Menopause Care Deserts by State: What the 2024 Data Shows for All 50 States

By The HRT Index Editorial Team Editorial research — not medically reviewed Published: August 3, 2026 · Last source verification: August 3, 2026 Underlying data snapshot: May 1, 2024 · Dataset version: 1.0

HRSA's published shortage framework does not designate menopause care deserts. The source study behind this report also says no established benchmark exists for the optimal number of menopause subspecialty clinicians per population. So this page uses a narrow definition anyone can reproduce: a state is classified as a menopause-certified practitioner access desert when its reported Menopause Society Certified Practitioner density falls in the lowest quartile of the 50 state rates.

Thirteen states fall in the bottom quartile of certified menopause-practitioner density in the May 1, 2024 snapshot. Mississippi's reported rate was 0.03 MSCPs per 10,000 women ages 45–64, compared with 0.79 in Vermont—a 26.3-fold state spread.

That works out to approximately one included MSCP per 333,333 women ages 45–64 in Mississippi and one per 12,658 in Vermont.

Editorial independence: The HRT Index earns referral commissions from menopause telehealth providers elsewhere on this site. The /research section carries no advertising, affiliate links, provider recommendations, or lead capture. This report was produced independently of the site's provider-comparison content. It compares an academic workforce source with a commercial publisher's later access figures, so the disclosure belongs up front.

Menopause care deserts by state: which 13 states fall in the bottom quartile?

Thirteen states fall in the lowest quartile of reported MSCP density: Mississippi, Alabama, North Dakota, Nevada, Kentucky, Missouri, Oklahoma, West Virginia, Indiana, Arkansas, Florida, Tennessee, and Texas. The cutoff is 0.2225 MSCPs per 10,000 women ages 45–64 under the inclusive linear-interpolation method described below. This is a relative comparison, not a clinical adequacy standard.

Florida, Tennessee, and Texas sit at 0.22, just below the calculated cutoff. Iowa and South Carolina are the next states at 0.23 and therefore fall outside this report's bottom-quartile group.

The 13 bottom-quartile states

Mississippi is the outlier in a category of its own. Its reported rate is less than a third of Alabama's, 8.6% of the 50-state median, and about one twenty-sixth of Vermont's. The source prints state rates to two decimal places, so every inverse figure on this page is approximate; the apparent precision of 333,333 comes from dividing 10,000 by the printed rate of 0.03, not from an exact practitioner headcount published for Mississippi.

What does this data show, and what does it not show?

This dataset compares states by the density of included Menopause Society Certified Practitioners assigned to a verified primary practice address in the May 1, 2024 source snapshot. It does not measure the full menopause-capable workforce, appointment availability, insurance participation, affordability, care quality, or treatment outcomes. A low rate means few included MSCPs were represented relative to the target-age population. It does not mean a state has no competent menopause care.

Three source details matter.

The poster does not support one clean national practitioner total. Its results narrative reports 1,371 included providers and says 69% were physicians. Table 1 instead states a total of 1,396, lists 947 MD/DOs and 399 NP/CNM/PAs, and those two components sum to 1,346. Because the source contains three incompatible totals, this page does not publish a definitive national MSCP count or calculate a definitive nonphysician share from them.

One composition result is internally consistent. Table 2 lists 759 of 947 physician MSCPs as obstetrician-gynecologists, or 80.1%. Internal medicine accounted for 75 of 947, family medicine 84, endocrinology 12, and other specialties 17; those counts sum to 947.

The source applied a narrow geographic cohort. It verified primary practice addresses through the Centers for Medicare & Medicaid Services and manual searches, then excluded practitioners offering exclusively remote services or unable to prescribe medication. The poster labels those two exclusions together as 3%; it does not report separate percentages for remote-only and nonprescribing practitioners. The resulting state allocation is based on one primary practice address, not every state in which a clinician may be licensed or able to provide remote care.

The current Menopause Society directory adds another limitation: the Society says the directory is not a complete compilation, includes members and MSCPs who asked to appear, and does not list people who are not accepting new patients. The source study selected people designated MSCP from that directory; it did not establish a census of every person holding the credential.

Sources: AcademyHealth poster; The Menopause Society practitioner directory.

What does “menopause care desert” mean in this report?

The source study says there is no established benchmark for the optimal number of menopause subspecialty clinicians per population. For this report only, a menopause-certified practitioner access desert is a state in the lowest quartile of reported MSCP density among the 50 states. That is an editorial definition with a published calculation—not a medical standard, not a government designation, and not a finding that a state lacks menopause care.

Why use the bottom quartile?

A quartile cutoff is arbitrary in the sense that the medical literature did not hand us this threshold. It is not arbitrary in the sense that matters for reproducibility: the rule is stated explicitly, it uses one metric across every state, and anyone using the same 50 numbers and the same quartile convention can reproduce it.

The calculation is:

Q1 = PERCENTILE.INC(the 50 state rates, 0.25)
Q1 = 0.2225 MSCPs per 10,000 women ages 45–64
Operational access desert = reported state rate ≤ 0.2225

The interpolated cutoff falls between the 13th state rate, 0.22, and the 14th, 0.23. It therefore selects the 13 states reported at 0.22 or below.

We considered and rejected three alternatives:

• A zero-practitioner definition. Every state has a nonzero printed rate, so this would produce no state-level deserts and erase a 26.3-fold spread.
• A borrowed federal primary-care threshold. The federal geographic HPSA threshold generally uses people per full-time-equivalent primary care physician and counts several physician specialties. The numerator, denominator, service, and purpose are different.
• A composite score. Combining practitioner density with insurance, affordability, awareness, and other measures can answer a broader policy question, but it cannot answer the narrow question here: how many target-age women are represented per included MSCP in each state?

Why use the longer phrase?

“Menopause care desert” can sound like an absence of all care. “Menopause-certified practitioner access desert” says what this dataset actually measures: the relative scarcity of one credentialed cohort in a directory-derived snapshot. The longer phrase is clumsier and more accurate.

How does every state compare for certified menopause-practitioner access?

Reported state rates range from 0.03 MSCPs per 10,000 women ages 45–64 in Mississippi to 0.79 in Vermont, a 26.3-fold spread. The 50-state median is 0.35, equivalent to approximately one included MSCP per 28,571 women. The District of Columbia reports 2.28 and is shown separately because it is not a state.

All 50 states, plus DC and Puerto Rico

What stands out in the full table

The bottom quartile is not limited to one kind of state. Texas and Florida appear alongside North Dakota and Mississippi. The highest quartile likewise contains states with very different populations and geographies, including Massachusetts, Montana, South Dakota, and Vermont. That is a descriptive pattern, not a test of what causes the distribution.

A high state position is not proof of adequate access. Vermont is highest among states under this one measure. The source study explicitly says there is no established benchmark for the optimal number of menopause subspecialty clinicians per population, so “highest” means highest in this comparison and nothing more.

DC is a genuine outlier and is kept out of the state thresholds. Its printed rate of 2.28 is 2.9 times Vermont's 0.79. Including it in a 50-state quartile calculation would also mix a federal district into a state-only comparison. Puerto Rico is shown for completeness but handled as a territory rather than a state.

How much of the country is within a 60-minute drive of an included MSCP?

The poster's detailed results report that 70% of U.S. census tracts were within a 60-minute drive of an included MSCP and that those tracts contained 61% of the target female population. Put the other way, 39% of that population lived in tracts outside the study's 60-minute geographic-access area.

The poster also reports:

The headline callout on the poster says something different: it says 70% of females ages 45–64 live within a 60-minute drive. The detailed results say 70% of census tracts, covering 61% of the target population. This report uses the detailed result because it identifies both units.

The poverty and insurance results are area-level associations. They do not establish that low MSCP access caused higher poverty, caused public-insurance enrollment, or caused a clinical outcome.

Does HRSA designate menopause care deserts?

The federal shortage-designation framework reviewed for this report does not contain a menopause-specific designation. HRSA designates Health Professional Shortage Areas for primary care, dental health, and mental health. Its maternity-care overlay measures maternity workforce need inside primary care HPSAs; it does not measure menopause care.

The distinction is easier to see in the actual rules.

A geographic primary care HPSA generally requires a population-to-full-time-equivalent primary care physician ratio of at least 3,500:1, or a ratio above 3,000:1 with unusually high need or insufficient capacity. The physicians counted include MDs and DOs practicing principally in general or family practice, general internal medicine, pediatrics, and obstetrics and gynecology.

Maternity Care Health Professional Target Areas are narrower overlays inside primary care HPSAs. HRSA's criteria use females ages 15–44 and full-time-equivalent obstetrician-gynecologists and certified nurse-midwives. The criteria were finalized in 2022. A revised scoring approach was published May 7, 2026 and is scheduled for implementation starting August 15, 2026; it removes the Social Vulnerability Index criterion and reallocates points to population-to-provider ratio and travel time or distance.

The age band matters. The National Institute on Aging says most women begin the menopausal transition between ages 45 and 55 and that the average U.S. age of menopause is 52. The maternity-care denominator ends at age 44, while the access dataset on this page uses women ages 45–64.

The federal material explains what current shortage designations do and do not measure. It does not establish why Mississippi's MSCP rate is lower than Vermont's, and it does not prove that federal designation rules caused the 26.3-fold state spread.

How do these figures compare with a July 2026 commercial analysis?

A July 2026 Hone Health article published a second set of state ratios, but it is not a like-for-like update to the 2024 poster. It uses women ages 40–64 rather than 45–64, counts menopause-certified physicians rather than the poster's broader included MSCP cohort, and does not state the date on which its practitioner-directory counts were accessed.

Across the ten states named in the Hone article, the poster-derived inverse ranges from 0.39 to 4.22 times the Hone figure. The direction differs sharply in Idaho and Alaska: both have smaller women-per-practitioner inverses in the poster dataset than in the Hone article, while Mississippi, Alabama, Nevada, and several others have larger poster-derived inverses.

Why the two sets of figures differ

At least five documented differences prevent a direct update comparison:

1. Different age denominators. Hone uses women ages 40–64. The poster uses women ages 45–64.
2. Different practitioner numerators. Hone describes menopause-certified physicians. The poster includes its selected MSCP cohort across physician and listed advanced-practice categories, subject to the poster's inclusion rules.
3. Different inclusion details. The poster describes primary-address verification and a combined 3% exclusion for remote-only or nonprescribing practitioners. The Hone article does not state an equivalent address-verification or exclusion protocol.
4. Different and partly unstated timing. The poster's directory and ACS sources were accessed May 1, 2024. Hone published in July 2026 but does not state the directory access date for its practitioner counts.
5. A changing, incomplete directory. The Menopause Society says its directory is not complete, is opt-in, and omits people who are not accepting new patients. Counts can change as listings and patient-acceptance status change.

The clean conclusion is not that one table corrects the other. It is that a menopause-practitioner ratio is incomplete without the age band, practitioner definition, inclusion rules, and directory access date beside it.

How we produced this dataset

We did not count practitioners ourselves. We transcribed the jurisdiction rates printed in a 2025 AcademyHealth conference poster, calculated the inverse of each rate, computed inclusive quartiles across the 50 states, and assigned access positions that preserve ties. Every formula is below.

The source

Where Are the Menopause Specialists? A Nationwide Analysis of Access to Certified Practitioners. Arina Chesnokova, Allison Schachter, Marilyn Schapira, Makeba Williams, and Alice Abernathy. Poster presented at the AcademyHealth Annual Research Meeting, 2025.

The poster says the study used the Menopause Society practitioner directory and the 2018–2022 American Community Survey five-year estimates at the census-tract level, both accessed May 1, 2024. It selected practitioners designated MSCP, verified primary practice addresses through CMS and manual searches, excluded practitioners offering exclusively remote services or unable to prescribe medication, geocoded the remaining prescribing providers, and applied a 60-minute driving radius. Analyses were conducted in Stata 17.0 and ArcGIS Pro 3.2.

This is a conference poster, not a full peer-reviewed journal article with a methods supplement and published correction history. We did not locate a full journal replacement or corrected supplement in the source review completed August 3, 2026.

The calculations

Approximate women per included MSCP

10,000 ÷ reported jurisdiction rate

Worked example:

Mississippi: 10,000 ÷ 0.03 = approximately 333,333

The source displays rates to two decimal places, so the inverse is approximate.

Bottom-quartile cutoff

Q1 = PERCENTILE.INC(the 50 state rates, 0.25)
Q1 = 0.2225
Operational access desert = reported state rate ≤ 0.2225

This selects the 13 state rates at 0.22 or below.

Median and upper quartile

50-state median = 0.35
Q3 = 0.46

Access position

Position = 1 + number of states with a lower reported rate

Ties share a position. That is why the table moves from position 5 to position 9 and from 11 to 14.

Jurisdiction handling

Quartiles and positions use the 50 states only. The District of Columbia and Puerto Rico appear as comparison jurisdictions and do not affect the state thresholds.

What we checked independently

On August 3, 2026, The HRT Index:

• Retrieved the poster directly from the AcademyHealth conference host.
• Checked all 52 printed jurisdiction rates against the dataset.
• Recomputed all inverse figures.
• Recomputed the first quartile, median, third quartile, and 13-state classification.
• Recomputed the tie-preserving access positions.
• Checked the current Menopause Society directory language.
• Checked the applicable HRSA, eCFR, Federal Register, NIA, AARP, HCCI, HRSA workforce-projection, and Hone source pages used in this report.

The state rates are source-produced. The inverses, quartile tiers, positions, 26.3-fold spread, federal-framework comparison, and Hone reconciliation are The HRT Index's calculations or structured synthesis.

Source discrepancies and unresolved limits in the AcademyHealth poster

The poster contains three internal inconsistencies and one underspecified comparator. They do not change the numbers printed in Table 3, but they limit what can be said about the national practitioner total, the exact denominator label, population drive-time coverage, and the oncology comparison.

There is a clue inside the total conflict: 947 divided by 1,371 is 69.1%, matching the narrative's rounded 69% physician share more closely than the other stated totals. That suggests 1,371 may have been the narrative denominator, but it does not explain the missing 25 practitioners relative to the two component rows or the 50-practitioner gap from Table 1's stated total. We treat that as an inference, not a correction.

Why menopause-care access data matters now

Treatment, diagnosis, and workforce sources describe different populations, but all three show why the supply question is worth tracking. They do not prove that low MSCP density causes low treatment or diagnosis rates.

AARP's treatment estimate is 5% of women ages 45–64—not 5% of all women in menopause

An AARP Public Policy Institute report, based on NORC analysis of pooled 2016–2021 Medical Expenditure Panel Survey data, estimated that 2.1 million women ages 45–64 were treated for menopause in an average year. The authors interpreted the pooled estimate as an annual estimate for 2021. That was 5% of the full age group and an estimated 20% to 25% of women in menopause. The report also gives treated prevalence of 6.3% for non-Hispanic White women, 2.7% for Hispanic women, and 2.5% for non-Hispanic Black women.

The pooled-data qualifier is part of the number: the estimates generalize to the average annual population over 2016–2021 rather than a single-year 2021 sample.

Source: AARP Public Policy Institute, “Women in Menopause Often Go Untreated”.

Recorded diagnosis differs by area-level vulnerability in employer-sponsored insurance data

The Health Care Cost Institute reports that, among women ages 45–64 in its employer-sponsored-insurance data, the share with any recorded menopause diagnosis rose from 13.7% in 2018 to 14.7% in 2022. In 2022, its menopause diagnosis encounter rate was 2,193 per 100,000 in the least-vulnerable areas and 1,688 in the most-vulnerable areas—a 30% difference.

Those are diagnosis and encounter measures inside an employer-insured population. They are not biological menopause prevalence and not an all-payer national estimate. HCCI's narrative describes women ages 45–64, while its methods line says the encounter-rate denominator was eligible women ages 44–65. This report retains HCCI's published narrative labels and discloses the methods-line conflict rather than silently choosing between them.

Source: Health Care Cost Institute menopause diagnosis brief.

The physician specialty most represented in the poster faces projected shortages

The poster's internally consistent physician table shows that 759 of 947 physician MSCPs, or 80.1%, were OB-GYNs. Separately, HRSA projects a national shortage of 7,660 full-time-equivalent OB-GYNs in 2038 and a 46% shortage in nonmetropolitan areas.

Those sources cannot be combined into a forecast of future MSCP supply. HRSA models OB-GYNs, not Menopause Society certification. The connection is narrower: the physician specialty most represented in the poster's certified cohort is itself projected to face substantial workforce pressure, especially outside metropolitan areas.

Sources: AcademyHealth poster; HRSA Health Workforce Projections.

What are the limitations of this data?

This is a directory-derived, state-level comparative dataset built from a May 2024 conference-poster snapshot. Every part of that description limits what the numbers can support.

Download the menopause care deserts by state data

The data files preserve the source rate, derived inverse, access position, access tier, snapshot date, source URL, and calculation note for every row.

• Download the CSV
• Download the XLSX workbook

The XLSX workbook also contains the methodology, formula-driven thresholds, limitations register, source log, and internal claim ledger used to check publication status.

Dataset: The HRT Index State Menopause-Certified Practitioner Access Dataset Version: 1.0 Underlying snapshot: May 1, 2024 Last source verification: August 3, 2026

How to cite this page

The HRT Index Editorial Team. “Menopause Care Deserts by State:
What the 2024 Data Shows for All 50 States.” The HRT Index,
August 3, 2026. Dataset version 1.0.
https://thehrtindex.com/research/menopause-care-deserts-by-state/

The state rates originate in Chesnokova et al.'s AcademyHealth Annual Research Meeting poster. The 13-state bottom-quartile classification, inverse figures, access positions, 26.3-fold spread, federal-framework comparison, source-discrepancy register, and cross-source reconciliation are produced in this report from the stated sources and formulas.

How current is this data?

Every state rate comes from a practitioner-directory and population snapshot accessed May 1, 2024. The source review and derived dataset were completed August 3, 2026. Those are different dates, and this page keeps them separate.

The state table stays labeled 2024 until a valid newer extraction becomes available through a full publication, corrected source, author supplement, or comparable new study.

Method: The HRT Index review schedule for dataset version 1.0.

Version history

Version 1.0 — August 3, 2026
Created the 50-state dataset from the May 1, 2024 source snapshot.
Added inverse rates, access positions, quartile tiers, the federal-framework
comparison, the cross-source reconciliation, methodology, limitations,
data downloads, and the source-discrepancy register.

Frequently asked questions

What is a menopause care desert?

There is no established clinical benchmark for the optimal number of menopause subspecialty clinicians per population, and the HRSA shortage framework reviewed here has no menopause-specific category. For this report, a menopause-certified practitioner access desert is a state in the lowest quartile of reported MSCP density among the 50 states in the May 1, 2024 snapshot.

Which states are menopause care deserts under this definition?

Thirteen states: Mississippi, Alabama, North Dakota, Nevada, Kentucky, Missouri, Oklahoma, West Virginia, Indiana, Arkansas, Florida, Tennessee, and Texas. The inclusive first-quartile cutoff is 0.2225 MSCPs per 10,000 women ages 45–64.

Which state has the lowest certified menopause-practitioner rate?

Mississippi, at 0.03 MSCPs per 10,000 women ages 45–64. That is approximately one included MSCP per 333,333 women and 8.6% of the 50-state median rate.

Which state has the highest rate?

Vermont, at 0.79 MSCPs per 10,000 women ages 45–64, or approximately one per 12,658. The District of Columbia reports a higher rate of 2.28 but is not a state and is listed separately.

Does a low rate mean my state has no menopause care?

No. MSCPs are a specialized credentialed cohort, not the full menopause-capable workforce. A low rate means few included MSCPs were represented relative to the target-age population under this source's method.

Are all Menopause Society Certified Practitioners physicians?

No. The Society's current credential is open to licensed healthcare professionals, including physicians, nurses, nurse midwives, nurse practitioners, pharmacists, and physician assistants. The poster's national provider totals conflict, so this page does not publish a definitive physician-versus-nonphysician split. Its physician-specialty table is internally consistent: 759 of 947 physician MSCPs were OB-GYNs, or 80.1%.

Does this dataset include telehealth?

It is not a telehealth-access count. The source excluded practitioners offering exclusively remote services as part of a combined 3% exclusion with practitioners unable to prescribe, then assigned included practitioners by verified primary practice address. The current Society directory has a separate telehealth-by-state search, but those results are not the state numerator used here.

Why is there no official HRSA list of menopause care deserts?

HRSA's published shortage framework covers primary care, dental health, mental health, and maternity-care target areas. Primary care is broad, and the maternity-care score uses females ages 15–44 plus OB-GYN and certified nurse-midwife capacity. No menopause-specific category was located in the HPSA, MCTA, or MUA/P framework reviewed through August 3, 2026.

Why are DC and Puerto Rico shown separately?

They are not states, so they do not enter the 50-state quartile calculation. Both remain in the source table and are included for comparison: DC at 2.28 per 10,000 and Puerto Rico at 0.13.

Why do July 2026 news figures look different?

The Hone Health article uses women ages 40–64, counts certified physicians, and does not state its practitioner-directory access date. The poster uses women ages 45–64 and a broader included MSCP cohort under a documented address-verification and exclusion method. The two ratios are not directly interchangeable.

How current are the state figures?

The underlying snapshot is May 1, 2024. The source review and derived dataset were completed August 3, 2026. The state figures remain labeled 2024 until a valid newer dataset replaces them.

How can I find a menopause practitioner?

The Menopause Society maintains its official practitioner directory, with location, ZIP-code, profession, and telehealth-state search options. The Society states that the directory is not complete and does not include people who are not accepting new patients.

Related research

• Menopause Laws by State — a 50-state statute audit separating enacted menopause-specific laws from bills, executive actions, resolutions, and general laws; it also identifies which qualifying statutes contain insurance or health-plan provisions.
• Menopause Workplace Laws by State — a 51-jurisdiction review of enacted accommodation rights, official guidance, pending measures, executive actions, and local rules.
• Menopause Medical Education Statistics — the evidence behind curriculum, clinical-exposure, resident-preparedness, and standards-language claims.
• Menopause Diagnosis Statistics — an evidence map separating diagnosis codes, encounter rates, documented-code prevalence, stage classification, and treated prevalence.
• Menopause Statistics — source-traced prevalence, symptom, age, duration, treatment, and denominator corrections.

Primary sources

State rates and geographic-access study

Chesnokova A, Schachter A, Schapira M, Williams M, Abernathy A. Where Are the Menopause Specialists? A Nationwide Analysis of Access to Certified Practitioners. AcademyHealth Annual Research Meeting poster, 2025.

Practitioner directory and credential

• The Menopause Society practitioner directory
• The Menopause Society: Choosing a Healthcare Practitioner and the MSCP credential

Population denominator

• U.S. Census Bureau, American Community Survey five-year datasets

Federal shortage designation

• HRSA: What Is Shortage Designation?
• HRSA Health Workforce Shortage Areas data
• 42 CFR part 5: designation of health professional shortage areas
• Criteria for Determining Maternity Care Health Professional Target Areas, 87 FR 30501, May 19, 2022
• Revised MCTA criteria, 91 FR 24882, May 7, 2026

Menopause age and workforce context

• National Institute on Aging: What Is Menopause?
• National Institute on Aging: Research Explores the Impact of Menopause on Women’s Health and Aging
• HRSA Health Workforce Projections

Treatment and diagnosis context

• AARP Public Policy Institute and NORC: Women in Menopause Often Go Untreated
• Health Care Cost Institute: Menopause Diagnosis Steadily Increased from 2018–2022

Commercial comparison source

• Hone Health: Survey—Millions of Americans Struggle to Access Hormone Care

This page is educational research about health-workforce distribution. It is not medical advice and does not describe any individual's care options. For questions about menopause symptoms or treatment, consult a licensed clinician.