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Scaling a Policy-Restricted Men’s Health Clinic: 3,435 Conversions at $37 CAC With 80% Spam Reduction

October 18, 2025 - 3 minutes

SpartanMD needed scalable lead volume for a policy-sensitive core service (penis enlargement). Google blocks explicit queries in Keyword Planner and disallows direct ad copy for explicit terms. The account also suffered heavy spam attacks and bot activity that threatened data quality and ad performance.
 

Goals:

  1. Acquire high-intent, qualified leads at a sustainable CAC.
     

  2. Maintain full policy compliance (no suspensions).
     

  3. Eliminate spam / fraudulent signal so reporting and bidding could be trusted.

Case Study Metrics​

Date Range: Sep 1, 2024 – Sep 30, 2025
 

Geographic Location Of The Company:

– Pennsylvania (clinic region)

– California (clinic region)

– Select out-of-state markets for travel-ready patients

$126,409.07

Total Ad Spend

$37.01

CPL

3,435.67

Conversions 

5.44%

Conversion rate

80%

Spam reduction (est.)

Strategy overview

  1. Keyword intelligence without Keyword Planner: pull seed terms from Ahrefs Content Explorer and SpyFu; then validate via low-budget broad match probe campaigns.
     

  2. Linguistic finesse for ads: avoid explicit phrasing and use dynamic keyword insertion {KeyWord:} and well-tested alternative terminology to preserve relevance while staying policy-safe.
     

  3. Anti-fraud + validation stack: ClickCease + Google IP exclusions + server-side GTM + reCAPTCHA v3 + UA/IP filters + server-side form validation.
     

  4. Conversion hygiene: reconfigure tracking to filter spam form fills and duplicates; send validated events to Google Ads only.
     

  5. Transparent reporting: Looker Studio dashboard combining Ads + ClickCease for real-time visibility into real vs. fake traffic.
     

Geo strategy: focus Pennsylvania and California footprints, with ad groups and campaigns tuned for patients willing to travel to neighboring states.

Execution

Keyword & search-term collection
 

  • Pulled base seed terms from Ahrefs Content Explorer and SpyFu paid-keyword exports for competitors.
     

  • Ran 14-day broad-match probe campaigns ($10/day caps per probe) to collect real search queries and validate intent.
     

  • Built a custom keyword universe combining: validated search terms, long-tail indirect queries, and medical-adjacent phrases. (Added 7,537 negative keywords over optimization to remove low-intent traffic.)
     

Campaign architecture

​

  • Search campaigns segmented by geography (PA / CA / travel-state pools), funnel intent (awareness → consideration → contact), and match type:
     

    • Broad match (probe) — low budget, high coverage, strict negative lists.
       

    • Phrase & Exact — scale high-intent queries.
       

  • Ad copy technique: RSAs + {KeyWord:} fallback + tested safe synonym sets (e.g., “penile enhancement” → “men’s enhancement consultations”, “urologic reconstruction”, “size enhancement consultation”).
     

  • Landing pages: tightly aligned to campaigns; forms instrumented with server-side validation and reCAPTCHA v3.
     

Bidding & budget

​

  • Start: Maximize conversions on probe campaigns to collect search terms.
     

  • Scale: migrated high-performing ad groups to Target CPA (target around $35–$45) once conversion quality validated by server-side filters.
     

  • Daily caps per probe campaign remained low ($10/day) to limit spend while mining queries.
     

Anti-fraud & tracking

​

  • Deployed ClickCease + Google native IP/data-center exclusions — auto-blocked repeat IPs and known bot hosts (reduced fake traffic by ~30–40% initially).
     

  • Implemented server-side Google Tag Manager to reduce client-side injection and spoofed events.
     

  • All form and call conversions passed through reCAPTCHA v3, UA & IP checks, and server-side time-on-site thresholds.
     

Conversion pipeline reconfigured to ignore spam form fills and duplicate submissions; only validated leads counted for bidding.

Results

  • Total spend: $126,409.07
     

  • Conversions: 3,435.67
     

  • Conversion rate: 5.44%
     

  • CAC: $37.01
     

  • Policy violations: 0 — account maintained full compliance throughout.
     

  • Spam reduction: 80% (end state after progressive hardening).
     

  • Fraudulent click block rate: 35% (ClickCease + exclusions).

    Impact
     

  • Scaled a highly restricted healthcare vertical profitably while keeping the account clean of policy strikes.
     

  • Restored attribution fidelity so automated bidding could operate on real conversion signals rather than noise — this is the single biggest multiplier for sustainable scale.
     

  • Demonstrated that with privacy-safe tracking, strong anti-fraud controls, and careful language in creative, Google Ads can be a growth engine even for policy-sensitive procedures.

Key optimizations & lessons learned

  1. Probe before you scale. Low-budget broad match campaigns produced real user queries that Keyword Planner blocked — essential for building the keyword universe.
     

  2. Treat conversion quality as the priority metric. A lower raw conversion count with a high real-lead ratio beats inflated conversions that teach bidding the wrong signals.
     

  3. Server-side tagging + validation is non-negotiable for sensitive niches — it removes client-side spoofing vectors and improves signal integrity.
     

  4. Linguistic engineering in ads. Keyword insertion + careful synonyms preserved relevance while avoiding policy triggers. Always A/B test multiple safe-word sets.
     

  5. Negative keywords are a force multiplier. 7,537 negatives removed wasted spend and improved overall CTR/CR quickly.

Author

Anna Rose Thomas

Anna is the visionary content writer extraordinaire at Solutions 8, a true artist of words. With a self-taught mastery of canvas, she weaves vibrant tales that pulse with life, injecting her imagination into every stroke. Driven by an insatiable wanderlust, Anna fearlessly embarks on soul-stirring solo escapades, her camera an extension of her soul. Through this lens, she captures the raw, unfiltered beauty of the world, distilling it into captivating imagery. Her passion for art, travel, and the enchantment of storytelling is unrivaled, making her the ultimate purveyor of spellbinding narratives.

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