She made TIME’s Invention of the Year while focusing on Women’s Health

29:00And now that I've actually set up this tampon manufacturing, I know that it's not that expensive. You can afford to do it. Like gamma irradiation is a standard process that enables you to have a clean tampon at the end of your production process. metal detectors are not that expensive lab testing is not that expensive um but at the same time it's it's challenging to introduce a better tampon to the market because it seems that the consumer mostly cares about price and less so about all of the other like sustainability absorbency safety

29:34Valentina Milanova:components yeah there's a massive education piece to the customer and i remember when day started outside of it being absolutely beautiful and the design being so wonderful and the branding and just that immediately catching my eye um there was the education piece vitals was the blog where you were sharing more information more education around um not just obviously product but the period experience and um all of the things that go with that and um sexually transmitted infections and diseases and how did that then kind of naturally segue into the diagnostic? Well, for the diagnostic tampon, the very funny and true story of how I had the idea is that I had sex with someone and they called me and said, I have a STI, you need to get checked.

30:20I was like, oh my god, it was my first STI, I was so shocked. So then I tried to book an appointment in a sexual health clinic in London. It was a Monday that I found out the first appointment was on a Saturday. So I spent a whole week in pain, nervous, worried, like, oh my God, I've never had an STI. What is this? Is my vagina going to fall off, etc. So then I went to the sexual health clinic. It was super awkward. I had to wait for like a few hours in this waiting room with a bunch of other people who are also obviously there for an STI test. And then I went to a room, a nurse gave me a swab.

30:54I swabbed myself. And then a few days later, I got the results via SMS. And then I had to go and find a pharmacy that would give me the antibiotics. It was so painful, so unnecessarily painful as an experience. And at that time, I was already working on the pain relieving tampon. So like literally, as I was walking out of the sexual health clinic, the thought popped into my head, like, why is this being done with a swab? And why can I not use a tampon to get tested at home? and then I started looking at literature and it turns out that we've known since the 1980s that's when the first paper on this was published the tampons as a self-sampling device increase the sensitivity and specificity or the diagnostic accuracy of STI testing there was a study that was done in South Africa with with sex workers yeah and then we designed our tampon diagnostic tampon process and ran clinical trials and now it's on on the market and what's the process now

31:48Valentina Milanova:So like what happens if I was to get the diagnostic tampon? So you order it online or you pick it up from a place like Boots. You then go home. You use a tampon on your sofa as you normally would. You take it out. You place it in a pouch and then you drop it off in a red postal box outside of your house. And then you get the results online a few days later. And if you do test positive, you get a 30 minute complimentary phone call from one of our sexual health nurses who are trained to be very empathetic. and they're trained on the latest clinical standards. And then you can get prescription treatments delivered to your door if you need any prescription treatments so that it's not such an invasive and painful process.

32:27Valentina Milanova:Yeah. And so much of this whole field is also shame and embarrassment and trying to figure out kinder ways around that is so important. And you've also discovered that this diagnostic tampon could be used for other things. Where's the research at with that? Yeah, so we've completed our clinical trials and they're published now in the Journal of Clinical Microbiology and BMC Women's Health. And what we were able to demonstrate is that for cervical cancer prevention, you can use a tampon as well. And it again offers the same advantages around convenience, increased diagnostic accuracy, higher acceptability, particularly amongst underserved patient populations.

33:11So some of our clinical trials were with people who had never used a tampon before, with South Asian populations, with Muslim populations who don't engage with cervical cancer screening programs. So again, you can use a diagnostic tampon at home to see if you have a high risk HPV strain, which is the cause of 99.98 % of cervical cancer cases. And the women's health space in general can often be quite depressing, right? It's underfunded. It's under-innovated. And still to this day, there's worsening female health outcomes across the UK, across the US. But one of the real bright spots, I think, in women's health today is that it's perfectly feasible that we eradicate cervical cancer as a disease by 2040.

33:53We need more people to get screened regularly. We need more people to get vaccinated. But we have excellent methods for screening. We have really reliable vaccines. And if you are vaccinated, you still need to get screened. A lot of people assume that if I'm vaccinated, I'm good to go. the vaccine doesn't protect against all high-risk HPV strains, it protects against some. But how exciting is that? The deadliest female cancer on a global level, 600 ,000 women will die of cervical cancer every year, can be eradicated within our lifetime. Perfectly feasible if more people get screened and vaccinated.

34:27Valentina Milanova:It's incredible. And obviously, in order to implement that large scale, you'd probably need to work with something like the NHS. How does it feel to work with a sort of slow moving administrative giant like the NHS? Well, I'll start by saying that it feels like a huge privilege that we even have the opportunity to work with the NHS and to help them because they've also committed to eradicating cervical cancer by 2040. And particularly now in the context of integrated care boards, ICB budgets being reduced by 50%, the NHS being on the brink of bankruptcy, we do need to find ways to optimize costs.

35:02And self sampling for HPV is a great way to save costs and to free up appointments because you can you're perfectly capable to do it by yourself, you know, with the help of a tampon that enables you to reach your cervix by yourself without the speculum exam. But the two main questions that I have around working with the NHS first the nhs is this country's religion so um private companies that are trying to deliver health care outside of the nhs context are often um attack blasphemous yeah on on social media especially one of the key comments that we get is the nhs should offer this this should be free on the nhs like why are you charging money like very happy to offer to the nhs but it takes 10 years for any type of change to happen through the NHS.

35:52And then I also ask myself, because it is such a traditional British organization, in a lot of conversations that I'm having with different NHS stakeholders, I often think to myself like, hmm, how do you feel about a Bulgarian that's trying to provide better solutions for cervical cancer screening? Like there is that feeling of, you know, I get a lot of questions like, oh, where's that accent from? Oh, where did you go to school? Just those like trying to place you in a box questions. And then the other question that I have about the NHS is given that there's so many systemic challenges, how come is the NHS still so focused on, and I'm not obviously against equity in healthcare, but there's so many different tick box exercises that you have to go through that no one really reviews, that no one's fully bought into to show equity and inclusion for the sake of it, rather than because you're actually going to deliver equity and inclusion in healthcare.

36:53So it's incredibly fragmented, it's incredibly bureaucratic. And it seems that a lot of NHS decision making is based on who you know, who you grew up with, who you went to school with that can recommend you to someone else, versus like a genuine meritocracy. So I'm really curious to see what Keir Sammer does with his NHS reforms.

37:17Valentina Milanova:Yeah, it's such an interesting field, obviously, because there's such a dichotomy between those two worlds, the fast paced startup world, as you're saying, where you're trying to get solutions to people, but they have to be paid for versus trying to get into the NHS. And you're trying very hard, it sounds like we're working with the NHS now, but it's a slow, slow process. Obviously, we've spoken about how intense it is to be a female founder doing all of these things are there any solutions or ways that you've found to create more space for yourself recently has there been a way that you've been able to take some or any of that responsibility off your shoulders some of the absolute musts i think if you're an entrepreneur is to create a system around you that encourages reflection so i believe it's absolutely a must even though it's expensive and it's costly to have a therapist and to have a professional coach, especially if you're going to be a single founder.

38:13But even if you're not a single founder, your life moves at such an incredibly fast pace, you never have time for reflection. And that really robs you from the ability to look back, look forward and make high impact strategic decisions. So I actually started therapy really early. I was 18 when I first started therapy and then I stopped when I was 22 and then I started again in COVID. And now recently my therapist has fired me and I really miss her because she said like, I don't think we should continue. This is, you've had enough. But I work with my professional coach. I have, you know, a weekly session with him where I go through daily challenges that I've had, but also reflection upon what I want this company to be, what the opportunities are, how do I reduce the complexity in the business.

39:05And then I also WhatsApp with him during the week. He's very generous in allowing me to WhatsApp with him. And I'm currently focused on addressing my extreme workaholic tendencies. I have this complete misconception that I'm capable of doing everything and anything. and I just keep piling and adding to my plate. And now day is at the stage where it would really benefit from me doing less and delegating more. And I can also afford that luxury now because we have an incredible leadership team and an incredible team of individual contributors. And there's a lot that I don't have to be involved with anymore at the level that I was before.

39:51But that takes a really long time. Building a strong leadership team takes a really long time and don't believe anyone that tells you that, you know, they just met someone off the street and two weeks after they had the perfect relationship. It takes trial and error and it takes commitment and honesty and being candid and giving each other feedback and creating a safe space where you can actually do that. It takes years.

40:14Valentina Milanova:Would you say that hiring and building a team is maybe the hardest part of your business? One of the hardest parts for sure. And just making sure that everyone is looked after, that everyone has their personal and professional needs looked after. And I think part of this comes from the fact that I am a female founder. So people look to me naturally to be maternal and nurturing. I think if I was a male founder, that probably wouldn't be the case. It would be someone else that would have taken this role. but because I am a female founder people do look to me a lot for that maternal nurturing component of management which can be quite hard that can be quite mentally draining.

40:54Valentina Milanova:I was going to say how do you do both how do you both be the leader and the visionary and the hard-on people pushing them to be better but then also be the shoulder to cry on or the person to come to if you're looking for you know more time off for family issues or something like that. It's very challenging. I'm laughing because literally last week I was having this conversation in one of my weekly syncs with one of our design engineers. The most important manager trait, in my opinion, is consistency. I think the worst managers are those that like love bomb you one second and then tell you that you've done an absolutely terrible job.

41:30So what I strive to be is consistent. So I strive to have like consistent values on the basis of which I make consistent decisions. But it is so hard to be both the bad cop and the good cop. Like, I haven't cracked that. I haven't figured it out. And mostly, yeah, I mean, I really have to be both because no one else wants to be the bad cop, right? It's a very unattractive role. And then I can't only be the bad cop because then people become very demotivated. I need to also set the vision and inspire people to deliver on that vision. So I haven't cracked that code.

42:06Valentina Milanova:Yeah, it's a lot to try and do all in one go. Another part of being a female founder is obviously being a woman, literally in that sense. And you also have a period. What is your relationship with your period like? Are you aware of your phases? Is that something that you think about when it comes to work? It's been really helpful for me to arrange my routines and my calendar around my cycle. And I think people often really misunderstand what cycle syncing means. So it doesn't mean that before your menstruation and during your menstruation, you like take all of your meetings from bed. For me, what it means is, you know, there's different seeds that I eat, like poppy seeds, etc.

42:51Sunflower seeds in the different stages of my cycle. And I have found this to be one of the most incredible interventions, seed cycling for overall hormonal health and for lowering the intensity of the pre-PMS and post-PMS hormonal changes, or at least the way in which they impact me. And I also tweak my workouts around my menstrual cycle. So I know that, you know, during ovulation, but then also on the second and third day of my menstrual cycle, I have the most physical strength. so it's when I try and do the most progressive overload when I'm doing weight lifting and then in the few days before my cycle I do gentler exercises or I just push myself less in the gym I'll do fewer reps I do a lot of sauna and a lot of cold plunging which I just do it throughout my cycle and I found that to be one of the most helpful interventions for for stress management it's just the high is so incredible from uh going from the sauna to the cold plunge and then back again a few times it makes me feel like someone has taken a microfiber towel to all of my individual

44:00Valentina Milanova:cells and like polished them tell me again about which seeds should i eat when what's the order so everyone should google seed cycling there's a lot of really strong clinical evidence so it's it's a holistic measure that actually has clean co-evidence behind it it's actually my husband that manages this for me so because he makes me breakfast so he adds it to my to my uh breakfast um so i'm not sure what he does he knows he's the best no he really is um but it's poppy seeds sunflower seeds pumpkin seeds and um flax seeds and then you alternate which ones you take uh up until ovulation and then after ovulation and you just need like one spoonful a day super interesting we mentioned there your partner why do you think it's important for men to know more about these things because i think the conversation is spreading among women but why is it important for men to also hear what we've been talking about oh women's health is human health um we can't have healthy societies or healthy economies if over half of the population is stuck at home with a hot water bottle or drops out of their career because of unmanaged menopause symptoms um women are graduating from universities at higher rates than men, we tend to have higher grades at universities.

45:15And then for our first jobs up until our first child, we tend to be better compensated than men, and we tend to progress faster. So women are an incredible asset to society, which is currently put to put to one side. And until we have modern medicine, fully understand how to diagnose and how to treat the female physiology we're not fully taking advantage of the incredible resource that we have in the face of women in in society so i i see women's health not just as a feminist issue or a health care issue it's a societal and economic issue great answer yeah have how do you find ways

45:53Valentina Milanova:to slow down in your day-to-day do you have any tools if there's a particularly anxiety inducing thing about to happen if there's a big meeting about to happen or something do you have any tools tips tricks that you've maybe picked up from therapy or elsewhere that you do on a micro level in your day-to-day yeah well at this stage this company has faced so many issues and i have personally faced so many issues that it really takes a lot to get me out of my equilibrium um but i have a reminder on my phone i have a little alarm that goes off four times a day to do a parasympathetic sigh do you know what that is it's like the simplest routine ever um and it produces an immediate stress relieving effect so basically you just take one really deep breath from your mouth like this and then you top it up with a little breath from your nose like really top it up and then you exhale and you you can do it a few times i usually only have time to do it once um but it's just an immediate stress reliever puts you in your body i try to be really strict with exercising so i try because it's such an outlet for me it makes my sleep so much better i find that on the days when i exercise i need less sleep and i sleep more restfully and i wake up earlier yeah um and um you've seen the photos but my my husband and i installed a sauna in our living room because we're super sauna in enthusiasts and there was a sauna that was 60 percent off when we were driving one day so we literally just went and picked it up um so the the difference between hot and cold exposure for me it's just such a reset i try and do it at least once a week like an hour of 20 minutes in the sauna cold plunge 20 minutes in the sauna it feels like a complete reset for for the week and if you don't have a sauna a hot bath that you alternate with the cold shower does the same thing yeah i love that um and there's like diminishing returns i think also my you know a lot of people try and like compete with each other about how long they can spend in very very cold water and it's like about 90 seconds is quite good and then beyond that diminishing returns like there's no need need for it um so given that the business is still has these huge visions and goals for the future what does success look like for you now like have you redefined success for yourself in any way from when maybe you were 18 or when you started the business because you started so young?

48:23Such an interesting question. I've never asked myself this. I'm not really sure that I care about success. I would really like for these products and services to make a positive impact in the lives of others. I would really like to get to a place where I have a bit more time for things that I enjoy outside of work I would really not like to get divorced um but I I don't know that I ever did you grow up thinking about success is that an Eastern European thing where we didn't really care about that socialism like I think how

48:59Valentina Milanova:you've just defined success is wonderful the impact that you're creating for others to change society but very rarely do people sit and actually define what it means for themselves and so that's kind of the the question yeah I don't think I've done that for myself I just try and gravitate towards more things that make me happy and help me stay in a state of calm so yeah some of the things that I want is yeah quite literally for our products and services to reach more people and for my marriage to continue being a really healthy space where I feel good and connected to to another human being I actually think that my marriage is the good karma for all of the bad karma that I've had building this business I think it's the reward for for all of the hard work well that's a nice way of thinking about it but you also just are such a great match you and Anton yeah um is there anybody else's life and story that you look at and admire and think that's a really great work-life balance and way to do things and that's something I aspire to or do you try not to kind of look at people in that way?

50:08I really love reading autobiography. So I'm very curious about the lives of others. But I was never competitive as a child. People used to not really, and still to this day, like when we play board games, I always want everyone to win. So I'm like telling people what they could do, like what a better strategy is. I do get a lot of inspiration from others. I get a lot of inspiration from the people a day. But I wouldn't say that I look to others for how they live. I guess because the way in which I was raised, my parents never tried to tell me what to do. My parents were very disengaged parents.

50:49So my dad was 42. He already had four children with other wives. My mom was super young, like in her early 20s. So she was figuring herself out. So I was given so much freedom as a child. I grew up at the coast. my like I would pack my own bags and my dad would give me like a wad of cash and that's the money that I had to manage for the whole summer and like I was six when when this would happen and I lived with these Roma families because they had trucks outside of our house and we would like ride wild horses and have potato soup and things like that so and still to this day like my mother is very reserved, not in a code way.

51:34She just lets me do my thing. Like no one ever, when I was growing up, told me this is what you have to do. Other than my grandparents, they had really high expectations as every good Bulgarian communist did. But I just grew up with so much freedom. I think I didn't, I never developed that muscle of caring about what society tells me I should be. And I also always felt like such a misfit in every situation. You know, I'm very tall. And I've been one meter 75. What is that? Almost six feet since the fourth grade. So I was literally two heads taller than all of the children in my school. So I was always a misfit.

52:16Then I was a misfit at university because I was so OK. Primary school was very tall. High school, I had to work. So I was never around for like parties or anything like that. You know, I had jobs. University, I was like the weird Bulgarian girl. And then I went and I worked in these like fancy companies in London where everyone was from Eton and Oxbridge. And so I never thought that I had a chance of fitting in. So I never tried. Never tried. I was like, whatever. There's no point. Yeah.

52:46Valentina Milanova:Earlier, you described yourself as a workaholic. Where does that come from then? if you were sort of allowed to do anything that you wanted where do you think that fire comes from I have a big fear of poverty so I grew up in a lot of poverty extreme financial insecurity so I started working for money not like I'm shadowing my dad at his office job when I was 12 and all throughout high school I worked in bakeries in restaurants I cleaned houses I cleaned the entrances of houses then when I when I was at university you know I had the night shifts in the library. I worked in Bister Village. Shout out Bister Village.

53:24And I never want to be poor again in life. I never want to be so limited in what I can do by finances because the way we grew up, you know, my mother would mark the orange juice to where she, the bottle of the orange juice to where she had poured it so that we wouldn't sneak orange juice from the fridge when when she was away um and then when i moved to the uk and i went to waitrose and i saw those like freshly squeezed orange juice bottles i was so impressed with myself that i could buy them for myself and some of that feeling hasn't gone away like whenever i go and i get myself a takeaway coffee i'm like look at you look at you spending six pounds on a coffee i'm wondering because i feel

54:12Valentina Milanova:this all the time my partner doesn't have this at all he's just um you know raised in plenty and um and doesn't have this feeling of of lack and i i don't know if it's i say it's like being war-torn or something but i i often eat meals like i don't know when i'm gonna eat again like i eat like i'm like i don't know when the next meal is so i'm gonna really go for it like i always overeat if there's food i hate food waste it's literally my my worst thing in the world in my country I will I will finish other people's food because I don't want it to go to waste and my partner will say like you're not a bin like what are you doing and I'm like no I just I can't I can't have that happen I never got into coffee at all because I just felt that was such a waste of money um I never got into alcohol I still even now and earning like an okay living I will obviously always look at the prices on a menu and and determine what I'm going to order based on said price but i will look at like the price of a dessert and the price of a cocktail and go well i'll have the dessert instead of the cocktail like i would never have both um i have the same math in my head yeah it's such an interesting like a hang-up i suppose but also like not a terrible one to have in the sense of like i don't want to be wasteful yeah it's good to be financially prudent and we we don't talk enough about how important it is to be able to manage your own finances as women it always shocks me that like we know who does your nails like like you okay you and I have very different conversations but with my usual friends I know who does their eyebrows I know who does their hair like I know who where they go for laser hair removal but I know nothing about their financial investment strategy so I started doing this with my female friends where I would like bring up finances um specifically because I I think we should talk about this more and everyone was completely outraged.

56:00Like, oh, that's not, why are you bringing this up? That's not something we should talk about. But it's so important to be financially prudent.

56:06Valentina Milanova:Yeah, and, you know, I don't think men have the same issue. Like, a lot of my male friends have crypto WhatsApp groups and investment WhatsApp groups and all these kinds of things and we just get left behind because we're not having these conversations. So I 100 % agree. And, you know, it's also a very Eastern European thing. Unfortunately, my dad will make people very uncomfortable regularly by just being like, how much do you make? Like, how much do you make? like what is what is the takeaway you know and I think but they're also keen to learn right so like my dear friend Ramit was over last weekend and my parents had a lot of he's a millionaire and so they were like we have a lot of questions because and also like coming from the kind of socialism show us your credit card and then the oligarchy and the mafia in Serbia it's like well if you made a lot of money in the 90s something's got to give because you didn't make that in a fair honest proper way you made that in a slightly gray zone nefarious way and so my parents like grilled him with questions you know and and he answered and he was very open and very honest and i think they were surprised by his honesty they were surprised that somebody would sit them down like almost with a pen and go well this is how i made this money and then this is what i do with that money and they were like wow he's so willing to share and i'm like a lot of people are willing to share I just think there's this older mentality of we hold money you know under the mattress and it's all a big secret as to how much you have and and how to make more of it and that shouldn't be shared with other people so it's very interesting but how to manage it you know exactly and I think you know we're um we've um veered off course here I wanted to share a final question with you which is what I ask all of my guests if I had to watch one film read one book or see one piece of art that would help me understand you better what would it be oh this is a hard question but i'd like it um book uh from east of the west miroslav penkov hopefully it's in english so you're not going to need to translate it it's this um bulgarian who moved to the us and is a university professor in the us and published just an incredibly beautiful book of short stories about life in bulgaria but also life in the balkan so he talks about the war in serbia and kosovo and actually i learned a lot about balkan history from reading his book so east of the west absolutely love that book movie um have you ever seen the disney movie anastasia yeah of course love love that film grew up with that film watched it non-stop i still know all of the songs by heart and piece of art that's a hard one you don't have to answer all three it's more like pick a cultural thing that you think is interesting was it one of the three and i try you can answer it however i mean you're an overachiever by nature so that makes total sense but yeah i like ophelia ophelia yeah the feeling of just like floating like in the sea yeah is there a sea you prefer the bulgarian sea is the best where i grew up of course yeah see this is the thing it's like i'm so tied to the adriatic and that kind of sea just warm calm you know i'm going to lisbon next week and everyone's like oh we want to live by the ocean i'm like i don't understand it it's cold it's huge waves like i don't get it it's too much salt i don't follow so yeah what you're used to is usually good well thank you so much for your time thanks for having me winding and wonderful conversation that's gone in a lot of different directions a lot more questions I could obviously ask you but we'll stop there thank you thank you so much thank you for tuning in this episode was hosted and created by me Tiana Tambridge it was produced by Whitney Rosenthal with sound and video produced and recorded at Brazen Studios cover art and design by Natalia Ruhe and the sponsor for this whole season is Clue please subscribe to the slowdown to be notified of upcoming episodes tell a friend and leave a review because it really helps a podcasts like this get out there into the world.

1:00:06Valentina Milanova:And remember, we're all heading to the same destination and there is no prize for getting there early, so we might as well slow down.