473: Noula with Noelle Acosta

Noelle Acosta is Founder and CEO of Noula Health, a data-driven platform that uses personalized hormonal health data to deliver tailored care. Victoria talks to Noelle about helping patients with uteruses to better understand their bodies by providing them with hormonal health data that's unique to them and providing them with individualized care they deserve at their fingertips through a virtual app. Noula Follow Noula on LinkedIn or Twitter. Follow Noelle Acosta on LinkedIn or Twitter. Follow thoughtbot on Twitter or LinkedIn. Become a Sponsor of Giant Robots! Transcript: VICTORIA: This is the Giant Robots Smashing Into Other Giant Robots Podcast, where we explore the design, development, and business of great products. I'm your host, Victoria Guido. And with me today is Noelle Acosta, Founder and CEO of Noula Health, a data-driven platform that uses personalized hormonal health data to deliver tailored care. Noelle, thank you for joining me. NOELLE: Thank you so much for having me, Victoria. It's a pleasure to be here. VICTORIA: Wonderful. I'm excited to learn more about your product today that you're building. Can you just tell me a little bit more about it? NOELLE: Yeah, absolutely. Well, I feel like, [chuckles] one, you could work here. You did a phenomenal job of sharing what Noula is. But here at Noula, we are a virtual care platform that really empowers women and patients with uteruses to better understand their bodies by providing them with hormonal health data that's unique to them. Based on that information, we're able to provide them with the individualized, tailored care that they deserve at their fingertips through a virtual app. VICTORIA: Wonderful. And I'm wondering what led you to think I need to make this company. What happened in your life where you decided this needs to exist in the world? NOELLE: Really it stems from my own personal brush with an undiagnosed chronic condition where I truly was the one in five women who felt dismissed, denied, and ignored in the traditional healthcare settings. And that is really something that's actually unified us all as a team here at Noula. We have the shared frustration in terms of the gaps that we experienced overall; not one, two of our health journeys looked alike. And so during this time, I found myself really just kind of banging my head against a wall where I had these ongoing symptoms that disrupted every aspect of my life, not just my physical health, but it became really very much an emotional roller coaster as well. Because despite having access to care and wonderful employer-sponsored health insurance, I was finding that my doctors were essentially brushing me off, attributing it to stress. And it really led to me kind of just having this inner monologue and questioning myself as, like, is this in my head? Maybe it is stress-related. This doesn't feel normal. Should this be normal? And so I, just like 70% of millennials, turned to Google as my medical companion. I lost trust in healthcare settings and just turned to do research around what could be possibly causing the symptoms in my overall health. And I just refused to believe that this was my sense of normalcy. And through my own research, I started finding things like my ethnicity and my environment could have an impact in the symptoms that I was experiencing. I was dealing with chronic pelvic pain, irregular periods to the point where I was actually menstruating for seven months straight. I had horrible migraines. And so I just really turned to these medical journals to try to figure out and uncover what my body was telling me. And so, based on that research, I finally went back to the doctor demanding an ultrasound, where they ended up finding over 40 abnormal follicles and cysts on my ovaries. And even at that point, my treatment plan was a Band-Aid fix. And so, ultimately, I really felt like the system fundamentally failed me. This Band-Aid fix was essentially, hey, we'll put back your former birth control method and call us when you're ready to have a baby, and we'll figure it out then. And so, to this day, I actually haven't received any additional care, guidance from any clinician despite being in and out of the doctor's office with the symptoms. And so I ended up being diagnosed with a condition called PCOS. Again, from my own research, I learned that Mexican women with PCOS, so yours truly, we have the most severe phenotype that puts us at the highest risk for other complications that are beyond just reproductive health. It increases my risk for diabetes. It increases my risk for hypertension. And these are ultimately very costly to my health. And I was just frustrated. I thought, why am I learning about this through my own research versus the doctor's office, where it really felt like a one size fits all approach to care? And so, based on my experience, I started talking to more and more women. And I found that I wasn't alone with this shared frustration. We see that 80% of people who menstruate suffer from hormonal imbalances. And more often than not, women are juggling with more than two chronic conditions at a time. And so it's truly something that I felt as a patient that we were missing to feel empowered in our health and actually feel seen and heard. And then, when I actually spoke to clinicians as well, they felt that they weren't set up to care for their patients in the way that they wanted to care for them. VICTORIA: And I'm wondering how those women and the people you talked to started to inform the roadmap for the product that you were going to build. NOELLE: Yeah, yeah, absolutely. I mean, truly, the voice of those members, and these patients are the center of our lighthouse in terms of how we shape our product roadmap ahead. And so, ultimately, it really came down to us initially doing customer discovery. So I was really surprised to see how many people were willing to talk about their experiences navigating their health as a woman or a person with a uterus. And that was really telling in itself because I've heard from folks where they had to pay others with gift cards to have this conversation about how they might navigate certain workflows as it might relate to the products they're building. But naturally, these folks wanted to talk about their experiences. So we kind of tackled this in a couple of parts, one, I was going out into my own network, reaching out to friends of friends, posting in Nextdoor Facebook groups, really asking for 15 minutes of people's times to learn about their experience. And within two weeks, I had almost 100 customer discovery calls booked where these women were wanting to talk about their frustration and what they wished they had in terms of the care that they wanted. And so that was point A, like, okay, I think we're onto something. Our gaps in our experiences are shared across the board. And this is the pain that not only I experienced, or the Noula team has experienced, but that hundreds of women have experienced. The other piece, too, is, believe it or not, you know, we're constantly doing customer discovery as an early-stage company. But when we launched our beta, we launched with an initial hypothesis. But we saw that what our members were coming in for more aligns with their hormone health than what we initially thought, where we thought majority of folks would be coming to us at a family building stage. And then even [laughs] truly through social media, our TikTok channel alone when we lead with these persona stories it helps drive this just natural virality to it. And daily, we have folks reaching out to us asking if what they're experiencing is normal or what they should do. And so they're coming to us because we really fill this very prevalent gap in care today. VICTORIA: It must be really reassuring on a personal level and also on a business level that you found a problem that you can really help and make a difference with. NOELLE: Yeah, absolutely. I mean, it's frustrating that we are all bonded and unified by this experience. But ultimately, we'll continue to use the voice of our members as our guiding light to shape our roadmap ahead. And actually, that's what you see today with Noula. We took the learnings from the beta. We took the conversations that we've had with so many members and just women and folks outside of Noula to really shape what you see today. VICTORIA: That's wonderful. And you already mentioned one surprise that you found in your customer discovery process. I wonder if you could even tell me a little bit more about any hypothesis you had that you found from research; the outcome was quite different, and that changed your business strategy. NOELLE: Yeah, yeah, absolutely. So we have always seen ourselves as truly being this co-piloted partner for women in their healthcare journeys for life. But when initially launching our beta, we thought our niche today is going to be folks navigating family planning, so people who are looking to start a family in the near future, actively trying to conceive, pregnant, or recently postpartum. So we built a beta around that. And it was very low-code. This is before I had any technical talent [chuckles] on our team and essentially no money. And so, we built this low-code/no-code beta and launched it. We brought on about 100 folks to this closed beta. And with that, we built the product with that hypothesis in mind that we're going to be targeting specific stages. But what ultimately happened is as we were onboarding the 100 users, we found over...with each onboarded user, we started to see the scale tip where all of a sudden, 80% of those users very much had a story that mirrored my own experience with health. They were coming to us because they suspected that they had a hormonal imbalance or these unexplained symptoms that they didn't know what was causing them. Several of them had been diagnosed with conditions like PCOS, endometriosis, or fibroids. Many of them were dealing with unexplained period pain and irregular menstruation. And so we started to scratch our heads to be like, oh, wow. Okay, so these folks are actually coming to us for a different reason than we had [chuckles] initially anticipated. They're using the product differently. And also, they are far more engaged than our initial hypothesized users, which were pregnant people. And so while we have been able to really create a product that is able to adapt with these users over time, we found that that messaging and creation of a safe space for those users was incredibly important, and we wanted to lean into that. VICTORIA: That's really cool. And maybe talk more about creating that safe space in dealing with healthcare data. Were there any special considerations you had to bring into building your tech stack with those really delicate elements? NOELLE: Yeah, yeah. I mean, ultimately, safety and security of their data and honoring that privacy. We will never sell any data whatsoever. And I know that was a concern for many and still is since we've seen in the news this has been happening with other apps and stuff where they're selling user health data to social media sites. So honoring and protecting that privacy, first and foremost. The other piece is we had to also empower our care team to support our members in the best way that they can with the information that they had about their unique health. And so, unfortunately, our members were coming to us at such an emotionally turmoil time in their lives that they wanted answers. They were frustrated. They were saying, "Why is this happening to me?" We had to really ensure that we could be that empathetic ally for them, empower them with information, and really arm them with tools to use inside and outside of the clinic to get the answers that they deserve. VICTORIA: Right, and I see that. So on your site, there's a quiz you can take about your symptoms, and then you can sign up for what's ultimately going to be a home test kit. Is that right? NOELLE: Yes, yes. So users are able to sign up for Noula at no cost to you. So you can start free tracking your symptoms, and these symptom trackers are going to be customized to you. So based on... similar to the quiz that you mentioned, you'll be able to answer questions about what you're experiencing, what your goals are. And Noula will make recommendations of what to track within the app itself. You can then track your symptoms that you select over time and get this customized snapshot to build this true picture of your health. You can then continue to add on to that snapshot of your health through that home hormone test. So you don't necessarily need to purchase the test if you don't want to. But you have the ability to test your hormones to get a clearer picture of your baseline hormonal health. And we're able to really help arm you with that information about your body. And then, from there, beyond just that information from that data set, you have access to empathetic coaching from medical experts. All of our care coaches are registered nurses. So you do have that expert at your fingertips who's there to really steer and guide you every step of the way. And that was something that I actually felt was missing from my own experience when navigating my own symptoms pre-Noula. I found myself running these tests [chuckles] on my own, like ordering tests online trying to figure out what was going on. And just kind of hit this wall where I said to myself, I don't know how to interpret these. I don't know what to do with these. I don't know how to talk to my doctor about this. What do I do? VICTORIA: That's so interesting. And I heard you mentioned empathy a few times and how important that is. Would you say that's one of your core values that you bring into founding a company like this? NOELLE: Oh yeah, absolutely, absolutely. So I actually studied to become a doula. And so some of the pillars that we were trained in were really supporting our clients in these four primary pillars: ensuring that we can support them with physical support, emotional support, informational support, and advocacy. So really, those four pillars together have really steered us to create this foundation of empathetic care. And so that is truly integral to our brand and who we are, how we deliver that care, and also in such an inclusive and culturally competent way. VICTORIA: It sounds really important what you mentioned; building an app requires a lot of trust to be able to give you your data and trust that the results that you're getting are helpful. So I really love that that's a part of your core value that you bring to the organization too. NOELLE: Yeah, I think it was something that was really important to us from the very beginning, especially because we are a BIPOC and queer-co-founded company. It's rare that we see ourselves in the ecosystem, not just as founders [chuckles] but even just in how care is designed for us. So we wanted to ensure that we were creating this space where everyone can see themselves. And it's been so reassuring to hear from members and even just folks who find Noula on their own that they finally feel like they're seen and heard as an individual with Noula. VICTORIA: Well, that might be the answer to my next question, which is what keeps you going, and what's the wind in your sails that keeps you pressing forward with this? NOELLE: [chuckles] It's definitely that I think being able to hear from our members how Noula has helped change their life, even it is just a little bit where they feel more confident, where they feel supported, and they don't feel alone means everything to us. And the other piece is I feel incredibly proud when members have actually tuned in to listen to their bodies. And despite their experience feeling brushed off in the traditional healthcare setting, they really listen to themselves and turn to Noula. And there have been cases where we help support these folks to the point where because of Noula (One member is actually popping up in my head specifically.), they were able to find that they had a hereditary thyroid condition before it worsened because of Noula. And so that in itself was so powerful because their experience in the clinic was very much more like, well, no wonder you're fatigued and no wonder you have brain fog. You have a baby; what do you expect? VICTORIA: Oh, I love that; what a powerful message. And I think that speaks to the power of having systems in place that are designed with those people in mind. NOELLE: 100% yes. Mid-Roll Ad: When starting a new project, we understand that you want to make the right choices in technology, features, and investment but that you don’t have all year to do extended research. In just a few weeks, thoughtbot’s Discovery Sprints deliver a user-centered product journey, a clickable prototype or Proof of Concept, and key market insights from focused user research. We’ll help you to identify the primary user flow, decide which framework should be used to bring it to life, and set a firm estimate on future development efforts. Maximize impact and minimize risk with a validated roadmap for your new product. Get started at: tbot.io/sprint VICTORIA: So what does success look like in the immediate future and in the longer term for Noula? NOELLE: I think today, our success is very much qualitative. I think with health, especially digital health, it's a long game. And so today, we're measuring success by those member stories, by hearing from them that, again, this is a place where they finally feel empowered in their health. They have the tools that they need to unlock the best version of themselves so that they can get the care that they envision on their terms. So really, just through that qualitative piece. Patient satisfaction is another huge factor as well. We supercharge our algorithm based on the identified and pooled hormonal health data so that we can continue providing tailored recommendations that are personalized to each user. So in my example, my Noula experience might say, okay, we know that Noelle is a Latina woman who has PCOS. Other people who might have had similar symptoms to her have found these recommendations or tracking these symptoms to be really helpful for them, and so that's something that I would try. And so really just, again, creating a space where you're not alone is huge. And so that's where we really lean into the qualitative piece. And as we grow, we also incorporate the quantitative success metrics as well. So how are we measuring impact in terms of health outcomes so that we can also just inform the system to deliver better care? Because, I mean, there's just so much unknown about the female body specifically. It wasn't until 1993 that women were even required to be a part of a clinical study. So there's just a lot of gray area that needs to be addressed to deliver better health outcomes overall, especially when health outcomes amongst women in the U.S. is so poor. VICTORIA: And as a woman in the U.S. who has hormones, I 100% get the value and the potential for an app like this. Have you had that same positive reaction from investors or from other people who are looking to join your group? NOELLE: Yeah, yeah, absolutely. I mean, the investors who really understand it and get it, unfortunately, do because either they or someone they loved has been impacted by a hormonal imbalance or by being dismissed in the traditional healthcare settings. So similar to how the Noula team and our members have been unified by these experiences, we find that outside as well with investors. What makes me really proud, too, is connecting with clinicians. Like, our Medical Director, Dr. Marieme Mbaye, who is a highly rated physician in New York City, turned away from practicing medicine to join Noula because she even felt like her hands were tied behind her back with the type of care she can deliver. And so it's always incredibly reassuring when we hear from clinicians that this is why care should be designed to really proactively look out for groups of people who are often overlooked, which, sadly, tend to be women and people of color. VICTORIA: Right, almost like it was designed that way in the system. [laughter] NOELLE: Yep. VICTORIA: That's great. I'm glad that other people are seeing that benefit. And what hurdles do you see on the road ahead for where you're going with Noula? NOELLE: As we are bringing on members, the more that we've built this trust with our member base, the more they want from us [laughs] in terms of us truly just being their end-to-end care delivery partner, and we would love to get there. But as a very early-stage company, we have to build things quickly but one thing at a time. So oftentimes, I feel like, okay, we have this huge leap to make to deliver the care that our members are asking for, and so it's a blessing and a curse where they're like, "We love this so much. Can you be my doctor? I don't want to go to another doctor." Or, "Can I get this through you and only you, or do I need to go somewhere else?" VICTORIA: Well, that must be a great feeling to have. But also staying focused, like you mentioned, would be a challenge, and being able to get done within your capabilities. But it's funny because I think there's a huge demand in this market [laughs] that we've had similar kind of demand for other women's health-focused products or people with uteruses too. Clearly, something is broken. [laughs] So you've got a lot of great work you want to get done. Is there anything really already planned in your roadmap that you're super excited about? NOELLE: Yeah. And we'll be rolling out insurance-covered telehealth appointments very soon, so that's one thing that I'm particularly just incredibly excited about because I think it does...how we got to delivering that was through the feedback from our members. And so I think that, in turn, will allow us to take one step closer to truly being that healthcare delivery partner for all members on all those levels. Very, very excited about that because it very much aligns with our mission to deliver accessible and equitable care. VICTORIA: Yeah, that's a huge capability, and especially considering in some areas, there just might not be access to doctors or hospitals that you can go to in person, so... NOELLE: Yeah, yeah, absolutely. I mean, only 50% of U.S. counties have access to OBGYNs and with the average appointment length only being 15 minutes. Like, again, physicians have their hands tied behind their backs because that means per OBGYN, they're managing about 3,500 patients, which just isn't feasible or scalable. VICTORIA: Wow. Yeah, that's a lot of patients. [laughs] Well, I want to go back to some folks that you mentioned earlier on your team and just tell me about how it all started coming together with building your team at Noula. NOELLE: Yeah, yeah, absolutely. So my co-founder and CTO, her name is Suzie Grange. She is an absolutely wonderful, brilliant engineer. Her and I actually worked together at our previous employer company called Maven Clinic. So at Maven Clinic, I was responsible for helping lead sales and business development through some growth milestones. And Suzie was the founding engineer over at Maven. So she was there for the long haul, for over seven years. And so she had left Maven before I did. And once I took the leap into building Noula full-time, her and I reconnected, and we welcomed her to the team as a co-founder and CTO last year, which has been so instrumental to how we've built our product to date. We actually [laughs] ran into fun challenges many startups will where we've had to recently rebuild our entire tech stack and truly couldn't have done this without her and our back-end engineer as well. And so she's just been incredible. And then we also brought on our medical director, as I shared, Dr. Marieme Mbaye, who was a practicing OBGYN based out of Brooklyn, New York City. And she has also had experience advising for women's health startups like Natalist to Frame Fertility and others. VICTORIA: Got it. So you found your technical co-founder, or you maybe already started together and then got the technical expertise there. You mentioned taking the leap to do Noula full-time. What was that decision like for you emotionally? NOELLE: It was a really big decision, and it was also a very vulnerable decision on my part. And so I'm going to open up about this because I think it's important to also recognize that this is a scary decision for all founders to make. When I was dealing with these chronic symptoms, that was back in 2019, so this was before I joined Maven Clinic. And I knew I wanted to build something to change the system. But I thought the best way to ensure what I was going to build were to be successful was to contribute to a company, learn as much as I could, fail fast, fail forward. So I joined Maven. I was there for almost two years, and that experience alone was instrumental. But ultimately, what really drove me to make the leap and place this blind faith in myself and just jump into this unknown abyss was after another health scare. I promise you I'm healthy. But I went through...in early 2021, I had a massive seizure in my sleep, and I was hospitalized where they thought I had a brain tumor. And I just remember sitting in the ambulance. And this was during COVID, so I had to go alone. I was hospitalized alone. And I remember sitting in the ambulance, and I don't know why this sticks with me so much, but I remember seeing the light of the street lamp, and I was just looking at it. And I thought I'm not ready to leave the earth without making an impact here. And so I told myself, I was like, if I make it out of this alive, I'm going to do whatever it takes to change healthcare and make the impact that I want. And so I did just that. I'm okay. I don't have a brain tumor, thank goodness. And I trusted myself trusted that the conversations that I had with friends, family, and other people who shared those experiences with me would serve as our lighthouse to building an incredibly impactful product that would reshape the future of health for good. VICTORIA: Oh, that's incredible that you had that experience that made you think about what really mattered and what you wanted to do with the rest of your time. It sounds like you had friends and family to support you along the way with that decision, right? NOELLE: Yeah. And a lot of them didn't get it. To this day, my mom's like, "Don't you want to go to med school or be a nurse?" [laughs] I'm like, "No." [laughs] But yes, absolutely had their support. VICTORIA: Oh, that's wonderful. I mean, I can see that, even if you have a good idea that some people might be like, "Don't you need a job?" [laughter] NOELLE: Exactly. And that's exactly the kind of position I was in. I said, okay, I need to make a game plan. And when I quit Maven, I had joined an accelerator program called Visible Hands, which was designed by POC founders. And for three months, you got a small chunk of money. And I worked backwards, I said, okay, within this three-month period, I need to prove that Noula is a venture backable business. And so I worked backwards with how much savings I had left to continue supporting myself. And that gave me till...so the program started in September, and I had basically saved enough money for myself through end of February, maybe end of March is stretching it, of 2022. And so, I worked backwards from that date and closed an oversubscribed pre-seed round in February. VICTORIA: Wow. NOELLE: So that was really...it was very challenging. I don't think I've...I worked harder in my life than I ever had before. And so yeah, that's really kind of where we're at today. And it made me one of less than 100 Latina women to ever raise a million dollars, which is wild. VICTORIA: Awesome that you were able to do that, and sad that the number is so small. [laughs] NOELLE: I know. And I did the math, and we said, okay, 0.4% of venture dollars go to Latina founders. I need to have 200 meetings just to get one yes. And so I was chasing as many meetings as I could and chasing nos as fast as I could because I thought the sooner I could get a no, the quicker I could move on to the next. VICTORIA: So, really trying to weed out people who just weren't going to be a good fit. [laughs] NOELLE: Right. VICTORIA: That makes sense. But ultimately, you were able to find someone who aligned with you. Was there a checklist or some kind of way that you used to decide if those investors were going to be right for you? NOELLE: Yeah, I think, ultimately, the connection to our mission. At the early stage, they're making a bet too on founder fit, and so I wanted them to, one understand and feel confident in myself as a founder. And so I wanted to see that on the call. And then two, I also wanted to ensure they understood that this was a problem. And so there were some investors where they didn't understand the problem or why anyone would need this. And some of them didn't understand things like what menstruation was, not even kidding. [laughs] I didn't have any...at that point, I was like, I don't have a single check. I had to make the decision, like, this isn't going to be the right partner for me. And so those were kind of my two main criteria, like, do I believe they're going to be the right partner in helping us accelerate just my vision and supporting me as a founder? Do they believe in me and in our vision? And two, do they understand the problem and the impact? VICTORIA: Right, that makes sense. So then that kind of empowers you to continue doing the work that you know you should be doing. NOELLE: Right. VICTORIA: Well, I wanted to ask you a little bit more about TikTok too, and how you used social media to raise your brand awareness. NOELLE: [laughs] So, our TikTok strategy, I'm embarrassed at how long it took me to make our very first TikTok [laughs] because I probably spent way too much time trying to figure it out. But our TikTok strategy really aligns with our brand strategies. Our core pillars in terms of that really come down to leading with empathy, so showcasing real, raw, authentic stories from real people. So we can show, like, you are not alone in this. And then two, educational pieces as well. So we have a series called Dear Noula where anyone can write in anonymous questions to Noula. And our medical director, Dr. Marieme Mbaye, will answer those on TikTok. And so, really, what's helped drive the virality in our TikTok strategy is the marriage of that approach where one of our most viral TikToks is one of me with my ultrasound behind me. And then another one that's very educational based around what your vaginal discharge might be telling you. And so there's that blended approach to just, again, showing those real stories with digestible educational bits of content has really helped us build that brand awareness and also just the trust in our brand as well. VICTORIA: That's great. And I think that's something that a lot of startups might be thinking about marketing-wise. Like, how do they use those types of tools to really connect with people? And I like the approach that you've taken with being educational and with being very real, [laughs] which makes sense. Okay, so we asked about what your biggest challenges were on the horizon. What do you think are the biggest opportunities that you could potentially take on at Noula in the next six months to a year? NOELLE: What I'm particularly very excited about with Noula is our ability to adapt with users over time. So what we often see with a lot of digital health solutions, especially in women's health, is they tend to be very stage-specific. You use this product for fertility-related stuff, this one for pregnancy-related stuff, this for postpartum-related stuff, or STIs, for example. So they tend to be very specific. And what I'm particularly eager to showcase is truly how Noula is designed to adapt with those folks over time, so from menstruation through menopause. And the more that you use Noula, the longer you use Noula, the more customized insights you'll have about your unique body to inform providers to deliver that individualized care. So truly, the thing I'm looking forward to most is time, seeing how Noula can truly fit patients' lives versus the other way around. And also being in a position where our solution isn't tied to just a reproductive stage. It's truly encompassing our whole health beyond just reproductive organs but taking into account genetics, lifestyle, environment, stress, sleep, nutrition, et cetera. VICTORIA: That's very cool. So kind of expanding into even more tailored patient data and services that you can provide over time. NOELLE: Yeah, and, I mean, this is information that most people's doctors don't have access to. VICTORIA: Yeah, I could see that. And, I mean, anyone who's used a menstrual tracking app you can predict things based on the longer time period you've been tracking it, right? NOELLE: Exactly, exactly. VICTORIA: That's very cool. I'm excited to see it come out. And I think by the time this podcast airs; you'll have launched a new product. Is that right? NOELLE: Yeah. So by the time this podcast launches, we'll be completely launched. I will have the app and care coaching available for anyone to use, sign up for, and it's really, really exciting stuff on the horizon. VICTORIA: That's super cool. Well, my last question for you is if you could go back in time to when you first started Noula, what advice would you give yourself? NOELLE: I tend to be a perfectionist. So I'd say just ship faster; don't chase perfection because things are going to change. I learned that from the beta itself, where we spent time building this product that we wanted to be so perfect. And again, [chuckle] what we learned was that the initial cohort of users who we thought would be our biggest advocates and earliest adopters of Noula was not true. And so being okay with your first iteration as being imperfect is okay. Some of the best advice I actually got after we launched our beta was that if you're not embarrassed by your MVP, you launched too late. VICTORIA: [laughs] That's really funny. It should be kind of awkward, right? NOELLE: Yeah. Isn't that great? [laughs] VICTORIA: That's really good. [laughs] NOELLE: I wish I had heard this before. I [laughs] spent so much time trying to perfect this to the T. [laughs] VICTORIA: I think we're going to maybe print out a banner that says that and hang it behind [laughter] our screens or something. Yeah, I love that. And I love just how much went into the customer discovery and how you were flexible to change your hypothesis for what was going to work for people based on that. NOELLE: Yeah. And I think one thing that really helped, too, just honestly from my sales background, was I was very mindful of not leading a horse to water when doing customer discovery. So I think often we hear that, you know, we ask very pointed questions to try to lead folks to say, "Yes, I would use your product," or, "Yeah, that sounds useful." I purposely asked very open-ended questions like, "Walk me through your experience navigating your health," and just listened. And that allowed me to find patterns across the number of conversations that I had that ultimately led us to build the beta in our product that you see today is through those very open-ended questions and hearing from users themselves as far as what they thought was missing versus me saying, "If we build this feature, would you use it?" VICTORIA: That's very cool. And I learned a lot just from taking the quiz on your website. [laughs] NOELLE: Oh, awesome. [laughs] VICTORIA: So I'm really excited to see what you all come up with next. Are there any final takeaways or thoughts you want to leave for our listeners today? NOELLE: We'd love to hear about your experience using Noula. So you can use Noula free for a limited time. We're offering 30 days of free care coaching for anyone that signs up and discounted access to the hormone testing. So just really excited to share with the world because it's about damn time we get the care that we deserve. VICTORIA: Absolutely. Thank you so much for joining us today. And you can subscribe to the show and find notes along with a complete transcript of this episode at giantrobots.fm. If you have questions or comments, email us at [email protected]. And you can find me on Twitter @victori_ousg. This podcast is brought to you by thoughtbot and produced and edited by Mandy Moore. 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