Three archetypes, segmented by where each sits in the symptomatic journey.
Treated-and-recurrent (the Hemorrhoidectomy Avoider, the key launch persona). Never-treated (the Silent Professional). Postpartum-and-constrained (the Postpartum Mother). Lifestyle labels are channel shorthand, not segments. Archetypes are not mutually exclusive; a patient can sit in two at once. Abbreviations: HD (hemorrhoidal disease), RBL (rubber band ligation), OB (obstetrician).
Already treated, now at a fork: repeat banding or escalate to hemorrhoidectomy. RBL is what most have already tried, and most will need again. Roughly 320,000 hemorrhoidectomies happen in the US each year; the majority of that population is procedurally eligible for Thermora. She is the launch persona because she is symptomatic, already in the system, already decided to act, and actively trying to avoid the next step her physician has named. For her, the message leans hardest into one and done: end the loop in a single visit, not another course of bands.
- Age 40–65, even gender split, slight female lean in care-seeking.
- Suburban/exurban, mid-to-upper middle income.
- Commercial or Medicare-insured.
- Has followed instructions: done the bands, eaten the fiber. Values being a "good patient."
- Dreads hemorrhoidectomy. Knows someone who had it.
- Wants to finish the problem, not manage another loop.
- Second-opinion oriented. Researches procedures before agreeing.
- Sees banding as "temporary" after 2+ recurrences.
- Open to new technology framed as "between banding and full surgery."
- Naming a treatment doubles physician prescribing rates.
- Brings a phone screenshot to the appointment. Asks by name.
"I've done this 3 times. Each time it comes back. Now they want surgery, and I do not want weeks of recovery. There has to be something better."
Frustrated, dreading the surgery date, willing to do almost anything that is not a hemorrhoidectomy.
Deep-searches "hemorrhoidectomy alternative," brings printed material to the pre-op consult, asks by name. The patient most likely to name the procedure at launch.
After 2 recurrences, the physician's next step is hemorrhoidectomy, the one she's trying to avoid. The surgeon is the gatekeeper: if they don't perform Thermora, she can't have it. The brand wins in two lanes: search (so she walks in with Thermora on her phone) and surgeon-to-surgeon referral (so the gatekeeper has somewhere to send her).
Never treated procedurally. Lives with symptoms for months or years, self-manages with OTC, rarely sees a clinician. Embarrassment is the dominant barrier; only 30.8% of symptomatic adults seek medical advice. This is the largest population by volume, the longest delay to care, and the highest-leverage source of net-new procedural patients once they finally decide to act.
- Age 35–55, commercial PPO-insured professional.
- 55–60% female skew in care-seeking. Symptom prevalence roughly even by sex.
- Suburban, college-educated, $90K+ household income.
- Values privacy, control, professional image. "Low-maintenance" about health.
- Fears workplace exposure and being told they need surgery.
- Wants normalcy back without disrupting the work calendar.
- Believes "it'll go away" until the 3rd or 4th recurrence.
- Equates "hemorrhoid surgery" with 3 weeks of recovery. Would rather suffer.
- Shame disproportionate to severity. Calls it "embarrassing to discuss."
- Self-treats with OTC for months to years before any clinic visit.
- Women search at a higher rate than men (86% vs. 73%).
"This can't be that bad. Other people have this too. But I can't keep dealing with it."
Embarrassed, secretly anxious, tired of managing flares, suspicious of anything that requires "downtime."
Searches "hemorrhoid treatment no surgery" at 11pm. Books a telehealth visit. Asks apologetically if there's an in-office option. Thermora wins by showing up in that midnight search.
Her midnight search lands on CRH's "non-surgical, fast, painless" content first, vocabulary Thermora cannot match (prohibited by regulation and positioning). The brand wins on the page she lands on next, by being credibly different: real procedural care, performed by a surgeon, with a 5-year asymptomatic signal. The first asset needed is the one that catches her after CRH.
Symptoms often first emerged in pregnancy, but per Gareth's 5/26 guidance we treat postpartum, not during pregnancy: going near third-trimester patients would require a separate IRB-controlled trial. Pregnancy is an awareness and education play (normalize that this happens, build the relationship), and treatment begins once she has delivered. Many cases resolve on their own; the subset that persists past the postpartum window rolls into the general population. She is a distinct, named archetype because she carries a constraint stack (breastfeeding, time poverty, a new baby) and because her path to us runs through her OB.
- Age 28–40. Often her first experience with the disease.
- Within ~12 months post-partum (the treatment window).
- Commercial or Medicaid, broad income range.
- Medical conversation is already open. Healthcare-engaged from the pregnancy.
- Lower shame load than the Silent Professional; much higher time load.
- Body is already a subject of clinical discussion. Privacy concerns are different.
- Cannot use most topical medications during pregnancy or breastfeeding. "Just put cream on it" does not apply.
- Wants something definitive that won't interfere with feeding or delivery recovery.
- Trusts OB guidance above all.
- Asks the OB or midwife first. Defers to their guidance.
- Reads on her phone, late, with a baby in arm.
"One more thing my body is doing that nobody told me about. I want it gone and I want to get back to the baby."
Exhausted, surprised at how much this hurts, careful about anything that might affect feeding.
Asks the OB at the post-partum check, accepts a referral if endorsed. Thermora wins by being the option her OB feels comfortable recommending.
The constraint is timing: we educate in pregnancy and treat postpartum, never making a treatment claim for a currently-pregnant patient. Clinical timing (post-delivery vs. post-breastfeeding) is answered with her OB, not by patient-facing copy. The brand's job is two-sided: be visible in OB-adjacent and postpartum search, and develop the OB referral stream, which is already mature (many OBs prefer sending patients somewhere other than the GI banding shop). Give her OB a surgeon-credible answer to hand back.