product that wasn't marketed and that was an FDA approved and that was the beginning of it all.
- [09:28]
Dr. Mary Claire Haver
What gave you the idea for Sprout? So you started with Slate. Did you sell that company or.
- [09:33]
Cindy Eckert
Yes. So Slate was excellent because here I am in sexual health, Right. And here's why I love sexual health. Change somebody's connection with the person they want to be most connected to you change their life. It was like on a different level than any other category. I had Been in, and I had been in all these different medical categories, cardiovascular, bone, health, all of that. And then I. This was just so deeply meaningful when you had this impact in somebody's life. So here I am running a male sexual health company. I am the lone woman in pink in a sea of blue pills, as I like to describe it. And yet I was at a meeting in 2010 and they were presenting data on what it is that unlocks desire for women. And I looked around the room and recognized like no company was running toward this. And it was really like lightning struck me. How can I be a woman running a company and loving actually the difference I was making in men's lives, but not have the recognition that there are 26, at that time, FDA approved treatment options for men to lead a more satisfying sex life and not a single one for women.
- [10:36]
Dr. Mary Claire Haver
Did your team say, amazing, let's do this.
- [10:40]
Cindy Eckert
So were they like, Cindy on my all male board was like, hi, our company is flying. And listen, Slate was like a classic startup. You know, the first year you're just like, oh, it's so tough. And then you find your stride if you have a great product and it just goes like this. And we were loving that. Like we were the only long acting. It was a great technology. It is the original testosterone pellet, the FDA approved version that now is knocked off a lot of different ways. But you know, we were doing so well. And then I get like this wild idea like, no, no, we're going to go take this on for women. And we're small and they're like, well, no, Pfizer needs to do that, Glaxo needs to do that. What are the big companies? And it was such a deep calling to me that I was doing it no matter what. And. And luckily I was convincing and they all went along. So we had to sell Slate off. Reason I called it Sprout is we actually acquired the technology of Addie inside of that company. And the day that we. So we sprouted that out to start a new company and sold off Slate. And I looked at all of those investors and I'm like, I'm going to need of that money back to go do this for women. And they said yes.
- [11:49]
Dr. Mary Claire Haver
So what was the next step in the process? Well, you know, I know this is.
- [11:52]
Cindy Eckert
Where the story gets interesting. Yeah. Well, first let me say, why did lightning strike me? I'm standing at the Sexual Medicine Society meeting in Miami, Florida. There's a researcher who's presenting a paper that had just been published in neuroscience and what they had done is they'd taken women who were struggling with their libido, put them into an mri. They'd taken women who were like, you know, I'm good. Like, nothing's changed. These women are like, I don't think about it anymore. Like, I want to, but I just don't. Something's happened. Put them both in an mri, expose them to porn. Their brains light up totally differently. And they published this result. And it was like the room was looking at this brain scan imaging. And it was as if in a collective, all of us went like, holy shit, it's biology. And exactly at that moment, like, it's almost so absurd that we hadn't considered it before, that everything we had told women who were struggling with this issue was something rooted in her emotion. Relax. Schedule date night. You're stressed. Like, those things may all be true. Right. But also, of course, we're wired biologically to have sex drive. And so the room looked at it, and that is what really lit me up. So when we took on the science, you know, the fun was like, what do you do? You sit down with the fda. The FDA actually defines success. FDA tells companies. These are the endpoints you must demonstrate in clinical trials with statistical significance versus placebo. Right. So you have a roadmap. And that was the beginning. As we just, you know, started out on that roadmap, then it got interesting.
- [13:28]
Dr. Mary Claire Haver
So let's back up a little bit, walk our listeners through what is Addie. So what is this drug? Like, how does it work? Yeah, Addi, do you rub it on your vagina?
- [13:37]
Cindy Eckert
That's such a great, great question. We are brain flow, not blood flow. I think this is the beginning of all of this, is that this is.
- [13:46]
Dr. Mary Claire Haver
Where desire, female Viagra, is a misnomer.
- [13:48]
Cindy Eckert
Totally.
- [13:49]
Dr. Mary Claire Haver
Right. Because there's arous and then there's desire.
- [13:52]
Cindy Eckert
Totally.
- [13:53]
Dr. Mary Claire Haver
Viagra is for arousal, and it actually works in women.
- [13:56]
Cindy Eckert
Yes, for sure.
- [13:56]
Dr. Mary Claire Haver
And desire is where most women complain.
- [13:59]
Cindy Eckert
That's right. Addi's a mood drug. So it's got a fun origin story, you know, so does Viagra. Viagra was a blood pressure drug with a really interesting side effect of directed blood flow. And when they found that observation, by the way, this is common in, like, medications. This is the story of Botox, which was being used for, you know, helping folks with strabismus or their eyes being crossed because it relaxed the muscle and actually was discovered because they're like. But wait a minute. All their wrinkles went away. Like, this is the nature of drug discovery. So Addie was a mood drug that happened to have this really interesting effect in that it promoted sex drive. And once they saw that, like, that that was its it factor.
- [14:38]
Dr. Mary Claire Haver
I wonder, like, that's not a standard questionnaire question. Were women just like, hey, right, not only am I happier, but I want to have sex?
- [14:48]
Cindy Eckert
You know why it was found? Because actually, every other mood drug we have, like, on market today, so classically, like, an antidepressant decreases sex drive. Decreases sex drive. So when you're studying these drugs, you actually have to use an instrument that measures how much am I sort of killing your sex drive.
- [15:06]
Dr. Mary Claire Haver
Okay.
- [15:06]
Cindy Eckert
And in this case, all the scores went the other way. And they were like, ooh, what? And then they changed the course of study right then and there. And they were looking at desire, as you said, desire, specifically, because that is women's most common issue. Actually, what's interesting, even in our data, is once you ignite that desire, actually those other variables of sex, arousal, orgasm, everything improves, right?
- [15:32]
Dr. Mary Claire Haver
Because the neurotransmitters increase blood flow. I mean, you know, it all works.
- [15:36]
Cindy Eckert
It is. It's like I say it. My, my, my non. Dr. Mary Claire Haver way is you get the party started. The. When you start the party in the brain, you know, everything else starts to respond, and then you get a great, like, sort of reward, feedback loop because it's a better orgasm. So now I have more desire to do it the next time. So, yeah, awesome.
- [15:55]
Dr. Mary Claire Haver
Okay. So we have this medication. Women have increased desire when they're taking it. You're reading the studies. You know there's a biological component to this. And female desire is complicated. I describe it like a traffic circle. There's several things that kind of feed into it. But, you know, for the patients who have a great partner, a great relationship who used to have desire, and then now it suddenly is gone without, like an environmental factor causing it. And they can orgasm. They don't have any issues with arousal. Or this is a medication that may.
- [16:28]
Cindy Eckert
Be helpful for them 100%.
- [16:30]
Dr. Mary Claire Haver
So if a woman hears this and says, I feel like this is me, and I feel like I would like to try Addie, this may be something I'm interested in. Where does she go? How does she find it?
- [16:40]
Cindy Eckert
Walk me through. So any doctor can prescribe it, but don't be surprised if your doctor has never brought this up before. And what we're finding is that women are really leading this conversation specifically. So some. Our. Our audience is OB GYNs, family practice, all of the above, in which a Woman has really led this. And what they can expect is, look, you need to talk to your doctor directly on whether or not this is right for you. Let me say that. But it's just a return of that drive like that. The first thing we hear from patients and trials where it's working and it's not a panacea. No drug works for everybody. But the first thing we hear is like, oh, my gosh, I'm having, like, little thoughts and fantasies again. Which makes perfect sense when you think about the mechanism in the brain. And, you know, I was just at a trade show and a woman came up to me. She was a nurse practitioner, and she said, oh, my gosh, I just sent my first nude. And I'm like, okay, don't show it to me. But I'm just. I'm so glad to hear. But it's that, like, percolating of interest and desire. And then we see them, you know, being receptive to their partner, where they probably were, like, going to bed early and avoiding sex. And then they're initiating themselves. And that's really the progression.
- [17:48]
Dr. Mary Claire Haver
How long do, like, when you start the medication, would you expect.
- [17:52]
Cindy Eckert
It works on neurotransmitters, so just like other drugs. Wait. Like we basically say, you know, if at eight weeks you haven't seen a result, you're not going to, so you can stop taking it. But there's a climb. Like, it's not zero to 60. You're not taking home the hot waiter tonight. Sorry, ladies, you are waiting because it's building in your system over time. And it's those little things that percolating that you start to notice and get back to that place where you were happy with your desire. It's very similar to all other mood drugs in that regard, Right. If we took an antidepressant, we wouldn't expect to be euphoric. We tell patients the next day, right, it's going to take a little bit of time. And it's not that you're going from depressed to euphoric. Same with Addie, right? You're not going from never having sex to nymphomania. You're coming back to that place that you were happy with. That was your normal, Okay. I actually spent a year just talking to women with this condition before I ever pursued it because I wanted to see what was the there, there. And like, at that time, I knew all of these amazing sex researchers in the world who'd built, like, you know, the house of Viagra, so to speak. Like, all of those researchers And I'm like, are you seeing female patients? Can I talk to them? And what's so funny that you just said that triggered me is every single one of them started the conversation like this with me. I love my partner. They wanted to make sure I knew. Like, I love my partner, but, like, something's changed. Like, it's like the switch went out. I heard it over and over, and I. They were different walks of life. Different ages. Yeah. Different back, different relationship status. Every single one of them told me the same story. And when I'd been told that story over and over again for a year, I'm like, there is something there. And while I will concede that humans are complicated, this is what I do take issue with. Women aren't uniquely complicated. Like, we're not uniquely complicated when it comes to sex. Men are complicated, actually, when it comes to sex, too. Right. So I think that's a bit of it. I mean, men in the Viagra trials get an erection on placebo. So, like, there is, like, this whole, you know, biopsychosocial thing going on. But I think that we've sort of allowed women to be so complicated that we didn't have to bother to fix it.
- [20:01]
Dr. Mary Claire Haver
I was taught that women tend to somat. Somaticize psychological conditions, so. And that her decreased libido is probably a side effect of that. And there's not much we can do for that. The basis of my training. Okay, so you've got this drug. You know, preliminary studies are showing that, you know, it should work.
- [20:20]
Cindy Eckert
Yeah.
- [20:21]
Dr. Mary Claire Haver
Now you go to the fda.
- [20:22]
Cindy Eckert
Well, you don't know.
- [20:23]
Dr. Mary Claire Haver
Right?
- [20:23]
Cindy Eckert
Fda. I go to the fda, they give the roadmap, and we did the work. Like, we went out and we did.
- [20:28]
Dr. Mary Claire Haver
What does the roadmap look like?
- [20:30]
Cindy Eckert
So there were three things we had to prove. So in clinical trials, not one thing. Three things. We had to prove that women who took the product had more interest in having sex, more desire for it, that when they had sex, it was more satisfying for them, and that it actually decreased the distress they were feeling because of this issue. Because, look, if you're not having sex and you don't care, you would never take a product for it. Right. I mean, actually, I think what we miss because we joke about sex or we minimize it is people are really struggling with this. Like, they're struggling not only in their relationships and interpersonally, but personally, how they feel about themselves. And so we had to measure those three things. So now you do the studies, you break the blind, you see like, okay, what's our effect versus placebo. And we'd made it. And I was so excited because you.
- [21:16]
Dr. Mary Claire Haver
Don'T know how much. How many patients had you put through the trials?
- [21:19]
Cindy Eckert
Yeah.
- [21:20]
Dr. Mary Claire Haver
And how much does this cost?
- [21:22]
Cindy Eckert
Oh, my God. Okay, so. So first of all, I'm very proud of this. We are the largest ever studied drug in women submitted to the FDA. 13,000 patients in our clinical trials. That is not the norm. The norm is when you include rare disease in there. It's like just a little over a thousand. But as you know, let's use Viagra as the comparator. They had about 4,000. Okay, so look at that. Like that difference. Right? Three times as many patients worth of data, and it cost hundreds of millions of dollars. I mean, I went out and by the way, VCs laughed me out of the room.
- [21:58]
Dr. Mary Claire Haver
Okay, so what's VC?
- [22:00]
Cindy Eckert
Venture capitalist. Right.
- [22:02]
Dr. Mary Claire Haver
So you have this drug.
- [22:03]
Cindy Eckert
Yes.
- [22:03]
Dr. Mary Claire Haver
And you're like, I need to raise money.
- [22:05]
Cindy Eckert
Yes.
- [22:06]
Dr. Mary Claire Haver
To get people to invest in this so we can do these studies.
- [22:10]
Cindy Eckert
Because you're not so expensive.
- [22:11]
Dr. Mary Claire Haver
Yeah, because the trials are very, very, very expensive. So you have to go to rooms full of old guys and convince them. And that was not going well. No.
- [22:21]
Cindy Eckert
And let me just remind you, I'd sold a company already with a male sexual health drug for hundreds of millions of dollars. And yet I remember presenting at the biggest healthcare conference, like the biggest banking conference, where companies like me get to go showcase and you might get investors. And I started to talk about it and the whole room broke into laughter. Laughter. And I thought, you're joking me. And I can remember, like I had a countdown clock. You know, I was watching it, like, this is your shot and you're losing this time. And I can remember I, like, fast forwarded my slides as fast as I could to the brain scan imaging of women. And I pointed to that screen and stayed silent till the room went quiet. And I'm like, I'm just here to talk about the biology sex in women. Can I begin? And they all shut up. And we started to go, but still, it wasn't getting me checks. I was laughed out of rooms. So we ultimately raised $100 million through private individuals. So I put all my money on the line, like, all in, all in. I so deeply believe in this. And it's not about a product. It's always been about so much more than a product for me.
- [23:31]
Dr. Mary Claire Haver
So you've raised the money, you get the sign off from the fda, prove these things. You have this giant cohort, and the numbers are in Your favor. You're so excited.
- [23:44]
Cindy Eckert
So excited.
- [23:45]
Dr. Mary Claire Haver
Then what happened?
- [23:46]
Cindy Eckert
They say no. And I really, like. I couldn't believe it.
- [23:51]
Dr. Mary Claire Haver
How. Just how could they say no?
- [23:53]
Cindy Eckert
Because they're the fda and they get to make the decision ultimately. And really, what they said, and this is the tell is they said, well, the benefit is only modest, and therefore no risk would be worth it. And I think really, what you have to look to there is if we assign no value to the benefit of something, then, sure, any risk would be too great. And were we really just saying that we don't think women need this? Because we 26 times we looked at medications for men that have benefits and risks, and we said, yeah, here you go. Make the decision with your doctor. But we wouldn't do this. And it became like, this media frenzy of, like, oh, well, how many more times do they have sex a month? And how many more times is the right amount of times? And my answer to that is, go ask the woman struggling with it. Go ask her if going from not having sex to having satisfying sex even once a month is meaningful. You ask her. Because in our trials, by the way, we also had to use an index. It's called the Patient Global Impression of Improvement. Just nerd terms for does it matter? And they said, yes, with statistical significance. And so data was on our side. I mean, when we got the news that FDA rejected us, I gotta tell you, that was. I was blindsided by it. I couldn't believe it.
- [25:17]
Dr. Mary Claire Haver
You did everything right.
- [25:18]
Cindy Eckert
We did the work. You defined success, and we made it with statistical significance. And now we're gonna debate the merit of, like, how much is enough for her to deserve it. That was brutal. And really, I thought the end. I mean, I can remember the day I got the news. I happened to be flying in. I'm based in Raleigh. I'd been in New York, and. And my assistant called me right when I got off the plane, like, oh, no, I need to tell you this. Because they'd sent it through. And I went to the office, and I basically gathered everybody around the table and really just set the mood. Like, the champagne was chilling. Cause we knew the results of the trials at that point. We'd broken the blind. And, like, everybody came to the table, like, here's Cindy is. Here's the great news. And I said, go home and work on your resumes. It's over. And I took that weekend. And I swear, this is a bit of, like, women have always been the people who directed me. Right, Right. A woman who'd been watching the results. Nobody knew this tiny little company doing this at this point, right? No, the media frenzy hadn't even begun. And she reached out to me because she saw, like, a blip probably coming across like AP or something. And she said, I need to speak with you. And she'd been a patient in one of our trials. I drove to dc, Sat with her, and I was reminded of why I did it in the first place. Like, it was for her. It was for her. It was the validation. And I went on Monday morning, I gathered my team around the table, and I said, we're going to fight the fda. And my IT guy said, can you do that? I'm like, we're about to find out. And that really, the next day, he put a pair of boxing gloves on my desk. And they've been there ever since.
- [26:55]
Dr. Mary Claire Haver
So walk us through the fight.
- [26:57]
Cindy Eckert
It was brutal in that, like, the minute we did that, Nightline shows up, right? Like, here's this tiny little company rally. Knock, knock. Hi. You're fighting the fda. And then it just. Everyone was coming and commenting, and what was really happening was the great cultural debate of, does it matter for women to have pleasure? And we were maligned and smeared, and you were.
- [27:22]
Dr. Mary Claire Haver
This is the part I remember as a young practicing physician with this new medication. It really doesn't help that much.
- [27:29]
Cindy Eckert
The very first headline, like, I still remember was, Female Viagra. Isn't that jewelry? I mean, that's not that long ago. And so it just started coming. I mean, there were the things that were printed, the photographs of me where I'm read like the devil. My brother still has it as a screensaver on his phone when I call him. Because what would a big brother be if not doing that to you? I look back on it, and at that moment, I just built an armor of pink, right? Like I was going to. We were gonna have this conversation. Go ahead, come for me. Let's talk about it. Because in the end, I have the data, and science cures bias. I'm not backing down. And that was really with the FDA as well. You know, being in that room, my pink kept getting brighter and brighter and brighter. Because this was the conversation we were gonna have that you minimize. View it as weakness. You know, go ahead, honey, just have a bubble bath. It'll be okay. No, no. I think, you know, progress begins when somebody says no out loud. And so it was a wild ride. A lot of smear. And. And the fda, to their credit, opened their doors to the public. And this is actually their mandate. We pay for them with our taxpayer dollars. And their mandate is to put patients at the center of conversations. It's called patient focused drug development.
- [28:50]
Dr. Mary Claire Haver
Yeah.
- [28:50]
Cindy Eckert
Who should we be talking to if not the people that are affected by the condition? And so to their credit, they had all these public meetings that were like a three ring circus and picketers. And it's crazy because. Why? Because we so don't want women to have a medical option. An FDA approved medical treatment that is proven safe and effective to the standards of the FDA for a medical condition that was first characterized in 1977. So ultimately we won fair and square on science, but women won.
- [29:21]
Dr. Mary Claire Haver
But you brought the patients into the fda.
- [29:23]
Cindy Eckert
Yes, and they did too. They invited patients into the. And they're the heroes of the story. Like I think about it like women who arranged for childcare, took time off.
- [29:35]
Dr. Mary Claire Haver
Work and got up and told probably some embarrassing stories.
- [29:39]
Cindy Eckert
You're at a federal agency and you're like opening the doors of your bedroom to tell your most private struggles. And they did it because they knew if I don't say it, it never changes. And like, they're my heroes, I'm going to get emotional. I sat in the audience with them, you know, watching them up there, and they were mocked, ridiculed, berated. Stories were written about them in the press. And there was one moment in particular where a woman had just gotten up and said, like, really this had caused the demise of her relationship. It wasn't sex alone. But once they stopped having sex, like, all the resentment started to build and she was on the brink of divorce. And somebody got up and they said, hey, I have something you can do for this. Eat chocolate. And I just sat there, like gritting my teeth like, I cannot believe we talked to women this way about a medical condition.
- [30:32]
Dr. Mary Claire Haver
What were some of the biggest misconceptions about female sexual desire that you. I mean. Cause I didn't know much about it. You had a lightning bolt moment watching those images of the brain scans which.
- [30:45]
Cindy Eckert
Have been repeated all over the world now. Like Stanford did big work in the United States, it was discovered in the Netherlands.
- [30:50]
Dr. Mary Claire Haver
Like, this is unequivocal, but that didn't trickle down.
- [30:54]
Cindy Eckert
I know, but it's really so much about what is so deeply embedded culturally about our right to desire.
- [31:02]
Dr. Mary Claire Haver
So, you know, no one owns this in medicine. So OBGYN barely covers it.
- [31:06]
Cindy Eckert
Totally.
- [31:07]
Dr. Mary Claire Haver
At least until 2018, I was a program director. We didn't touch on desire, just barely. And I got zero in my training and urology, they get tons for men and almost nothing for female you know, family medicine, all the primary care docs like. But obgyn, really, there's not. No, you know, a female sexual specialty. I mean, there's organizations that you can join after you finish your training.
- [31:36]
Cindy Eckert
That's right.
- [31:36]
Dr. Mary Claire Haver
Like Ishwish. But no one really owns this part for women. They do for men. It's urology.
- [31:42]
Cindy Eckert
Absolutely right. That's right. Yes.
- [31:44]
Dr. Mary Claire Haver
But usually it falls under psychiatry.
- [31:48]
Cindy Eckert
I know. I can't even. I mean, that is like. That is the biggest misconception, though, that everything that goes wrong for women as it relates to sex is rooted in emotion. And everything that goes wrong for men is rooted in biology. And that is the big diss. And it actually happens across medicine. Right. It's what you talk about so beautifully all the time.
- [32:11]
Dr. Mary Claire Haver
We've had, you know, so far on the pod, we've had cardiology, urology, internal medicine, and obesity medicine. And really it's everywhere. Like, it's outside of the bikini, the breast, the uterus, you know, the part of the body covered by the bikini.
- [32:27]
Cindy Eckert
Yes.
- [32:27]
Dr. Mary Claire Haver
You are a man with, you know, like Ms. Potato Head. You just pop on the breast and pop in the uterus and ovaries and that. What we're understanding now and what I'm pushing is actually every cell in our body is different.
- [32:39]
Cindy Eckert
Yeah.
- [32:40]
Dr. Mary Claire Haver
And it's going to respond differently to different medications. All right, so you go and you fight.
- [32:46]
Cindy Eckert
Yes.
- [32:47]
Dr. Mary Claire Haver
And when did it get approved?
- [32:49]
Cindy Eckert
It got approved in 2015. So we're at 10 years on the market. 10 years, and to this day, they print misinformation. That is crazy. We got approved. And like, I can remember, like, you know, it got approved. I was in my office. Of course they waited until 7:30 at night. So I sat there all day. Oh, my God, is it coming? Oh my God, is it coming? And all my family came and everything to wait for the big news. 7:30, we got it. I got on an airplane. I went. I mean, this was a huge news story. Like, if you think about it, more women struggle with this than men have ed. So let's just contextualize, like, prevalence of this.
- [33:27]
Dr. Mary Claire Haver
ED is erectile dysfunction.
- [33:28]
Cindy Eckert
Yes.
- [33:29]
Dr. Mary Claire Haver
For our listeners.
- [33:30]
Cindy Eckert
Think about that. Right? Like, more women struggle in the bedroom than men. Now there is, for the first time ever, an FDA approved treatment option for it. And I went up to do the morning shows and it doesn't change the questions they asked. Like, a very famous broadcaster had me on to talk about the big news, and he's like, yeah, but it has side effects. I'm like, does the blue pill you take have any side effects? Because I'm pretty sure there was death in the clinical trials, but not likely to happen in real life. These are clinical trials. You test extremes too, understand? And yet it's that. It's exactly the dismantling of whi. It's the fear mongering that when something exists for a woman, we lead with the risk. And when something's for a man, we lead with the benefit. Time magazine put Viagra on the COVID of Time magazine. It was, it was the world's like the biggest invention of its time.
- [34:23]
Dr. Mary Claire Haver
How long did it take for Viagra to make it through the FDA approval process?
- [34:27]
Cindy Eckert
Oh, I love this question. Okay, let's do a tale of a tale of two sexes. Pink pill, blue pill, blue pill, is deemed to meet such an important unmet medical need, a national emergency, if you will, that it was fast tracked for approval in six months.
- [34:40]
Dr. Mary Claire Haver
Six months.
- [34:40]
Cindy Eckert
Men getting erections was that important. Pink pill, six years, two rejections. Public meetings and we had three times as many patients worth of data. There's more data. This is a great news story, but I do think it's missed because we often talk about in women's like sexual health even. We need more research and we need more research. Let's not miss that. There's more research in a product for women, sex, sexual health than any product for men's. We have research, actually. Now we're finally having the conversation.
- [35:12]
Dr. Mary Claire Haver
Yeah, then you get approved and then you sell.
- [35:16]
Cindy Eckert
I did.
- [35:17]
Dr. Mary Claire Haver
That was always the goal, right?
- [35:19]
Cindy Eckert
Well, the goal. We were 34 people. I think nobody knows that. We were like this tiny little band of scientists. And you know, I'm the business person. I had this great scientific team and we were like determined on this mission. But, you know, this was a, this is a condition that affects, you know, first of all, half the population. The recent Mayo Clinic data said 50% of women over 50 have this. 50% of women, okay. So huge prevalence were 34 people. This deserved the attention of a big company. To globalize it, to do the education, to have the super bowl commercial with Bob Dole. I can think of like more interesting women than him on both of my hands that are, you know, on Addie, like it was really that opportunity to scale. That was the dream. And then they didn't do it.
- [36:04]
Dr. Mary Claire Haver
Walk me through how you felt when you like they bought it and you're like, okay, yeah. And they put it on a shelf.
- [36:11]
Cindy Eckert
Brutal. I mean, never been more depressed in my life. We got one. We, we crashed the ceiling where more innovation, more products would come to market for women. We sold it. They were going to globalize it. I was going to stay. Within three months, they dismantled our entire team and they shelved it. They never launched it. That's also a mistake that people make in this story, because I think what happens is, oh, well, Big Pharma did it, and it didn't work. No, Women couldn't get it in the pharmacies. And I sat every day and thought about those women who went to a federal agency and said, please give me a product for this, and they couldn't get it. And I was crushed. Like, I felt like I had let my team down, the medical community down, and those women down. It was brutal.
- [36:57]
Dr. Mary Claire Haver
But you got the company back.
- [36:58]
Cindy Eckert
Hell, yes. At some point, wallowing in my. Like I said, progress begins when somebody says no out loud. I thought, not on my watch. No. And I picked myself up. They had, at the time, changed the CEO. And I asked the new CEO if he'd had breakfast with me in New York. And he sat down, and I said, give it back. And he looked at me and he's like, what? Like, we've paid you a bunch of money for it. Like, we own it. And I'm like, yeah, but women can't even get it. Give it back. And I will give him credit. Like, it took us a while and a little bit of a battle, a legal battle, but ultimately they gave the product back. And now we've had. We've been able to launch it on our own terms. Still a tiny company.
- [37:42]
Dr. Mary Claire Haver
What's the hardest lesson you learned through this whole thing?
- [37:45]
Cindy Eckert
That no matter what, the smear still comes. You just have to stay the course in issues like this, where we've deemed them taboo or stigmatized or we feel no personal accountability for putting our opinion on somebody else's suffering. Yes, that is extraordinary to me. I do think it's breaking, but I do think it has taken a really long time. And I still sit. I still sit with physicians who I love, who have no idea how this even works. No idea, nor would they bring up the conversation. And it's like, bit by bit, you just keep going. And you've got to build whatever that armor is that allows you to do that.
- [38:28]
Dr. Mary Claire Haver
What are the plans for Addie in the future?
- [38:31]
Cindy Eckert
Maybe I will have a Super bowl ad. I think I deserve one. It would have taken me this long to have honestly, like, somebody come out and admit they're on it. I mean, I know a lot of people behind the scenes who are on it. But you know, they're nervous about, about having this conversation and like society's got to get to a place of permissiveness. I mean, when we got it back and we, you know, first we went back to the FDA and we unburdened the label with some nonsense actually that had been there. But we also like couldn't advertise because all of our ads were taken down because they said sex in them, which they have to by regulation because the name of the condition is hypoactive sexual desire disorder. And like we've had to change meta policy and this, it's just been a long, a long road.
- [39:13]
Dr. Mary Claire Haver
A long road.
- [39:13]
Cindy Eckert
But what's great is that once you change it, you change it for everybody else who's coming behind you too.
- [39:22]
Dr. Mary Claire Haver
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- [40:32]
Cindy Eckert
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- [41:02]
Dr. Mary Claire Haver
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- [42:27]
Cindy Eckert
That was the value of keeping the money that the big pharma company paid me. So even though I got it back, I kept their money. And that has helped with other female disruptors. And that's my love. Like, who's the person doing that work in particular? And how do you help them get there faster than you got there yourself? Like, what are the landmines? They don't have to, you know, step on. And so we've done everything from, you know, infant formula made to standards that are better than what the FDA standards were at the time. Like, they've improved them. And, you know, an epidural that's more comfortable for women. Like, those are the things I love when it's women's health and it's disruptive. A date rake drug that was to detect, basically. I could stick my finger in this and see if it could.
- [43:14]
Dr. Mary Claire Haver
Yeah, that was so cool for the rehydna. So if someone comes to you and is pitching something like, how do you mentor and coach those women?
- [43:24]
Cindy Eckert
It's so much less about the idea and so much more about who's championing it. Like, it comes down to the jockey always. And I do see, like, what are the stakes for them? What is that passion? I remember I actually, it's funny, the guys, many of them who laughed me out of the room back in the day, I gave them a billion reasons to believe and now they want to look at things with me, um, when I'm thinking about investing. And I love that actually, like, I think I never sat in, like, the frustration or anger with them for having, like, embarrassed me or laughed Me out of the room. I kept the door open for them to make a better decision the next time. Like, I think if you keep that open, you don't hold onto that. You actually allow them to change with you. And. But we were sitting in a room and a woman came in and I can remember she presented. And in the middle of the picture, the pitch, she started to cry and we walked out of the room. And it's funny, they looked at me and they were like, why didn't you say to her, like, listen, you know, there's no crying in baseball kind of thing, like, you can't cry in the middle of a pitch. And I said, boy, we see the world so differently. The moment she started to cry was the moment I knew I was putting money in, because I could see in her all of that emotion, all that passion that she's going to wake up every day and work on this tirelessly until she sees it through. Win or lose, she's going to put it all on the field. And like, that was such a. And they were like, God, I've never thought about it that way. So, you know, I, I coach them to be authentically themselves. That's the truth. Right? That is, that's the, the best lesson is show up in pink, right? Show up in pink and be you. And like, it's going to piss some people off if you're changing something 100%, it will. But you just, you can never allow that to push you back or to tone you down.
- [45:10]
Dr. Mary Claire Haver
Yeah, I have, my husband and I, me first. But then he's jumped in to help. You know, we have a company, we have self funded, we've built this company from scratch and. But we have through the years had VC and private equity come to us looking to perhaps invest. And so, you know, we take all.
- [45:33]
Cindy Eckert
The calls because why not?
- [45:35]
Dr. Mary Claire Haver
I want to hear what they have to say. And, and we've never accepted any. But there's this theme. And so of course, I have a menopause company and it's always, almost always a man. Yep. And he has to start the conversation with his mother or for his daughters and why he wants to do this. And I know he seems sincere, but it's like, isn't this just a good fucking idea?
- [45:58]
Cindy Eckert
Yes, it is. Exactly.
- [46:00]
Dr. Mary Claire Haver
You know, like, do you have to feign interest in women's health? It's like when Viagra, when they were looking for investors in erectile dysfunction, did they talk about the health of their son's penis?
- [46:11]
Cindy Eckert
Right, exactly. You know, or their son's sex life.
- [46:14]
Dr. Mary Claire Haver
They're like, this is a goddamn good idea.
- [46:15]
Cindy Eckert
Of course. I mean, all you have to do is look at prevalence. You're like, okay, let's see. Half the population, this percentage of them have it. Like, I can see the.
- [46:22]
Dr. Mary Claire Haver
I'm so sick of people sleeping on women's health.
- [46:24]
Cindy Eckert
Yeah. And like, this is.
- [46:26]
Dr. Mary Claire Haver
This is real.
- [46:27]
Cindy Eckert
Totally.
- [46:28]
Dr. Mary Claire Haver
And women are ready to invest in their own health.
- [46:30]
Cindy Eckert
That's right. Of course, they will rue that day. If you look at the control of wealth and everything else, the wealth transfer to women, et cetera, like, you are really out of touch if you're not looking at these opportunities right now. Yeah.
- [46:41]
Dr. Mary Claire Haver
And we still get the calls and we just kind of laugh and say, okay, yep, sure. How do you think, like, women's sexual health, you know, you've been in it, you've seen it from the men's side. Sadly seen it from the woman's side. But I feel like things are changing.
- [46:54]
Cindy Eckert
I do too.
- [46:55]
Dr. Mary Claire Haver
I'm new to the party.
- [46:56]
Cindy Eckert
Yeah.
- [46:56]
Dr. Mary Claire Haver
So. But where. How do you see this changing?
- [46:59]
Cindy Eckert
We're having the conversation. I mean, I think that's extraordinary. And the conversation doesn't begin with nothing but hand wringing and qualifying language. Like, it's really that we're saying. Yeah. Like finally we're talking about this. And. And I think that people understand, like, it is my responsibility. I mean, look, this is my favorite thing of all at this point. You can't become a board certified obgyn, internal medicine urologist, or family practice physician without answering a question about hsdd. And Addie, that's huge. That's how it changes. Right. Once it becomes embedded in the education system. In the education system. But I think even, like in practice, I didn't get it in medical school. You feel it. Like you can feel this right now.
- [47:42]
Dr. Mary Claire Haver
A significant percentage of my non pregnant patients complained about this.
- [47:46]
Cindy Eckert
Yes.
- [47:47]
Dr. Mary Claire Haver
And I was a deer in the headlights, Cindy. I was like. I remember walking out to my boss at the time, you know, we'd go to our. Our more seasoned wisdom.
- [47:57]
Cindy Eckert
Sure.
- [47:57]
Dr. Mary Claire Haver
You know, older people and who happened to be a man. I don't want to, you know, make this about being, you know, sexist, but. And he would say, oh, tell her to have some wine. You know, just. Just very dismissive, very platitudes.
- [48:10]
Cindy Eckert
Yep.
- [48:11]
Dr. Mary Claire Haver
And that there was nothing, nothing to do. And these poor women. And like you said, I love my husband.
- [48:19]
Cindy Eckert
Yes, always.
- [48:20]
Dr. Mary Claire Haver
And so I started reading on my own. And I found Venus and Mars in the bedroom. Do you remember that book?
- [48:25]
Cindy Eckert
Yeah, I do. Of course.
- [48:26]
Dr. Mary Claire Haver
And so I read it and I took notes from it. Of all things, this was the only piece of literature I could find because I've had access to the medical library. I'm scanning the literature, and there was just almost nothing that wasn't rooted in psychology or psychiatry. So, you know, you telling that story as. I had no idea what you were going to say. You were just a business owner talking about this business. And as an ob gyn, I was just sitting there like. And I remember standing up and just like. I think I was a little teary and being like, hi, I'm an ob gyn and so many of my patients are complaining of this. And I have. I didn't even know about your drug. I didn't know that I could help them.
- [49:03]
Cindy Eckert
So I love that so much. I remember that. I remember that meeting in 2016. I think it was so many years ago. Look at that. We're almost at a decade from there. And it's just. But it is thanks to people like you. Like, I can't go. I write you. I. I send. I send you little texts. And I'm like, oh, my gosh, here. I'm here. And every woman comes up to me and they're like, do you know Dr. Mary Claire Heever? And I'm like, I do. It's like my best rock star status. And. But it's really that women also are fed up, and so they're gonna force the medical community to keep step with them. Like, they're forcing this conversation in a lot of ways.
- [49:40]
Dr. Mary Claire Haver
There's so much that is good and bad about social media, but one of the good things, I think, is that stories of women that were kept behind locked doors, that women had begun sharing these. These things and everything from, you know, their sexual function to libido to, you know, how to make a chicken.
- [50:04]
Cindy Eckert
Right.
- [50:04]
Dr. Mary Claire Haver
But. But it's this feeling of, oh, my God, that happened to me.
- [50:07]
Cindy Eckert
Yes.
- [50:07]
Dr. Mary Claire Haver
And I don't want to say me too, but, you know, I'm not alone. Wow. I mean, one of my most viral videos. Frozen shoulder.
- [50:14]
Cindy Eckert
Yes.
- [50:15]
Dr. Mary Claire Haver
Palpitations. You know, things that no one had connected in the past on a larger scale with menopause. And I think people being honest and sharing their stories of their sexual function and their frustration and. And this. This real thing about libido. I think social media has allowed women to realize they're not alone and that they. There's stuff that they can do for it. They don't have to suffer.
- [50:37]
Cindy Eckert
Agreed. And I think there's been a Dismantling of other, even stigmatized conditions. Like, I'm very interested in, I would be interested in your take. Like the conversation around obesity. I got to speak in la, so I asked this question. The audience, I'm like, by a show of hands, how many of you have ever tried a fad diet? And like the whole thing, right? The whole audience raised their hand and I'm like, but there were people we've always known who like, no matter what they did, they couldn't get like the weight off. Like there was something. And it's as if we're just now being like, sorry. It might also be genetics, of course. And I think so too. Will the story go around sex for women that, like, why would we not even consider that? It would also be a biological issue. Like, it doesn't mean it always is. If you're in a bad relationship and that's why you don't want to have sex.
- [51:24]
Dr. Mary Claire Haver
That's the first question I ask.
- [51:25]
Cindy Eckert
No pill is gonna fix it.
- [51:27]
Dr. Mary Claire Haver
Do you love your partner? I absolutely hate him. I'm like, well, I, you know, we, you need a new partner.
- [51:32]
Cindy Eckert
We can't fix that. Right. Like, but I think that it's just like thinking about us, like, if women could be considered, which you, you say, and it, it just makes me like, you know, the hair on the back of my neck stand on that. Every time you talk about the whiny woman, like the WW in the medical chart. Like, if we could just consider them like biological beings and if we would start there in science, in a scientific interaction, we'd be so much further along.
- [51:59]
Dr. Mary Claire Haver
So I have a question that we had an expert on. And we talked about the orgasm gap and we talked about same sex partners and heterosexual and how there's a difference there. Were any of the people in the study unpartnered?
- [52:11]
Cindy Eckert
They were. So FDA criteria was that they had to be in long term relationships and this had to have been going on for some period of time. That said, the measure of satisfying sex could also be masturbation.
- [52:25]
Dr. Mary Claire Haver
Okay, so it could be on masturbation data.
- [52:28]
Cindy Eckert
It's good. I mean, more satisfying sex. And that that might have been for some of them, like their own masturbation, not partnered sex. So I think that was part of what was looked at. But like the, the enrollment criteria was long term, partnered, long time. Like women had been struggling with this for at least five years throughout the child.
- [52:48]
Dr. Mary Claire Haver
You didn't have to, you know, if the FDA was not in the picture, how would you have designed this study?
- [52:52]
Cindy Eckert
Oh, Interesting. This is gonna be the. The craziest thing that anybody has ever said, designing a clinical trial. But I would've actually started with women who had survived breast cancer. And here's why. Because this is non hormonal and because I think we might have gotten out of our own goddamn way and had a little bit of compassion. And if you think about a woman who goes through that and has struggled and survived and she's now given a life sentence of, like, a lack of libido and a lack of that intimacy, you would actually not be arguing about, like, does it matter if she has it? Like, I. That's honestly what I would have done. I mean, this is. You can understand, like, in clinical trials, there's so much going on for, you know, a patient who has cancer that a lot of times that's not the population they would want.
- [53:40]
Dr. Mary Claire Haver
And they are very loud right now, which is great about our needs are not being met. Like, okay, you've cured my cancer, but you've left me with this armamentarium of side effects, and my quality of life is so poor.
- [53:54]
Cindy Eckert
Listen, 80. It's north of 80. I'm gonna say 85%, right? 85 to 90% of women who survive breast cancer will struggle with this medical condition that Addie treats, and yet less than a third get any information about it. And what's crazy to me now, I'm gonna go back. Maybe my. The greatest thing I had in my back pocket is that I had built a company in male sexual health, and I knew what happened there and what the trials looked like. And, you know, suddenly I started getting asked all different questions that I'd ever been asked before. But, like, when men survive prostate cancer, one of the outcomes of surgery might be that they become impotent or they have erectile dysfunction. You better believe we go to work on that fast. We're like, oh, that can't happen. So, like, let's put them in a program. Let's have this, let's have that. And yet here we are with women cancer survivors who are going to have sexual side effects, and we're like, well, just be happy you're alive. Well, you're alive, but you're not living or you're not living life on the terms that you want to live life on. That's how I would have done it differently.
- [54:57]
Dr. Mary Claire Haver
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- [57:28]
Cindy Eckert
Eczema is unpredictable, but you can flare less with Epglis, a once monthly treatment for moderate to severe eczema. After an initial four month or longer dosing phase, about 4 in 10 people taking EBGLIS achieved itch, relief and clear or almost clear skin at 16 weeks and most of those people maintain skin that's still more clear at one year with monthly dosing. Hempglos Lebricizumab, LBKZ, a 250mg injection, is a prescription medicine used to treat adults and children 12 years of age and older who weigh at least 88 pounds or 40 kilograms with moderate to severe eczema, also called atopic dermatitis, that is not well controlled with prescription therapies used on the skin or topicals or who cannot use topical therapies. EBGLIS can be used with or without topical corticosteroids. Don't use if you are allergic to Epglis. Allergic reactions can occur that can be severe. Eye problems can occur. Tell your doctor if you have new or worsening eye problems. You should not receive a live vaccine when treated with ebglis. Before starting Ebglis, tell your doctor if you have a parasitic infection. Ask your doctor about ebgliss and visit ebglis.lily.com or call 1-800-lilyrx or 1-800-545-5979.
- [58:33]
Dr. Mary Claire Haver
What would you tell your younger self walking into those all male meetings in your pink outfit?
- [58:38]
Cindy Eckert
What makes you think that they know better? They may sit there, they may, you know, criticize your idea, they may marginalize it. They may tell you it can never be done. But why do you think they know better than you do?
- [58:53]
Dr. Mary Claire Haver
So it's out. We prescribe it in our clinic. Our patients are sometimes struggling to get it filled or covered. Yeah, you have a good story. I want you to share.
- [59:02]
Cindy Eckert
Oh, man, I gotta tell you, this is also like, this is where it never ends, right? And like, who bears the responsibility for this?
- [59:10]
Dr. Mary Claire Haver
Like, and how many journalists?
- [59:12]
Cindy Eckert
This what this, like, who wrote the article that minimized this, that said there was a reporter in the FDA announcement. Sorry, sidebar that just came out that was so big. And he stood up in the room and I can remember the very first time I had a conversation with him about hsdd. He's like, but aren't they just sad? And I thought, so it's just this reaction, right, that I, that I have to it now I lost my total train.
- [59:37]
Dr. Mary Claire Haver
So the story from.
- [59:39]
Cindy Eckert
Oh, I know. So listen to this. An insurance company sent a basically prior authorization, which is the hoop jumping that insurance company.
- [59:49]
Dr. Mary Claire Haver
Every single person listening knows what a.
- [59:52]
Cindy Eckert
Prior auth is, right? Try to deny. And so a woman who'd been like diagnosed with hsd, been prescribed addie by her physician it's the, you know, one of the FDA approved drugs. She gets it, they send a prior author and they say, well, first she.
- [60:08]
Dr. Mary Claire Haver
Has to try marriage counseling just to fail marriage counseling.
- [60:11]
Cindy Eckert
Fail it. What does that look like? Yeah, I don't know. What if she sends her a divorce certificate decree? Does she get the medication then? Is, is that what it looks like? This is a huge national insurer. Are you kidding me? You must first fail marriage counseling, please. So of course, you know me, I'm like, well, please show me a time in which you have required that a man fail marriage counseling before he gets Viagra, Cialis, any other medication. Because if you don't, I'm printing it on the front page of the New York Times. Like, this is the thing. It's unacceptable. We have to be thoughtful about what our responsibility is in that if we position this for women as just an emotional thing because then they can get away with saying it. I think that's. By the way, let me be a little optimistic here. I think that's the next domino to fall, that actually insurers are going to cover the things that are approved for women. That's the next domino to fall. That actually, you know, we, because we talk a lot and you know, we have this conversation as well about, we can talk a lot about. Women need more funding, we need more research, we need more of those things. Yes. But for the things that do that, right. That get the research, get the approval, then they can't access them anyway. So what is the incentive for anybody to go here and do that? And that's the thing that has to crack. I talk to rooms of friends who have a perception like, well, there's nothing for women. I'm like, well, actually, look at this page I have of all of these different things that are approved for you. You just have either never heard of them from your physician or they're not covered by your insurance. And that's crazy. Like we can't have a world in which your vasectomy is covered but your care for miscarriage is not.
- [61:54]
Dr. Mary Claire Haver
I often say, where do they think the Viagra laden penises are going? You know, like, you can't treat half of a couple.
- [62:01]
Cindy Eckert
Yeah.
- [62:01]
Dr. Mary Claire Haver
And some of the, you know, feedback. Does your husband know you're on this? And you know from that I've heard from patients coming back of just, just how lots of people not in the relationship feel like they need to weigh in from pharmacists down to their insurance coverage.
- [62:18]
Cindy Eckert
Unbelievable.
- [62:20]
Dr. Mary Claire Haver
And they don't see that when their husbands go get vasectomies or Viagra. But when you get your tubes tied or. That's right, when it's your health, your right, your choice. Again, this is a bigger conversation.
- [62:34]
Cindy Eckert
And let's just say this here. Don't mistake that paternalism is only male.
- [62:40]
Dr. Mary Claire Haver
Oh, God.
- [62:41]
Cindy Eckert
Yeah. So many women are so paternalistic about this and I think they're blinded by their own superiority.
- [62:49]
Dr. Mary Claire Haver
It really seems to be a certain generation. This really seems to be generational. When I talk to other clinicians, one, if you're at the bedside, if you are treating the patients, if you are an academician who is not actually seeing patients sitting there getting the emotional like waves of this coming off of a patient, it's a lot easier for you to dismiss this and dismiss what this medication could do for the patient. I also think there is a definite generational thing where maybe this generation of scientists was not in their own psychological and socio biopsychosocial development. This was not a thing they were expected to serve and fade and not to embrace their own sexuality. Now, Lauren Stryker is not like that. You know, I had just had her on the podcast. She's, you know, a little bit older than me and definitely has been training a lot longer. I was a geologist before, so I have a little gap. But, you know, it's not all. I certainly don't want to generalize this by age, but I do see, you know, if you're at the bedside, if you're actually treating patients, and if you tend to be have been brought up with this, biopsychosocial sex is a good thing, you deserve to have pleasure, then you're a lot more easy to embrace.
- [64:10]
Cindy Eckert
Yes.
- [64:10]
Dr. Mary Claire Haver
There's just so much we have to.
- [64:12]
Cindy Eckert
Dismantle, so much in, so much judgment in it that we really need to self examine of. Like, why would we. That was always what was so fascinating to me. Like, I feel like I've lived this like unbelievable social experiment, you know, in Addie, like watching reactions and what is like the cultural embedding of that. But like, what I could never quite put my finger on, and I can never explain for another person, is why would you ever stand in the way of somebody else having it? If you don't want it, no problem, don't take it. Why would you not want somebody else to have it? What is that like, what is that with sex or with women specifically, that you feel entitled to stand in her way of having access to it. That is a crazy thing. And I will just say, because I'm a little less forgiving than you are. For all of the excuses I have heard through the years of, well, I just wasn't trained on it. You know, I too, was not trained on Microsoft Excel. And yet I've had to learn how to do it to be a CEO. And so I feel like there's also just a requirement in this world, right, to keep learning and evolving so that you can take the best care of people.
- [65:19]
Dr. Mary Claire Haver
What's one myth about women's sexual health? You want to retire forever?
- [65:23]
Cindy Eckert
Okay. Right here, right now, we're doing this. It's men's right to receive pleasure, and it's women's to deliver pleasure.
- [65:30]
Dr. Mary Claire Haver
Good job.
- [65:31]
Cindy Eckert
Own your pleasure. In the bedroom, in life, in the boardroom, wherever it is, own your pleasure. Awesome. All right.
- [65:39]
Dr. Mary Claire Haver
What is the documentary? The Pink Pill. Sex, drugs, and who has control?
- [65:44]
Cindy Eckert
Oh, my God.
- [65:45]
Dr. Mary Claire Haver
Tell me the story. Like, you were sitting at home one day and the phone rang.
- [65:48]
Cindy Eckert
Actually, I'll tell you because it's a shared friend of ours, Dr. Rachel Rubin, gave a lecture in D.C. and she told my story. And a woman who was there for her own learning because she was going through menopause came up and said, do you know this woman? She's like, yes. And I can remember she called me and she was so excited. She's like, somebody wants to make a film about this story. I'm like, nope. And she's like, what do you mean? And I said, no, it's always twisted. Like, I have so much PTSD from all the twisting and manipulation. And, like, we've gotten so far, I couldn't look back. Like, I've always been just like, keep going. Just keep going. Just keep going. We're gonna make progress. And we have made so much progress that I didn't wanna go backward and basically relitigate everything again. And I will give credit. This filmmaker called me for three years. I was like, please don't ever call me again. And she's fabulous. She's like, you know, these are, like, award winning women. Yeah, they're incredible. And ultimately, she said, look, we're telling the story sort of with or without you, but I'd really like for you to sit for an interview. And I sat for an interview. And she said, in order to earn your trust, I'll show you. So I have no involvement, like, no editorial control, Nothing. Right.
- [67:01]
Dr. Mary Claire Haver
You just gave an interview.
- [67:02]
Cindy Eckert
Scary. Like, it's very scary for me because, like, the product is doing so well in the market, and we are shaking off the myths and misconceptions, and we are having this conversation and she said, to earn your trust, I'll let you see a sneak preview. And I sat in a room, and I cried like a baby. And I just. It honors why you fight for this, why the stakes, why it matters. And I think it honors all of the women in the room that day who stood very bravely and, like you said, told their most personal struggles front of a bunch of strangers, in front of a panel that was looking at them like this. And like, they. And they got mocked and they were made fun of, and they did it anyway. And I think that's all my emotion in it when I watch it. And it's also so spectacular that it shows the you. Right. What is the Mary Claire Haver effect? What is the Rachel Rubin effect? Like, what is this. Like, this new guard of women who are just not accepting it anymore on behalf of other women. And we're saying, women are smart. Give them all the information, they're gonna make their best decision with their doctor.
- [68:14]
Dr. Mary Claire Haver
I believe that.
- [68:14]
Cindy Eckert
But why do we gatekeep information or prejudge it? It's just. It honors that so deeply. And that is what I love about it. And I'm incredibly honored to be the subject of this film. Who would have ever thought, like, again, when I started this, I built a company for male sexual health. I just thought, nah, nah, nah, nah, nah. It's just because you could have taken your straightforward process.
- [68:34]
Dr. Mary Claire Haver
I mean, Cindy, you could have taken your big fat check, paid off your people.
- [68:39]
Cindy Eckert
Yeah.
- [68:39]
Dr. Mary Claire Haver
And gone off into the sunset. You didn't have to work again, I'm guessing.
- [68:43]
Cindy Eckert
I mean, you know, it's true.
- [68:45]
Dr. Mary Claire Haver
So, like, you're always working.
- [68:47]
Cindy Eckert
I'm always working. What is it? I know it's because this is my passion, and I won't stop working until it's done. And when it's done is when we're not having these nonsense conversations. We're really treating women equally when it comes, not differently. Equally. Again with the fda, I never asked that we get special consideration. I asked that we got equal consideration, same standard. That's it. That's all I ask for. And that's what I hope we get to in women's sexual health. I think it's the next frontier.
- [69:20]
Dr. Mary Claire Haver
All right, so why do you keep doing this? What is driving you right now?
- [69:24]
Cindy Eckert
I've decided I'm allergic to hypocrisy.
- [69:29]
Dr. Mary Claire Haver
That is awesome. 2016, I sat in a room, and you were the first person in all of my training, in all of my years, who made me look at how we treat women. Sexual desire as a medical condition and you changed my life and therefore you changed the life of all of my patients and now millions of followers.
- [69:52]
Cindy Eckert
So thank you. I adore you. Thank you.
- [69:57]
Dr. Mary Claire Haver
You can find Cindy on Instagram at Cindy Pink CEO and through Addie's website@addyady.com I'd love to hear from you about this topic and anything else that's on your mind. You can find me on Instagram rmaryclaire and get honest and accurate information on health, fitness and navigating midlife@thepauselife.com My upcoming book, the New Perimenopause is available for pre order at Amazon. If you're loving this podcast, be sure to click Follow on your favorite podcast app so you never miss an episode. While you're there, leave us a review and be sure to share the show with the women you love. We would be so grateful. You can also find full episodes on YouTube at Dr. Maryclaire Unpaused is presented by Odysee in conjunction with pod people. I'm your host, Dr. Mary Claire Haver. The views and opinions expressed on Unpaused are those of the talent and guests alone and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis or treatment.