Historically, chiropractors have had rather diverse marketing strategies, often targeting miniscule demographic populations instead of determining their true gateway consumers. Faced with decreasing coverage and falling reimbursement rates, chiropractors have consistently divided their marketing attention on many different levels, often trying to be everything to everybody as opposed to focusing on the single most untapped source of potential revenue: women. This, combined with the fact that the age 40-plus population is the fastest-growing population segment, makes it imperative that chiropractors use unique female-centric products to develop their practices.

According to the National Institutes of Health, women make 75% of all health care decisions for their families and personally account for 60% of all visits to doctor's offices. Hormonal dysfunction—particularly menopause and its predecessor, perimenopause—are among the most symptogenic for women. Due to similar etiology of decreasing hormone levels, menopause and perimenopause generate many unique symptoms. Typically, these include insomnia, fatigue, hot flashes, palpitations, night sweats, anxiety, mood alterations, depression, muscle cramps, headache, and loss of libido. Biotics Research, in conjunction with Michelle Pouliot, ND, have worked together to create three products that support menopause and perimenopause symptomology: BioPause-AM™, BioPause-PM™, and BioDrive™.

Daytime Help

BioPause-AM contains a proprietary blend of Cimicfuga racemosa (root), Rhodiola rosea (extract, root), Leonurus cardiaca (aerial part), and Vitex Agnus-castus (berries). This formula was designed to address daytime symptoms, such as hot flashes and palpitations, that are experienced as a result of decreasing estrogen levels. The adaptogenic properties of BioPause-AM assist with fatigue and menstrual irregularities. Clinically, women reported less anxiety, more energy, and improved mental clarity as a direct result of taking BioPause-AM. Cimicfuga racemosa, commonly known as black cohosh, contains cimicifugosides, triperpene glycosides, cinnamis acids, 27-deoxyacetin, ferrulic acid, and fukinolic acid. While no estrogenic properties have been confirmed, black cohosh has been successfully used in Europe for more than 40 years for menopausal symptom support, and studies have shown that it is effective for relaxing muscles and for relieving hot flashes.¹ Rhodiola rosea, also known as golden root or roseroot, contains several pharmacologically active ingredients, the most commonly referenced one being rosavins.

These three products can help your female patients alleviate symptoms associated with hormonal dysfunction.

A known adaptogen, Rhodiola rosea influences biogenic amines, acts as an antioxidant and psychostimulant, influences neurotransmitters (norepinephrine, dopamine, and serotonin), and has a nicotinic cholinergic effect on the central nervous system.² Additionally, its effects on physical work capacity have been well-noted.³ Classically, it has been used for irritability, short-term memory improvement, and for mental and physical stress support. Leonurus cardiaca, commonly known as Motherwort, has a long history of medicinal use. It has been most commonly used in the support of menstrual irregularities; and for relieving anxiety, tension, and muscle cramping. It also has a mild vasodilatory effect and can slow heart palpitations.

In Chinese medicine, Leonurus cardiaca is reputed to promote longevity. The final component of BioPause-AM, Vitex Agnus-castus—or Chaste tree berry, as it is most commonly known—contains agnuside and aucubin, both of which act on the pituitary to stimulate the secretion of more lutenizing hormone, which tends to lengthen the luteal phase and to decrease prolactin levels. It has been shown to be useful for menstrual irregularity, PMS, hot flashes, infertility, and galactorrhea.⁴

Nocturnal Help

BioPause-PM is the nighttime equivalent of BioPause-AM. It was formulated to address common nocturnal complaints such as night sweats, anxiety, and restlessness. In addition to Cimicifuga racemosa, it also contains magnesium glycinate, Passiflora incarnate (flower), and melissa officinalis (leaves). Magnesium glycinate is a chelate that is important for its sedative and muscle-relaxant properties. Passiflora incarnate has long been used to support restful sleep. It has been noted as an analgesic, antispasmotic, and general sedative.⁵ Melissa officinalis, also known as lemon balm, also shares a long history as a sleep enhancer, and for treating agitation, nervousness, and gastric upset.⁶ Mild sedative qualities, as well as antibacterial, antiviral, spasmolytic, carminative, and antispasmotic actions, have also been noted. Melissa officinalis also demonstrates a high polyphenol content, which may explain its antioxidant effect.

Libido

As a physical complaint, libido loss is a commonly occurring, yet frequently unreported problem stemming from decreasing hormone levels. BioDrive contains a proprietary blend of Rhodiola rosea (extract, root), Turnera diffusa (leaves), Ginko biloba (leaves), Panax quinquefolius (root), and Urtica dioica (extract, root). Turnera diffusa, also known as Damiana, contains several active compounds, the most frequently cited being pinene, cineol, and sesquiterpines; and it has been extensively used to increase sexual functioning.⁷ Ginko biloba has been demonstrated to have several pharmacological effects, including the "inhibition in age-related reduction of muscarinergic cholinoceptors and 2-adrenoceptors as well as stimulation of choline uptake in the hippocampus," systemic improvement of blood flow, particularly microcirculation, and neuroprotective effects.⁷ Panax quinquefolius—or rather, American ginseng—is also an adaptogen, but it is not as warming as the other ginsengs. It contains ginsenosides, which are believed to resist stress and fatigue via the support of the adrenal glands.⁸ Traditional uses have also included support for digestive and sexual dysfunctioning.⁹

Urtica dioica (nettles root) is of particular interest because it helps with sex-hormone-binding globulin. This is especially important when women are perimenopausal or menopausal, because they are often hyper-estrogenic, which will drive up sex-hormone-binding globulin, which in turn will bind up a lot of the free testosterone. This may be what is primarily decreasing their libido.⁴

One other supplement deserving mention in the support of perimenopause and menopause is 5-Hydroxytryptophan (5-HTP). 5-HTP, an amino acid precursor to serotonin, has been shown to improve mood and anxiety, improve sleep quality,¹⁰ and to aid in weight loss¹¹—all of which are typical menopausal complaints. Ongoing research is also implicating it in the support of hot flashes, migraine headaches, and fibromyalgia. The addition of 5-HTP supplementation may be particularly useful with women whose symptoms have been resistant to other therapeutic support.

While the perimenopausal and menopausal patient may present with a series of diverse complaints, she indubitably seeks treatment. Chiropractors willing and able to treat this demographic are not only helping an underserved group, but they are accessing a potentially huge new-patient base. As gateway patients, women aged 40 and older typically are responsible for making all family doctor appointments, and they subsequently will refer other family members to a practice. It is estimated that Baby Boomers compose 40% of the population, yet they control three quarters of the health care dollars spent in the United States. The Women2Women Communications Group of Campbell-Ewald found that 62% of Baby Boomer women claimed to actively pursue the maintenance of their youth.¹² For the nonmarketing-oriented chiropractor, this translates to a huge base of potentially long-term patients who are willing and able to pay for services rendered.

Women want hormonal support, and they need hormonal support. As primary health care providers, chiropractors are poised to treat this effectively and efficiently.

Miranda Jorgenson, DC, is physician adviser for Biotics Research Corp in Rosenberg, Tex. Contact her at .

References

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2. Brown RP, Gerbarg P, Ramazanov Z. Rhodiola rosea: A phytomedicinal overview. HerbalGram. 2002;56:40-52.
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4. Pouliot M. The Journey of Menopause. Seminar. Biotics Research Corp; May 20, 2006; Waterbury, Conn.
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11. Halford JC, Harrold JA, Lawton CL, Blundell JE. Serotonin (5-HT) drugs: effects on appetite expression and use for the treatment of obesity. Curr Drug Targets. 2005;6(2):201-213.
12. Newspaper Association of America. When it comes to baby boomer women, youth is the marketing watchword. Available at: www.naa.org/r2/boomergirls.html. Accessed February 1, 2007.