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DoctoriumGP · Track 1 · Continuation of Manus Handover · 16 Aug 2026

US Menopause Engine
Launch & Compounding Plan

From £5,000 float and a founding review cohort to 12 retained US$250 sales/day and the £17,000/month extraction (£12k grinder + £5k living) — with tax reserves held, ROAS floors enforced, and every scaling step gated by evidence.

Model: compound_model.py · run 16 Aug 2026 FX: $1.3533/£ 4:1 ROAS: audited 16 Aug — NOT supported · plan at 2.0–2.5x (§00)

00ROAS verdict — 16 Aug 2026 audit

Ade asked: do we concur with 4:1? No. 10-agent research sweep — 7 evidence angles, 97 sourced findings, 3 adversarial audits (source fidelity · metric definition · applicability). Every load-bearing figure opened and checked at source. Full detail: ROAS_AUDIT.md.

4:1 sustained, cold, at scale
No case found
2025–26. It is the pre-iOS14 rule of thumb — multiple sources call it outdated
Market medians 2025
1.19–1.86x
Triple Whale ~35k brands 1.86x · H&W 1.50x · healthcare 1.19x (Varos)
Audited central plan
2.0x
2.5x with AOV stack + email · 3.0–3.4x = success case
Closest real analogue
0.95:1
$495 course · $920/day cold Meta · 18 months · webinar funnel · 2.95x blended only via high-ticket backend — in 2019's easier conditions

Where the 4:1 actually dies — the conversion leg

4:1 at $250 and $1.25 CPC is the 2.0% cold click-to-purchase assumption. Verified reality: stores with AOV >$200 convert at a 0.79% site-wide median including warm traffic (DTC Pages Q2 2026); cold paid-social course pages at $97–297 run 0.5–1.5%; Meta traffic is 86–94% mobile, converting ~40% below desktop; and realistic health-vertical CPC is $1.38–2.07, not $1.25. Holding 4:1 at realistic CPCs needs 2.8–3.3% cold mobile CVR — 3.5–4× the observed median.

Three structural findings

  • Meta health restrictions hit this product squarely. Menopause meets the "specific health status" definition; education positioning does not escape it. 84% of 159 women's-health orgs had ads rejected; agencies call 1.8–2.5x "realistic at scale" for remediated accounts. Remediation infra ($2–5k + $500–1k/mo) now budgeted into month 0.
  • No precedent in the menopause market. The category leader (Haver, $43M/yr) prices her course at $99 and rides 3M+ warm followers; every $200+ course sells to a warm audience; the one paid-acquisition DTC menopause brand went through Chapter 11. Nobody sells $250 one-off cold at scale.
  • Every verified 4:1+ case rests on assets this project lacks at launch — warm audience, email list, retargeting pool, low-ticket entry or high-ticket backend. 4:1+ is real only as a 6–12-month cohort outcome after building those assets.

Consequence for the £17k/month objective (refunds corrected to 8%)

Blended ROASContribution/saleSales/day for full £17kAde benefit at 12/day
2.0x — audited central£64.1621.6£8,855/mo
2.5x — with AOV stack + email£82.6416.8£11,780/mo
3.0x — success case£94.9514.6£13,730/mo
4.0x — top decile£110.3512.6£16,166/mo

Bottom line: not fucked — but it is a different play than Manus modelled. A flat $250 page on cold traffic cannot carry £17k/month alone. What changes: (1) offer re-architecture becomes the critical path — order bump + upsell (~$287–300 effective AOV), email spine from day one, VSL/webinar test; (2) price architecture gets tested against the market's proven $99 anchor — Stage 1 of the ladder is now a live price test, and a stacked $99–149 front-end may out-earn a flat $250; (3) Gemma-fronted US organic content is the mechanism behind every verified 3x+ case — it moves from garnish to core; (4) the engine's Money Plan role resets to a £9–13k/month line by month 15–18 at audited central, with upside from the levers, not from hoping the old 4:1 shows up. The stage-gate ladder survives unchanged — discovering the true number still costs ~£2–3k, and Stage 1's live data replaces every benchmark on this page.

01Executive answer — engine mechanics by ROAS level

Counting from the first paid month (after a 6–10 week build/entity phase). The bottleneck is never cash and never audience size — it is platform scaling speed and whether ROAS holds. Post-audit (§00): read the 2.0–2.5x rows as the central planning rows; the 4:1 row is the top-decile case, kept for reference.

12 sales/day at 4:1
Month 12
Range 10–17 by scaling aggression
£17k/mo extraction
Month 15
12/day held 3 months + cash cover
Minimum start cash
£78
Mathematical, at 4:1 — hold £5k float anyway
If ROAS is 2:1
Stop
Never reaches 12/day under decay. Fix funnel or kill.
Proven blended ROAS12 sales/dayExtraction startsSustainable Ade benefitSales/day for full £17k
4:1 (Manus hypothesis — audit: top decile)Month 12Month 15£16,700/mo11.6–12.3
3:1 (success case)Month 13Month 16£13,300/mo13.3
2.5:1 (audited central, stacked offer)Month 15Month 18 (partial)£10,500/mo15.1
2:1Never (under decay)£6,200/mo max18.9

Calendar terms: ~2 months of product build and entity resolution, then 12–16 months of compounding ⇒ 12/day around late 2027 if ROAS proves ≥3:1, full £17,000/month extraction from roughly Q1 2028. Faster only if 4:1 proves early and Meta permits aggressive budget growth.

02Reality gates the Manus pack could not know

Local knowledge that reshapes month 0. These are sequenced before the first paid dollar.

Hard gate

Entity: DoctoriumGP is dissolved

Dissolved 5 May 2026; RT01 restoration in progress. No sale can be taken under that name today. Default route: launch under a separate consumer product brand owned by an active entity, clinically fronted by Dr Gemma Lewis MRCS MRCGP — the handover already flagged separate-brand as an open decision; the dissolution makes it the default until restoration completes.

Hard gate

The $250 suite does not exist yet

The 24-video YouTube pack is short-form organic content (mostly aesthetics). The product needs a structured curriculum — est. 4–6 hours of finished video, 6–10 modules, recorded by Gemma. Build: 4–8 weeks, in parallel with entity work.

Gate

Gemma sign-off

Every clinical claim, every testimonial, the curriculum itself, and whether she appears as principal expert (a UK GP/surgeon is a major US trust asset — this materially moves conversion). Agree a sign-off SLA up front.

Verify first

Meta health data restrictions (Jan 2025)

Ad accounts categorised "health & wellness" can lose lower-funnel pixel optimisation (Purchase events) — a direct threat to the 2% conversion assumption. Check categorisation before spending; position as education/course; use Conversions API; know the appeal path.

03Offer & validation ladder

Free users do not behave like $250 buyers. Engagement ≠ testimonial ≠ paid conversion ≠ retained purchase. Each stage produces the evidence class the next stage needs — and three cheap kill-switches precede the expensive 300-purchase full proof (~US$18,750 at target CPA).

StageOfferPurposeGate to advance
0 · Founding cohortFree, disclosed · 50–100 US women · no paid adsProduct quality, completion, honest reviews≥60% module-1 completion · ≥25 usable reviews
1 · Paid beta$99 · capped at 150Prove people pay · first retained-sale data≥100 sales · refunds ≤5%
2 · Early full price$199–249 · $25–50/day adsProve $250-class economics under paid trafficRetained CPA ≤ $75 across ≥3 creatives · 25+ sales
3 · Full launch$250 (+3×$97 plan later)The compounding engine below300 retained purchases = full proof

Payment-plan sales count at 90% value in ROAS maths (instalment default risk). Test the plan only after Stage 3 stabilises.

04The compounding engine — central 4:1 path

$25/day founding months, $50/day from month 3, budget grows ≤40%/month and never exceeds 60% of opening cash. ROAS decays with scale (4.0 → ~3.3 at ~$1,000/day). Overhead £1k/mo → £3k/mo once spend ≥$250/day. 25% Corporation Tax reserved monthly.

Daily ad budget ramp — months 1–15 (US$/day)
25
25
50
70
98
137
192
269
376
527
738
1033
948
948
948
M1M2M3M4M5M6M7M8M9M10M11M12M13M14M15

Gold = hold at steady state (~$948/day delivers 12.2 retained sales/day at effective 3.3 ROAS).

MonthDaily budgetEff. ROASSales/dayOp profit £Cash £Milestone
1–2$253.20.8~505,077Founding cohort at $99 · reviews
3$504.00.81,9096,508$250 launch
4$704.01.13,0728,812Gate 1 · 1/day
6$1374.02.16,98117,574
8$2693.83.911,41433,480Gate 2 · 3/day
10$5273.57.222,64162,635Gate 3 · 6/day
12$1,0333.313.242,476117,863Gate 4 · 12/day
13–14$9483.312.239,290176,798Hold · stability proof
15$9483.312.239,290189,266£17,000/mo extraction begins

Gate months across scenarios (first paid month = 1)

ROAS · decay1/day3/day6/day12/dayExtractionPlateau profit £/yr
4.0 · central48101215462,354
3.0 · central59111316368,111
2.5 · central69121518290,759
2.0 · central81521nevernever172,069

Scaling-aggression sensitivity at 4:1: cautious +25%/mo → 12/day month 17 · central +40% → month 12 · aggressive +60% → month 10. Full monthly CSVs in menopause-us-engine/model/.

05Minimum starting cash

Binary-searched minimum float keeping cash ≥ £0 throughout (central decay + scaling). The engine self-funds at ≥2.5:1 because every $1 of ads returns $2.24+ of net receipts in-month — the float covers timing risk, not losses.

At 4:1
£78
Effectively self-funding
At 3:1
£781
At 2.5:1
£1,171
Recommended float
£5,000
Refund clawback timing · Stripe rolling reserve risk · creative production · MoR onboarding

06Reinvestment waterfall & hard rules

Order of application of every month's net receipts. No discretion in the moment — the rules are set now, followed later.

Refund / chargeback reserve
3% of gross, held 90 days rolling.
Direct costs
Processing/FX 5.26% · delivery/hosting 2%.
Fixed overhead
£1,000/mo while spend < $250/day → £3,000/mo at scale.
Corporation Tax reserve — 25% of operating profit
Moved to a separate account monthly. Never touched for ads.
Ad reinvestment — 100% of the remainder
Capped at prior budget ×1.40 AND ≤60% of opening cash.
Extraction — £0 until the gate
12/day held 3 consecutive months AND cash ≥ 3 months of ad spend → then £17,000/month (£12k grinder + £5k living).
Stop-loss
  • Blended ROAS < 1.6 → halve next month's budget.
  • ROAS < 1.25 two consecutive months → back to $25/day; diagnose, don't push through.
  • Refunds > 8% in a month → freeze scaling until the cause is found.
  • Reference: contribution is zero at ~1.11 ROAS before overhead.
Scale-up
  • Advance budget only when the stage gate is met and 30-day retained CPA ≤ $62.50 across ≥3 distinct creatives.
  • One lucky ad is not evidence. Three winners are.
  • Once at 12/day: hold spend, bank stability, then extract.

07Review generation — genuine, disclosed, compliant

Governing rules to re-verify before launch: FTC Rule on Consumer Reviews & Testimonials (16 CFR Part 465, in force Oct 2024 — civil penalties for fake/purchased reviews, sentiment-conditioned incentives, review suppression) and the FTC Endorsement Guides (material connections disclosed; typical results; health claims need competent, reliable scientific evidence).

  1. Founding cohort gets free access never conditioned on any review — and never on a positive one. Ask: "share your honest experience, positive or negative".
  2. Every founding testimonial displayed carries: "Received free early access."
  3. Collect via an independent platform (Senja/Trustpilot) + in-product survey; keep consent records.
  4. No outcome claims ("cured my hot flushes" cannot run). Dr Gemma Lewis reviews every testimonial pre-publication.
  5. Negative feedback is product R&D. It is never suppressed — Part 465 explicitly bans suppression.
  6. Unincentivised paid-stage reviews become the primary social proof; founding reviews rotate out.

08Meta architecture & creative cadence

Month 0 setup

  • Business Manager + domain-verified brand site + pixel + Conversions API.
  • Health-categorisation check before any spend (§02).
  • US ad account + backup account + backup BM — health verticals see elevated restriction rates.

Structure at Stages 2–3

  • 1 × Advantage+ Sales campaign (broad; creative is the targeting) — the scaler.
  • 1 × ABO testing campaign, 3–5 ad sets — the lab. Winners graduate.
  • Separate mid-funnel retargeting only after $250/day.

Creative cadence

  • 3–5 new creatives/week; kill at 1.5× target CPA with no sale.
  • Angles: Gemma authority talking-head (UK doctor credibility travels) · educational myth-busting · disclosed founding-member stories · text-overlay listicles.
  • KPI that gates scaling: retained CPA (post-refund), 7-day click.

Compliance lines

  • Never imply knowledge of the viewer's condition — "Are you suffering from…?" is banned copy.
  • The ad sells the education, not a diagnosis or a cure.
  • Re-verify Meta Advertising Standards at launch.

09Landing page, checkout & email architecture

Sales page & checkout

  • Standalone product-brand site; long-form sales page A/B VSL; <2s LCP; mobile-first.
  • Trust block: Dr Gemma Lewis MRCS MRCGP, GMC-registered UK doctor (subject to sign-off) + education-not-medical-advice disclaimers.
  • $250 anchor · 30-day money-back at launch (test 14-day later).
  • Merchant of record at launch: Paddle (or Lemon Squeezy) — becomes seller of record, handles US state sales tax end-to-end. ~5% ≈ the modelled processing allowance. Revisit direct Stripe past ~US$1M/yr.
  • USD pricing, USD settlement to cut FX drag.

Email & retargeting (Klaviyo — already in stack)

  • Lead magnet: US-adapted GP-appointment toolkit (UK draft already exists, awaiting Gemma sign-off).
  • Welcome/nurture: 7 emails / 14 days. Abandoned checkout: 3 / 72h.
  • Post-purchase onboarding drives module completion — the #1 refund suppressor. Honest-review ask at day 14.
  • At 600 clicks/day and ~10% opt-in the list grows ~1,800/month — email should carry 15–25% of revenue at zero marginal CPA. That is what defends blended ROAS as media costs rise.

10Tax & entity

  • US: no federal VAT; state-by-state digital sales tax — the MoR route removes registration/remittance risk entirely at launch. Direct-Stripe economic nexus (~$100k or 200 transactions/state/yr) arrives fast at 12/day ($1.1M/yr) — MoR stays sensible longer than intuition suggests.
  • UK VAT: US B2C sales are outside UK VAT scope. UK buyers (minority) attract 20% — MoR handles it.
  • Corporation Tax: 25% main rate at modelled profits — reserved monthly in the waterfall.
  • Extraction split: per the handover's corrected bridge — £32,540 employer pension + dividends, until AWR confirms actual taper headroom (threshold/adjusted income, carry-forward).
  • Entity: model is entity-agnostic; confirm the vehicle before the first sale (§02).

11Key risks & mitigations

RiskLevelMitigation
ROAS proves < 3:1 at scaleReal — 4:1 unprovenStage gates + stop-losses cap discovery cost at ~£2–3k before Stage 3
Meta health categorisation blocks Purchase optimisationMaterialPre-spend check · education positioning · CAPI · appeal path
Ad account restriction (health vertical)ElevatedClean claims · backup BM/account · diversify post-proof (TikTok/YouTube)
Refund spike from ad-promise mismatchModerateOnboarding/completion push · honest ads · 8% freeze rule
RT01 timing slipsKnown unknownSeparate-brand route decouples launch from restoration
Gemma capacityRealBatch recording · sign-off SLA · curriculum locked pre-recording
FTC / state-AG exposure on claimsLow if §07 followedPer-creative compliance checklist · Gemma review · records
Creative fatigue at scaleCertain, manageable3–5/week cadence · UGC pipeline from customers

12Five decisions for Ade — everything else runs on labelled assumptions

1 · Vehicle

Separate consumer brand under an active entity now, or wait for DoctoriumGP restoration? Plan default: separate brand.

2 · Gemma

On camera as principal expert + agreed sign-off SLA.

3 · Float

£5,000 recommended (vs £78 mathematical minimum).

4 · Refunds

30-day guarantee at launch (recommended) vs 14-day.

5 · Merchant of record

Paddle (recommended) vs Lemon Squeezy vs direct Stripe.

Wealth link

Extraction month ~15 at 4:1 = £12,000 grinder + £5,000 living, with ads fed and 25% CT reserved throughout. At 3:1 the engine funds ~£13,300/mo until sales pass 13.3/day.