Survey: Millions of Americans Struggle to Access Hormone Care
At 28, Logan became what he calls a “walking zombie.” He had crushing fatigue, no sex drive, little emotion, and no motivation. Blood tests from his primary care doctor showed a testosterone level around 180 ng/dL, well below the standard diagnostic cutoff for low testosterone. But, because his doctor wasn’t experienced in prescribing hormone therapy — or the careful monitoring it requires — he referred Logan to an endocrinologist.
Logan, who lives in rural Michigan, waited three months for an appointment and drove 90 minutes to get there. After reviewing multiple blood tests over several months showing testosterone levels between 100 and 302 ng/dL, the endocrinologist told him his numbers were fine and his symptoms must have another cause. “I felt hopeless,” Logan says. “I knew what I was feeling, and no one was willing to help me.”
Logan lives in what longevity platform Hone Health calls a “hormone desert” — a geographic area where residents lack access to qualified hormone health providers. These hormone deserts are ubiquitous across the country, especially in the South, the Midwest, and in rural areas, according to a new analysis by Hone Health comparing U.S. census data with registries of menopause-certified physicians and board-certified urologists.
“Your ZIP code shouldn’t determine whether your hormones get treated, but for millions of Americans, that’s exactly what’s happening,” says Jim Staheli, D.O., Medical Director of Hone Health. “When people can’t access qualified hormone care, they don’t just live with symptoms longer — they miss opportunities for early diagnosis, losing the chance to reduce their risk of chronic diseases before they become much harder to treat.”
Hormone Care Availability Across the U.S.
Many less densely populated states such as Mississippi, Idaho, Oklahoma, Iowa, Wyoming, and Nevada have become hormone deserts, according to Hone Health’s analysis, but even more densely populated states may have regions where patients struggle to find qualified care.
Top hormone deserts for men
Nevada and Wyoming each have only 1 board-certified urologist per 10,000 men aged 40–64.
Arkansas, Georgia, Hawaii, Idaho, Iowa, Mississippi, Missouri, Nebraska, New Mexico, North Dakota, Oklahoma, Texas, and Utah have 2 urologists per 10,000 men.
California has 2.5 urologists per 10,000 men, but providers are concentrated in San Francisco, San Jose, and Los Angeles, while most of the San Joaquin Valley is a desert.
To understand the impact of these hormone deserts, consider Nevada as an example. With one urologist for every 10,000 men, and testosterone deficiency affecting an estimated 1 in 4 men ages 40–64, each urologist in Nevada would need to see 10 patients per day to meet annual demand.1 And that’s on top of all their patients with prostate cancer, kidney stones, bladder disorders, and other urological symptoms.
Read the full article on Hone Health.
Originally published July 24, 2026.