Background
This investigation forms part of a wider piece of work on ads making claims about the treatment of symptoms of the menopause. The ads were identified for investigation following intelligence gathered by the ASA.
Ad description
Five TikTok ads for Napiers The Herbalists' Wild Yam Cream:
(a) A TikTok ad on Kate Ring’s account @yourmategingerkate seen on 24 January 2024. The video in the ad featured on-screen text that stated, “Perimenopausal? Menopausal? Or post menopausal?”. Kate and on-screen text stated, “Where are my perimenopausal, my menopausal, and my post menopausal ladies at? Each to their own when it comes to HRT [hormone replacement therapy], that’s a choice and a decision that you need to make. However, before you go down that route, can you please just try a more natural way. I promise you it will be better for your long-term health. So with that said, Napiers Wild Yam Skin cream […] Essentially what this is, this is like hormone replacement cream that you put in areas of your body […] far far better than any pharmaceutical drugs you could take to balance hormones. Remember big pharma wasn’t always around and we did use plants and herbs and all of that woohoo stuff as medicine and guess what it worked.” Text under the video stated, “Commission paid”.
(b) The first of two ads on Yiolanda’s (Yolly’s) account @lifestyle_and_smiles, seen on 17 February 2024, featured text that stated, “Wild yam cream to help my perimenopause journey & balance my hormones” and “Commission paid” at the bottom. An accompanying video had on-screen text that stated, “Wild yam cream to support perimenopause symptoms”. Yiolanda and on-screen text then stated, “As you may know if you follow me I am adding a symptom of the day when it comes to perimenopause and to help balance out hormones and to help me with all of those symptoms and I’m feeling so good right now even better since coming off of HRT over five months ago and that’s using the wild yam cream. So if you are having perimenopause symptoms if you are on HRT you can still use the wild yam cream but they do suggest that you speak to your doctor first. Although it’s a completely natural product. But if you’re not on HRT and you’d like to try something naturally to help balance out your hormones, it doesn’t add either oestrogen or progesterone, it works by balancing out or firing up our own. If our hormones are balanced then that means far less to maybe even no perimenopause symptoms and I’m having far less right now. In fact I’m in the best place I’ve been in such a long time and there’s a flash sale right now.”
(c) The second ad on the same page, seen on 1 March 2024, featured on-screen text that stated, “Wild yam cream flash sale…. Commission paid”. An accompanying video had on-screen text that stated, “My perimenopause symptoms are balanced using the wild yam cream. Flash sale. Wild yam cream”. Yiolanda and on-screen text then stated, “There’s a flash sale on the wild yam cream right now so if you are looking to try it it’s a really good time to give it a go. I’ve linked it below for you if you’re already using it and loving it then also it’s a great time for you to stock up. I’ve been using this for almost six months now helping balance out my hormones, my oestrogen and progesterone since I came off HRT and I am feeling so balanced. No night sweats, no fatigue, no brain fog, no body aches, no anxiety, no rage, they were really my main symptoms I would say and I’m feeling in a really good place. I use it every single day and then I break for up to seven days when my period arrives. A pea size just upper arm or inner thigh [sic]. If you’re no longer having periods you do not need to break but you can take a break if you want to and you can use it up to three times a day but start slow”.
(d) The first of two ads on Michelle Haslam’s account @michelle.haslam, seen on 12 March 2024, featured on-screen text that stated, “How long have you been suffering from perminopausal [sic] hot sweats?”. A text bubble on-screen stated, “Reply to Lottie’s comment” and included the following text, “I’ve been suffering for ages and this is the best thing I’ve used. My hot flushes have improved so much. This is 100% better than anything. It may have just saved my sanity”. Michelle and on-screen text in the video stated, “I absolutely hate hearing that women have suffered for so long with perimenopausal and menopausal symptoms. Lottie’s been using the wild yam cream and has had an amazing result […] I’ve been using this now for just under two months and I still have absolutely loads left […] it’s having a massive effect on me, my rage and it’s not helping my insomnia at all but it’s helping my rage, my anxiety, I don’t really have that anymore and it’s helping Lottie with her hot flushes and yeah I just absolutely love this stuff. I’ve linked it below […] it’s amazing and no it doesn’t work for everybody okay, I am not saying it will work for everyone there are people in my comments that it doesn’t work for but for those it does it’s life changing.” Text at the bottom of the post said, “Commission paid”.
(e) The second ad on the same page, seen on 16 March 2024, featured text that stated, “[…] Perimenopaise [sic] symptoms are all going for lots of people in my comments. Rage, anxiety, night sweats and they’re sleeping better. #yamcreamforperimenopause #napierswildyamcream #wildyamcream”. On-screen text stated, “Wild yam cream flash sale Sat 16 March 10am – 1pm For perimenopausal symptoms”. A text bubble on-screen stated, “Reply to Susan Cropper’s comment” and included the following text, “Amazing 2 weeks in. No night sweats at all. Sleeping better x”. Michelle and on-screen text in the video stated, “If you’re lucky enough to be seeing this on Sat 16 of March between 10:00am and one pm you can get the Napiers wild yam cream on flash sale. People in my comments have been getting rid of night sweats, they’re sleeping better, their rage is going, anxiety is going, some people are coming off of HRT completely. So this is an absolutely incredible time to stock up for a few months, grab it while you can.” Text at the bottom of the post said, “Commission paid”.
Issue
The ASA challenged whether the ads made medicinal claims for an unlicensed product.
Response
The Edinburgh Herbal Dispensary Ltd t/a Napiers The Herbalists said they were committed to being compliant with advertising regulation. They said their product, Napiers Wild Yam Cream, was not intended to cure or treat any disease, injury, ailment, or adverse condition, whether of body or mind, as set out by the CAP Code, and therefore, no licensing was required under authorisation from the MHRA. They said it was not accurate to classify the perimenopause as a medical condition and it was not treated that way by the World Health Organization (WHO).
The TikTok creators used the word “symptoms” to describe their experience of using Napiers Wild Yam Cream, which was in line with the WHO, who said that “Although menopause is not a disease … the perimenopausal and postmenopausal experiences of women [are referred to], as symptoms because they can result in a level of discomfort that affects their quality of life”. They said it would be in disagreement with the WHO, general definitions relating to the menopause, and language surrounding the descriptions of women’s experiences, to classify perimenopause or menopause as medical conditions, or the claims as medicinal.
They strongly supported the ability of women experiencing perimenopause and menopause to discuss their experiences in an open way on platforms where their voices could be heard. They were concerned that restricting such language would have an adverse effect, particularly for those advocating for the normalisation of the discussion and sharing advice based on their personal experiences. They said that all the ads had been removed and the content had not been used in any other advertising by Napiers The Herbalists. They said they would ensure that content relating to the brand and all of their products was compliant in future.
Yiolanda Koppel said she was passionate about supporting women going through the perimenopause and believed she had not made medical claims about Napiers Wild Yam Cream on her TikTok account. She said the perimenopause was not a disease and that not everyone took or wanted to take HRT. She believed TikTok was a place to share her experience of the perimenopause and she had used Napiers Wild Yam Cream to support her perimenopause journey since she had stopped taking HRT.
Kate Ring said she took the CAP Code seriously and that her commercial content did not have the intention of promoting products with medicinal claims. She apologised if her content broke guidelines and said she was not aware the menopause was a medical term. She considered it to be a stage in a woman’s life, rather than an actual diagnosis. She said she would be more mindful with her content going forward and that she had removed the ad from her TikTok account.
Michelle Haslam said her content was not meant to constitute medical advice. Her intention was to describe her own experience of using Napiers Wild Yam Cream, and to share feedback from other users of the product. She also said she took the CAP Code seriously and that her commercial content did not have the intention of promoting any product with medicinal claims. She confirmed the ads had been removed from her TikTok account.
Assessment
Upheld
The CAP Code (which reflected legislation) stated that medicinal or medical claims and indications may be made for a medicinal product that was licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) or under the auspices of the European Medicines Agency, or for a medical device with the applicable conformity marking. A medicinal claim was defined by legislation as a claim that a product or its constituent(s) could be used with a view to making a medical diagnosis or could treat or prevent disease, including an injury, ailment or adverse condition, whether of body or mind, in human beings.
The ASA considered that consumers were likely to understand the claims in ads (b), (c), (d), and (e), “support perimenopause symptoms”, “balance out hormones”, and the claims the product could treat sufferers of night sweats, poor sleep, hot flushes, fatigue, brain fog, body aches, anxiety, and rage, to mean that Napiers Wild Yam Cream could treat the symptoms of the perimenopause and menopause. Similarly, we considered the claims in ad (a), “Each to their own when it comes to HRT. However […] can you please just try a more natural way”, “This is like hormone replacement cream that you put on areas of your body. Far better than any pharmaceutical drugs you could take to balance hormones”, and in ad (e), “some people are coming off of HRT completely”, were likely to be understood as referring to treatment for perimenopause and menopause symptoms.
We considered claims regarding the treatment and management of adverse symptoms of perimenopause and menopause were medicinal claims for the purposes of the legislation reflected in the Code. As such, the product was required to be licensed as a medicine in order to allow such claims. However, we understood that the product did not have the relevant marketing authorisation from the MHRA and because of that no medicinal claims could be made for the product.
Because the ads made medicinal claims for a product which was not licensed, we concluded that they breached the Code.
The ads breached CAP Code (Edition 12) rules 12.1 and 12.11 (Medicines, medical devices, health-related products and beauty products).
Action
The ads must not appear again in the form complained of. We told The Edinburgh Herbal Dispensary Ltd t/a Napiers The Herbalists to ensure that future ads did not make medicinal claims for unlicensed products.
