Recently, I ran a report on the search engine volume for Hormone Replacement Therapy. I had a hypothesis about organic search and compounding pharmacies that I was researching. I did not expect what I found.

According to MOZ a leading keyword search tool, there were well over 1000 terms to search for “Hormone Replacement Therapy for Menopause”. Not amazing in itself.

But what I find amazing is that all 1000 search terms only generated between 22,000 to 54,000 searches per month in the USA. Over 2 million women go through menopause annually, yet only 1-2% of them search for hormone therapy every month. Who is marketing hormone replacement therapy for menopause to the other 98%?

From a keywords perspective, there were other implications….

• 56.6% of keywords generated so little volume that the words could not be ranked by the search engines.
• Of the 434 (from 1000) keyword phrases that were ranked, 1 keyword word generated 55% of all searches. The phrase was HRT.
• The next 3 keywords combined generated 13.7% of the search volume. They were:
  • hormone replacement
  • hormone therapy and
  • hormone replacement therapy.
• The next 5 keywords each generated less than 1% of the search volume:
  • estrogen replacement therapy
  • hormonal therapy
  • what is hrt
  • estrogen replacement and
  • estrogen therapy.
• Just 9 phrases generated 79% of all search queries.
• Terms using bioidentical were used to search. But the search engines could not rank the terms meaning they were rarely used or could not be ranked.
• Terms using natural were more common than bioidentical and indeed 2 of them appeared in the top 20 searches. But again they only generated low search volume of between 100 and 200 searches per month nationally. The 2 terms are:
  • natural hormone replacement for menopause and
  • natural hormone replacement therapy.

You can find the the 1000 words at moz.com.

Digital Marketing Implications for Compounding Pharmacies

1. Rank for the Top Keywords: You could try to organically compete for the top keywords, but for HRT there are only 9 of them and organizations such webmd.com, menopause.org & mayoclinic.org already dominate them. Plus international and national news cycles can dominate HRT search when there is news about HRT. An example occurred in September 2017, when a clinic trial (clinicaltrials.gov Identifier: NCT00000611) of 27,347 women concluded ” Menopausal hormone therapy for 5 to 7 years was not associated with risk of long-term all-cause mortality.” This conclusion was picked up by national and international new organizations such as NY Times and The Guardian. This is the abstract. Even 2 months after they both published, both news organizations rank in the results for a hormone replacement search.

2. Long Tail Keywords: Ranking for long tail keywords (those with little search volume) is an appropriate SEO strategy for some businesses, especially if you sell to a national or international audience. But most compounding pharmacies are community pharmacies and by definition local. Your market is further confined by the State Board of Pharmacy license required for each state. There is so little volume nationally for long tail words, that locally the words may never by used by anyone. Thus a long tail keyword strategy is not appropriate to marketing a compounding or indeed any community pharmacy.

3. Paid Advertising: Google AdWords is an option to consider. But again the search volume is low for hormone therapies and will be proportionately lower in the areas you service and are licensed for. As I outline in my conclusions below, paid or organic results might be a better strategy for your compounding pharmacy as a whole, (as opposed to a single therapeutic category such as BHRT).

My conclusions:

1. A very small percentage (in my analysis <2%) of women going through menopause search for hormone therapies online.
2. Organic rankings for hormone replacement or related terms may not be the most effective way to market your BHRT compounding services online.
3. A long tail search engine strategy will have a limited impact for a compounding pharmacy due to a combination of low search volume and the local nature of a pharmacy.
4. Competing organically for high ranking hormone related keywords will be difficult, if not impossible. However, organic search may work better in a local setting for phrases related to compounding, compounding pharmacy, personalized medicine etc. 
5. A very high percentage (in my analysis >98%) of women don’t search for hormone replacement terms. Maybe they have no symptoms; use other words to search or seek help from other sources such as their physician. Or maybe, they just don’t have enough knowledge about hormone replacement therapy.
6. Paid search (Google AdWords) is likely to have similar results (for BHRT). 

Here are a few caveats to the analysis:

1. I used the phrase Hormone Replacement Therapy for Menopause. You will get slightly different results using a different term such as HRT.
2. There are other ways to rank for these or similar words in local searches. For example, HRT San Jose generates 0-10 monthly searches. For context, San Jose has a population of 1 million people.
3. A term like Hormone Replacement Therapy for Menopause is a mid to bottom of the marketing funnel term. Other phrases can be used by patients. For example a symptom of menopause could be used for search. This should be considered in the context of SEO.
4. People will use different search terms for the same thing depending on their knowledge of the subject and/or where they are in the purchase decision.