She spent afternoons playing Skat, a card game, with her mother and her mother’s friends, who taught her aphorisms such as “if someone shows you who they are, you should believe them” or “there’s nothing a hard drink can’t fix.”

“I was 12,” Ms. Pelletier said. “They were seasoned and wise and had been through hell. What they hoped for me was that I would get out and never come back.” Which she did. (Though “on really bad days, I get in my infrared sleeping bag and I drink a martini,” she said. “Grey Goose, very dry with a lemon twist”).

‘Reality Checks’

After attending Husson University in Bangor, Maine, Ms. Pelletier worked as a sales representative at G.D. Searle, the pharmaceutical company that first developed the birth control pill, now owned by Pfizer. She rose to become a head of global new business in the women’s health division. “Working in pharma taught me how to talk with influence, how to behave, how to present, how to use certain levers, how to read a room,” she said.

In 2009, she founded a nonprofit called Woman Care Global, which focused on reproductive health around the world. During her time there, in 2013, Ms. Pelletier came across a product called Amphora, developed by a team of scientists at Rush University in Chicago, and owned by a company called EvoMed that was in trouble. “They didn’t have the right strategy, they didn’t have the financing, the leadership,” she said.

Eventually, the investors in EvoMed separated the women’s health division, created a new company called Evofem and put Ms. Pelletier in charge. Amphora was later renamed Phexxi (the first two letters represent pH and the double X is for the sex chromosome.) In 2015, she became the company’s C.E.O. Since then, she has led Evofem in raising $491 million from investors and hired 128 employees.