All stages of a woman’s life are distinct, yet they blend seamlessly. During puberty, the menarche gives rise to fertility and the monthly hormonal cascade, followed by childbearing years and potential pregnancies, which in turn are followed by peri-menopause, menopause and post-menopause. Young women who purposefully adopt a healthy lifestyle that encompasses long-term supplementation with short-term natural remedies overall may ensure that their aging is one characterized by strength, vitality and decreased risk of developing illnesses such as osteoporosis and cardiovascular disease, among other age-related diseases.

As retailers, the category of products geared specifically for women’s life stages is a vast one, and selecting the most appropriate inventory may be a daunting and intimidating task. It is indeed an area of specialty all to itself and like women’s life stages, successful sales interactions in this particular category can certainly blend and carry over into other areas in the store: food, bodycare, green home care and supplements for the entire family.

“Women remain the primary household purchasers, and products that effectively meet their specific needs tend to be very successful,” says Marci Clow, M.S., R.D., senior director of product research at Rainbow Light Nutritional Systems, Santa Cruz, CA. “Sales are strong overall for the multi-million dollar women’s category. The dynamics of the category are changing in significant ways as more mainstream shoppers cross over into natural supplement aisles.”

Clearly, women comprise the majority of shoppers in this channel, so working with them to build a healthier, more wholesome life—not just ringing the cash register—will go a long way to create store loyalty and provide you with the satisfaction of knowing you are helping to improve the quality of life for many people.

Eileen Sheets, managing director of Bioforce USA, Ghent, NY, says that the company’s sales continue to grow and based on the consumer phone calls received in the office, it appears the overwhelming majority of Bioforce USA customers are women. She muses, “Part of it is fueled by the research that has shown HRT [hormone replacement therapy] to be not as safe as originally thought. But, it still holds true that women do the majority of the shopping for the family.”

Sheets adds pointedly that the recent scares of tainted food have brought new customers to health food stores in the belief that natural and organic products are safer. Once in the store, women quickly become aware of the variety of natural (i.e., safer) remedies and products available for themselves and their families.

Market Analysis

A disturbing news story appearing in Chain Drug Review (2-18-08) citing survey data from the TABS Group of Shelton, CT, asserted that supplement use among women declined by 13 points since its previous market survey of December 2005; the drop, said TABS, appeared to be from women aged 30 to 59. TABS president Kurt Jetta was quoted saying that the distinctive sales losses were in supplements such as black cohosh and soy, as well as in calcium. He also noted, however, that he has seen manufacturers and retailers decrease their marketing and merchandising support of women’s nutrition.

This article brings forth the challenging questions of what exactly has caused the apathy from women, notably in black cohosh and soy supplements as the research claims. Is it that these have been relegated out of the spotlight by other newer, “sexier” supplements? Is the purchase flatlining due to a tapering off of industry media, merchandising and marketing efforts? Or, are research teams focusing efforts on other nutraceuticals, and newsworthy studies that have slowed down? Is the lackluster purchase velocity of these two former powerhouse nutrients for women a reaction to research and marketing dynamics? Retailers who focus on finding answers to these questions will likely fare very well and see their sales velocity in the women’s health and other categories zoom higher.

Brad Douglass, Ph.D., technical specialist for Jarrow Formulas, Los Angeles, CA, says that Jarrow Formulas formulates and markets its women’s supplements by gathering and analyzing the information of up-to-date research findings on health-related conditions, market demand and consumer feedback. In the past three years, Jarrow Formulas has identified concerns such as menopause, beauty, energy, gut health and total well-being that have become more prominent among women.

“We’ve seen impressive growth in the past three to five years in the women’s health category,” says Grace Ormstein, MD, CTN, scientific herbal advisor for Himalaya Herbal Healthcare, Houston, TX. “We assess growth in category sales by following the increase in movement of our women’s products at a national level. In the past three years, sales of women’s products have increased 24%. Women are becoming ever-more aware of natural products, increasingly pro-active in matters of their own health, nutrition and comfort, and consequently, they’re turning to natural supplement manufacturers for more and more safe, yet scientifically validated assistance and answers.”

“Today’s woman is not the kind of consumer her mother was,” observes Jennifer Savage, director of operations for Natural Miracles, Inc., Colorado Springs, CO. “Mom’s generation was just beginning to acknowledge the unique issues women face—that her symptoms were organic and real versus something she was making up in her own mind. However, she didn’t have much available to her in the way of therapies. Today’s women are able to find information about every health topic imaginable on the Internet. They are joining online communities to discuss their health concerns, which expose them to new ways of thinking about their health and new ideas about how to take care of themselves. This category is growing exponentially in order to meet the needs of these women.”

In agreement is Craig Cameron, president and chief executive officer of Natrol, Inc., Chatsworth, CA, who notes that “key changes in this market include shifting attitudes where women are more open to natural therapies and are becoming more proactive in their health by asking what they can do to have a better quality of life, rather than suffering in silence or accepting a ‘one size fits all’ approach.”

In addition, he observes, women typically rely on their friends and family for natural product (and most other purchase) recommendations. This is accentuated by growing awareness about effective natural therapies—for everything from sleep support to menopause relief—among mainstream physicians and other healthcare professionals thereby making it easier for open discussions about individualized, natural approaches to maintaining a higher level of good health for longer durations.

Referring to the aforementioned flat sales data, Cameron predicts, “It is possible that most brands will be challenged to maintain or grow market share in the women’s health category due to overall category declines industry-wide; this may be at the mercy of current economics which may contribute to limiting the number of supplement purchases per household And this in turn can lead to more generic or private label purchases, particularly in the multivitamin category, at the expense of brands.”

Chris D. Meletis, director of science and research for Trace Minerals Research, Ogden, UT, is optimistic, remarking, “The growth is significant, for women continue to be the foremost advocated for taking care of themselves and, for that matter, their entire circle of influence of friends and family. Also with a growing segment of the U.S. population chronically aging, there is an overt refusal to allow their birth date determine their biological aging and vitality.”

All these factors and more are strengthening a more assertive group of self-care shoppers. A recent study underscored that a significant portion of the menopausal population uses complementary and alternative medicine (CAM) during their menopause, and the researchers sought to understand the motivation, noting that conversations with their clinicians about CAM are often unsatisfactory. The researchers found that there were four major themes motivating the decision to use CAM therapy during menopause:

• valuing CAM as “natural” even though this definition varied greatly,
• perceiving menopause as marking a change in life stage,
• seeking information about menopause generated from personal intuition and other women’s experiences, and
• describing experiences before menopause of using CAM and allopathic medication in patterns similar to current use (patterned responses).

The study authors concluded that women’s decisions about using CAM during menopause can be understood through their perspectives on menopause and overall health. Increased clinician awareness of these themes may promote supportive discussions about CAM during counseling for menopause (1).

Yet, when reviewing the four themes, they can easily transcend to all women’s health concerns beyond solely menopause; this, too, can serve as a basis for natural health retailers to help overcome any trepidation or objections and create an atmosphere of confidence in purchases.

Organic, green, eco-conscious and natural, the mass media and market has exalted each and continues to do so. And, women are responding. New consumer magazines and Web site communities geared to a healthy, wholesome and green lifestyle are cropping up by the bushel. This lifestyle opens wide the portals to addressing women’s health needs via supplements and foods like never before.

Shelf Considerations

As your women’s health department is likely one that is robust, it also must be evergreen, featuring innovative supplements as well as the reliable favorites. Here, we present some compelling choices spanning a range of female issues.

An article about women’s health would not be complete without mentioning the importance of essential fatty acids, notably omega-3 (docosahexanoic and eicosapentanoic acids) for prental and fetal development health.

Prenatal DHA from Nordic Naturals, Watsonville, CA, is branded as such so that women can understand that they need to be using it during pregnancy. According to Keri Marshall, ND, advisor to Nordic Naturals, “The prenatal DHA product is the only specific prenatal fish oil formula with the recommended dose of DHA that is required to maintain a healthy pregnancy. With this product, two capsules contain 450 mg of DHA. International organizations recommend a minimum of 300 mg a day to ensure proper brain development for the fetus. It also helps to prevent pre-term labor and post-partum depression.”

The latest addition to the Natrol family of products for menopausal symptoms is Promensil. Promensil, a supplement that contains isoflavones from red clover, is standardized to contain 40 mg of isoflavones in a ratio that maximizes effectiveness, according to Cameron. One tablet daily offers a natural, safe alternative to women for reducing the frequency and severity of hot flashes, while also promoting breast and heart health. Further, there are no major uncomfortable side effects that women just can’t stand such as weight gain and bloating, headaches and breast tenderness.

In 2007, Natrol announced the results of a large, three-year study (published in Menopause International) validating the safety of the supplement in a cohort of women who have a family history of breast cancer. The study revealed that the supplement had a neutral effect on breast density, in contrast to studies of HRT, which increases mammographic breast density (i.e., a marker associated with the risk for developing breast cancer) (2).

In addition, Cameron points out, two systematic reviews and meta-analyses of 17 randomized controlled trials of supplementation with red clover or soy isoflavones that demonstrate a significant reduction in menopausal hot flash frequency with red clover isoflavone use, particularly in women with frequent flashes.

Meanwhile, according to Ormstein, Himalaya Herbal Healthcare’s strongest performers in the women’s health category are MenoCare, MenstriCare and OsteoCare. “All three formulas were very strongly based on clinical research, versus responding quickly to marketing trends,” she asserts. “Approximately 1,112 clinical trials have been published on Himalaya Herbal Healthcare products in prestigious journals around the world like the European Journal of Clinical Pharmacology, Phytotherapy Research and JAMA, India.”

For Solgar Vitamin and Herb, Richard Passwater, Ph.D., director of research and development, says one of its most exciting women’s products launched recently is its PM Phytogen Complex Tablets, which offer 80 mg of Thai Kudzu (Pueraria mirifica) per serving. Pueraria mirifica contains a complex of phytoestrogens, including miroestrol, which is helpful for menopause support. Miroestrol is bio-similar to human estrogen, making it many times more powerful than diadzein or genistein, he says. Initial human studies have found miroestrol-containing Thai Kudzu effectively relieves common menopausal symptoms, including hot flashes, night sweats, headaches, mood instability, nervousness and fatigue (3, 4). Solgar uses a patented analytical procedure to validate PM PhytoGen Complex’s miroestrol content. Select B vitamins further address the emotional stress and fatigue that come with menopause.

BioMed Health provides its Femi suite that addresses comfort during menopause. Femi-Yin is an all-natural product that targets quick relief of symptoms such as night sweats and hot flashes, according to Dwight Sherman, Ph.D., the company’s vice president of marketing. The companion Femi-Strong is geared for long-term use to provide support for cardiovascular and skeletal systems. And for women concerned about a sluggish metabolism brought about by the menopausal hormonal cascade, Femi-Trim was created. “We assure consumers that they are purchasing highly effective, empirically tested products,” Sherman asserts. “The Femi line of products was formulated by a traditional Chinese medical doctor, a well-known cardiologist and a vice president of medical research at a major U.S. teaching hospital. ”Bioforce USA’s Sage Menopause Tablets features sage, which Sheets describes as being “effective at controlling the hot flashes that can make menopause difficult for many women. Of note, sage is not used much in the United States for this particular concern. Sage has a different mode of action from black cohosh, which has seen some concerns about its safety arise recently. It works by inhibiting excessive sweat production. This could be very appealing to women concerned about black cohosh.”

Bioforce AG has just completed a small clinical trial (unpublished) to investigate the effects of using Sage Menopause Tablets for the treatment of hot flashes in menopausal women. Thirty-nine patients took either Sage Menopause Tablets or a placebo for eight weeks and completed a daily diary card to record the frequency, severity and duration of their hot flashes. Patients were asked to rate their improvement in their overall clinical condition over the eight weeks. The patients were asked to rate their condition as being “better,” “much better,” “worse,” “much worse” or “same.” In the Sage group, 75% of patients rated their overall clinical condition as “better” or “much better” compared with 47% of patients in the placebo group. The average decrease per patient in the total number of hot flashes experienced over eight weeks indicates a decrease of 56.3% in the Sage group and an increase by 4.8% in the placebo group (5).

Douglass of Jarrow reports that the company’s signature bone-health product aimed at women, Bone-Up multinutrient supplement, continues to make a significant impact with repeat sales. “The most critical component of Bone-Up is the ossein-hydroxyapatite from free-range Australian calves,” he describes. “‘Ossein’ means that this form of calcium contains organic bone material and bone growth factors that may be critical in supporting bone health and calcium metabolism. Hydroxyapatite, or microcrystalline hydroxyapatite, is the three-dimensional form in which calcium exists in bone matrix. Bone-Up includes other critical nutrients for bone health like vitamin K (especially K2), vitamin D and magnesium. The Bone-Up formula is kept current with the most recent findings in bone science.”

A clinical trial was conducted on Bone-Up in which researchers found that in conjunction with resistance exercise, consumption of the supplement increased the intake of micronutrients that can improve bone health (6) and “may lower the risk of osteoporosis later in life,” Douglass says. “This study examined a widespread but largely untested hypothesis that in young adult women, increased micronutrient intake can enhance exercise-induced changes in bone metabolism.”

Another significant subcategory is PMS care. Peri-menopausal women are often prone to this condition as periods can become more volatile before complete cessation. Premenstrual syndrome (PMS) is a cache of discomforts caused by estrogen dominance in the luteal phase, as the uterus prepares itself for potential implantation/pregnancy, following ovulation and through the two weeks before menses. Women suffer from PMS differently. “Menstrual symptoms are caused by natural substances called prostaglandins (PGF2a) that are produced by cells in the uterine lining. At the beginning of the menstrual cycle, these prostaglandins cause the muscles of the uterus to contract, reducing blood flow and temporarily cutting off the oxygen supply to the tissues,” Savage explains. “When this happens, strong normal uterine contractions become cramps. Women with menstrual cramps have significantly higher levels of prostaglandins than do other women. Nearly 40 million women in the United States alone suffer each month with cramps!”

Natural Miracles, says Savage, has formulated Menstrual Magic to provide support during the luteal phase, describing the product as a supplement using a patent-pending formula of pharmaceutical-grade essential oils. “Greek sage leaf, Spanish oregano leaf, cumin seed, and peppermint leaf are combined in a softgel, allowing absorption to take place and the oils to work within 15–17 minutes to help alleviate cramps, bloating, nausea and other symptoms associated with a woman’s monthly menstrual cycle,” she says. An independent laboratory study revealed a 77.4% ± 1.8% inhibition of PGF2a (7).

Nordic Naturals offers Omega Woman, a generalized product for women’s health that contains evening primrose oil (EPO) and a small amount of DHA and EPA. This essential oil combination is formulated to help balance hormone levels and increase production of prostaglandins that can help alleviate PMS symptoms. “Omega Woman is unique in that it contains both evening primrose and oil and EPA and DHA from fish oil, all of which will help to eliminate inflammation in the body,” says Marshall.

According to Clow of Rainbow Light, retailers should be sure to have a good stock of products that “offer one-step solutions that cater to women’s busy lives.” Such products may include multivitamins that “support a variety of health concerns and goals including prenatal health, increased energy, extra antioxidant support, bone, heart and breast health, anti-aging, hormone-balancing and menopause concerns. We also offer therapeutic condition-specific remedies that deliver results, ensuring continued customer loyalty and repeat sales,” she says. Included in the company’s women-tailored line of supplements are Women’s One (a multivitamin with calcium, vitamin D, live probiotics, organic superfoods and a potent B-complex featuring folic acid), Prenatal One multivitamin, Women’s Nutritional System Multi+ Daily Program (for women of all ages interested in balancing hormones naturally), RejuvenAge 40+ Multivitamin (offers scientifically advanced nutritional defense against the effects of aging) and Women’s Answer Multivitamin (for women of all ages who take oral contraceptives or HRT, or who want extra support for stress management).

Rainbow Light also makes food-based, absorption-enhanced supplements that address PMS (PMS Relief), menopause (Complete Menopause Multivitamin, Menopause One Multivitamin, Black Cohosh Meno-Relief 1650), reproductive health (Women’s Answer Multivitamin), prenatal (Prenatal One Multivitamin, Complete Prenatal System, prenatal Pack including Prenatal One and DHA 250 Smart Essentials), breast health (Women’s Nutritional System Multi+ Daily Program) and flora balance (Advanced Enzyme Optima, ProbioActive 1B, ProbioActive 10B, Women’s One Multivitamin and Prenatal One).

Feminine Factors

In today’s society, what was taboo or unmentionable has become mentionable—albeit in a polite and dignified manner, of course. Women are more open to discussing bladder and urinary discomforts, yeast infections and sexual problems. This bodes very well for the natural product retail community, which exists to bring healthy balance, vibrancy and confidence in the lives of their customers.

According to Sherry Torkos, holistic pharmacist and author, 80% of all women will experience a urinary tract infection (UTI) in their lifetime and approximately 20% of women will have a UTI each year. Normally, she explains, urine is sterile and does not contain any bacteria, viruses or fungi. An infection can develop when these bugs enter the urethra and travel up into the bladder. Over 90% of UTIs are caused by the bacteria Escherichia coli (E. coli), normally present in the colon and rectal area.

“UTIs are certainly more prevalent among women. There are several reasons for their frequency in women. In women, the urethra is closer to the anus and much shorter, making it easier for bacteria to enter and travel up into the bladder,” she explains. “During pregnancy, women are at increased risk because the growing baby presses on the bladder, which may prevent the bladder from completely emptying. When urine is left to stagnate in the bladder, the risk of developing infection increases. Menopause also increases the likelihood of UTIs because the decline in estrogen levels leads to thinning of the urinary tract, again making it easier for bacteria to break through. Individuals that have a catheter are also at greater risk because bacteria can enter during insertion and removal of the device.”

In a year-long study that was randomized, double-blind, controlled, peer-reviewed and published in the Canadian Journal of Urology in June 2002 concluded that Cran-Max Cranberry Supplement (manufactured by Proprietary Nutritionals, Kearny, NJ) provided the most effective, convenient and cost-effective method of prevention for UTIs (8).

In 2007, Enzymatic Therapy launched the ActiFruit line with Cran-Max Cranberry Supplements, including the first one-per-day soft chew, as well as 30-count capsules. According to the company, one ActiFruit soft chew equals the antioxidant power of seven glasses of cranberry juice cocktail. The supplement supports bladder and urinary tract health and fights free radicals with beneficial antioxidants. “ActiFruit with Cran-Max delivers the ultra-concentrated power of cranberries in an easy, one-per-day dose,” said Matt Schueller, senior vice president of Marketing for Enzymatic Therapy. “The ActiFruit chews are a break-through product. It’s rare to find a supplement that’s really effective, but tastes like a delicious fruit treat.”

Curbita Bladder Caps from Sanhelios, available exclusively from Bioforce USA, is a pure, high-dose (1,000 mg) pumpkinseed oil from a rare, soft-shelled, medicinal pumpkin grown primarily in southeastern Europe (Cucurbita pepo L). “It can strengthen the bladder muscles to provide improved bladder function and women who have reached menopause can appreciate this,” Sheets remarks. “There is a positive Commission E Monograph for cucurbita and irritable bladder. Quite a few consumers and retailers have told us that Curbita is a supplement that really contributes to quality of life by promoting healthy bladder function,” she adds.

On a related note, an embarrassing problem that plagues women at least once in their lives is generated by candida colonies that suddenly go urban—also called “yeast infections.” Jarrow Formulas’ Fem-Dophilus is an oral probiotic product consisting of two probiotic strains (Lactobacillus rhamnosus GR-1 & Lactobacillus reuteri RC-14) that have more than 20 human studies and clinical trials that substantiate the product’s safety and efficacy for promoting vaginal health. Mechanistically, Douglass says, these probiotic strains have properties that help maintain a healthy vaginal environment that discourages colonization by harmful bacteria. These include lowering pH, producing hydrogen peroxide and synthesizing specific immune modulators and molecular defenses against harmful bacteria and yeast species.

“In addition to the obvious conditions such as osteoporosis, breast health, PMS, uterine fibroids, etc., many women are battling with various issues that greatly affect their self-esteem and mood,” observes Michael Murray, ND, director of product development and education at Natural Factors Nutritional Products, Inc., Everett, WA. Recently, Natural Factors has introduced two products designed to address what Murray identifies as two areas of extreme concern for women—libido and the health of their hair, skin and nails.

Sex Essentials addresses an important concern for women—a recent University of Chicago study found that 43% of women surveyed reported sexual difficulties. “Stress, depression, lack of sleep, too much work, prescription drugs, poor nutrition, hormone imbalances and menopause are a few reasons why women are lacking desire or having difficulty achieving orgasm,” Murray explains. “Sexual problems include lack of sexual desire, difficulty becoming aroused, inability to achieve orgasm, lubrication problems and pain during intercourse.”

Unlike what’s available for men in the pharmaceutical arena, prosexual nutrients are a safe, gentle and effective way for women to enjoy this special manner of expression and also improve their overall health. Sex Essential contains important prosexual nutrients found in Sex Essentials features Eurycoma longifolia also known as Malaysian ginseng.

In summary, the industry mantra of “educate, educate, educate” is the perfect allure for a majority of women who enjoy the experience of learning, and the empowerment self-education brings to making informed life choices, especially in self-care. Women also appreciate the personal touch, the one-on-one interaction that gives her respect. WF

References

1. L.E. Hill-Sakurai, et al., “Complementary and Alternative Medicine for Menopause: A Qualitative Analysis of Women’s Decision Making,” J. Gen. Intern. Med. 23 (5), 619–622 (2008).
2. T.J. Powles, et al., “Red Clover Isoflavones Are Safe and Well Tolerated in Women with a Family History of Breast Cancer,” Menopause Int. 14 (1), 6–12 (2008).
3. V. Chandeying, et al., “Preliminary Efficacy and Safety of Partially Purified Pueraria mirifica (Kwao Keur Kao) for the Treatment of Vasomotor Symptoms in Perimenopausal Women; The Thai Phase I Study,” unpublished (2001).
4. V. Chandeying, et al., “Optimal Dose of Partially Purified Pueraria mirifica (Kwao Keur Kao) for the Treatment of Vasomotor Symptoms in Perimenopausal Women; The Thai Large Phase I Study,” unpublished (2001).
5. Information from Bioforce USA.
6. R.A. Disilvestro, et al., “Effects of Micronutrient Supplementation plus Resistance Exercise Training on Bone Metabolism Markers in Young Adult Women,” J. Nutr. Environ. Med. 16 (1), 26–32 (2007).
7. “Evaluation of the Effect of an Essential Oil on Rat Uterine Contraction (An in vitro Study), (Study #3104/NMI) July 23, 2004.
8. L. Strothers, “A Randomized Trial to Evaluate Effectiveness and Cost Effectiveness of Naturopathic Cranberry Products as Prophylaxis Against Urinary Tract Infection in Women,” Can. J. Urol. 9 (3), 1558–1562 (2002).

Published in WholeFoods Magazine, October 2008