Later Spring data report

How many midlife women share one certified menopause practitioner, by state

Across the fifty states and the District of Columbia there are 41,698,792 women aged 45 to 64 and 3,359 clinicians who hold a menopause society certification. That is one certified practitioner for every 12,414 women — and where you live changes that number by a factor of 18.9.

Analysis of the Later Spring directory (7,390 listed practitioners). Data as of 15 September 2026.

Mississippi has one certified menopause practitioner for every 53,007 women aged 45 to 64. District of Columbia has one for every 2,802. The same certification, the same country, a 18.9-fold difference in how far you have to look.

The national figure is one certified practitioner for every 12,414 women in the age band where the menopause transition falls. 23 states are worse than that average, and 24,420,965 women live in them.

What this counts, and what it does not

This measures the density of clinicians who hold a menopause society certification. It is not a measure of the quality of care in a state, and a thin ratio is not evidence that women there are treated badly. Most menopause care in the United States is given by clinicians without this certification, many of them well. What the ratio measures is how far someone has to look to find a clinician who has evidenced menopause training specifically.

The denominator is the Census Bureau’s civilian population estimate for women aged 45 to 64. That band is used because the median age at menopause in the United States is 51 to 52, perimenopause typically begins about four years earlier, and symptoms commonly continue for years afterwards. It will include women who have no need of this care and exclude some who do.

Every state, best served first

US states ranked by the number of women aged 45 to 64 per certified menopause practitioner, best served first.
#	State	Women 45–64	Certified	Women per certified
1	District of Columbia	70,061	25	2,802
2	Montana	131,578	26	5,061
3	Vermont	83,553	16	5,222
4	Oregon	513,739	96	5,351
5	New Hampshire	189,736	34	5,580
6	Colorado	687,265	107	6,423
7	Wyoming	66,915	10	6,692
8	South Dakota	102,633	15	6,842
9	Utah	352,213	49	7,188
10	Minnesota	680,868	89	7,650
11	Washington	925,184	119	7,775
12	Massachusetts	910,685	117	7,784
13	Maine	187,929	24	7,830
14	North Dakota	80,033	10	8,003
15	Nebraska	221,476	27	8,203
16	Idaho	226,329	26	8,705
17	Alaska	78,505	9	8,723
18	Connecticut	483,612	55	8,793
19	Rhode Island	142,116	15	9,474
20	Hawaii	172,431	18	9,580
21	Michigan	1,268,019	131	9,680
22	New York	2,522,204	237	10,642
23	Iowa	373,175	35	10,662
24	North Carolina	1,409,273	132	10,676
25	Illinois	1,574,764	142	11,090
26	Ohio	1,460,555	129	11,322
27	Wisconsin	734,150	62	11,841
28	Pennsylvania	1,628,826	132	12,340
29	Virginia	1,102,961	88	12,534
30	Louisiana	556,379	43	12,939
31	Maryland	815,725	63	12,948
32	New Mexico	250,167	19	13,167
33	Kansas	336,152	24	14,006
34	Indiana	832,628	59	14,112
35	Kentucky	572,190	39	14,672
36	Arkansas	374,000	25	14,960
37	Delaware	135,859	9	15,095
38	New Jersey	1,236,629	80	15,458
39	California	4,777,107	309	15,460
40	Missouri	759,305	47	16,155
41	Georgia	1,429,006	84	17,012
42	Tennessee	910,854	53	17,186
43	Texas	3,614,967	208	17,380
44	Florida	3,004,511	172	17,468
45	Arizona	886,156	48	18,462
46	West Virginia	226,628	11	20,603
47	Nevada	399,159	19	21,008
48	South Carolina	703,790	26	27,069
49	Alabama	655,295	23	28,491
50	Oklahoma	470,445	16	29,403
51	Mississippi	371,052	7	53,007

The five states where the gap is widest

Mississippi — one certified practitioner per 53,007 women. See who is listed in Mississippi
Oklahoma — one certified practitioner per 29,403 women. See who is listed in Oklahoma
Alabama — one certified practitioner per 28,491 women. See who is listed in Alabama
South Carolina — one certified practitioner per 27,069 women. See who is listed in South Carolina
Nevada — one certified practitioner per 21,008 women. See who is listed in Nevada

Method and sources

Practitioner counts come from this directory: clinicians listed on the Menopause Society practitioner directory as holding its certification, counted by the state of their practice address. Population figures come from the US Census Bureau, US Census Bureau, Annual Estimates of the Civilian Population by Sex and Age for States: April 1, 2020 to July 1, 2024 (SC-EST2024-AGESEX-CIV), retrieved 2026-09-23. A clinician is counted once, in the state of the practice address on file, so someone who sees patients across a state line is counted where they bill.

The figures are free to reuse with attribution. If you are writing about this and want the underlying numbers, the aggregated dataset is published under CC BY 4.0, and we will answer questions about method.

Method and limits

Every figure on this page is counted directly from the Later Spring directory, which is compiled from two public professional registers. It measures listed practitioners, not all practitioners: clinicians who treat (peri)menopause without joining either register are not counted, so these numbers are a floor, not a census. Fields such as areas of expertise and telehealth availability are self-declared.