How AI Search Is Recommending TRT Clinics: Monthly Trends

Executive Summary

Hone Health remains the coverage leader in September 2026 at 42.7% valid recommendation coverage, but this is the brand's second consecutive month of decline. The gap to second-place Defy Medical is now just 1.9 points (40.8%), a narrower margin than the 47.4% tie both brands shared in August. Defy Medical has also declined for two straight months, falling from 48.8% in July to 40.8% in September.

The most consequential movement in September is Henry Meds, which registers as this category's largest decliner against the July baseline. Henry Meds fell 14.3 points from 23.9% in July to 9.6% in September, a drop large enough to stand out from typical month-to-month movement. Low T Center also declined against the baseline period, dropping 6.3 points to 1.4%.

No brand posted a significant rise in September. The month's story is a broad softening across the leader tier, with Hone Health, Defy Medical, Henry Meds, and Low T Center all recording two-month downward streaks. Maximus held the steadiest position among the top tier, moving just 1.2 points from 28.7% to 27.5% across the full series.

Each monthly run begins with 800 prompt-surface observations (461 unique questions in July, 532 in August, 535 in September) across the benchmark's defined AI/search surface universe. Of those, 800 in July and September and 799 in August mentioned a tracked brand or competitor; 419 in July, 405 in August, and 428 in September were relevant, and 381, 394, and 372 respectively were irrelevant. The public metrics use the 209 qualified observations in July and August and the 218 in September that survive both qualification stages.

Key Findings

Benchmark Context

The report separates the raw collection universe from the qualified analysis set. Brand-level recommendation percentages are calculated within the qualified benchmark set.

Benchmark-Level Metrics

These benchmark-wide figures track how many observations qualified for analysis and how the mix of recommendation-shaped answers shifted between the two months.

The intermediate month matters for this series: the recommendation-shaped answer share spiked to 49.8% in August before settling back to 39.9% in September, close to the July level. The valid recommendation shortlist share has now declined for two straight months, from 64.6% in July to 63.6% in August to 55.5% in September, indicating that a smaller share of answers are structured as usable recommendation shortlists as the series progresses.

AI Recommendation Trend

The leadership tier has loosened, with the top two brands now separated by less than two points after sharing a tie in August

Hone Health leads the category at 42.7% valid recommendation coverage, holding a narrow 1.9-point edge over Defy Medical at 40.8%. Maximus sits in third at 27.5%, with Marek Health in fourth at 17.0%.

The category change came from a combination of three declines against the July baseline that exceeded normal month-to-month variation — Henry Meds, Hone Health, and Low T Center — rather than a single dominant shift. The declines at Defy Medical, Marek Health, and Fountain TRT remained within expected bounds.

What Changed This Month

Hone Health: decline from baseline while holding the lead

Hone Health remains the category leader but has now declined for two consecutive months, falling from 53.1% coverage in July to 42.7% in September. The 10.4-point drop against the July baseline stands out from typical variation; the 4.7-point move from August to September did not.

The striking pattern is that presence rose while coverage fell. Hone Health appeared in 71.3% of July answers and 77.1% in September, a 5.8-point increase in raw mentions. Yet valid recommendations fell from 111 in July to 93 in September.

Rank-one placements tell a mixed story. The brand held 21 top recommendations in July and 18 in September, while its top-three rate slipped from 36.4% to 33.9%.

The distinction to notice: Hone Health is being mentioned more often but recommended less proportionally. The brand is surfacing in answers at a higher rate while converting a smaller share of that presence into valid recommendations.

Highest-priority diagnostic: Which prompt types now mention Hone Health without recommending it, and what changed in how those answers are structured.

Defy Medical: two-month slide narrows the gap

Defy Medical has declined in each of the past two months, moving from 48.8% coverage in July to 40.8% in September, a cumulative 8.0-point drop that did not register as a significant decline against baseline. The brand's position relative to Hone Health has improved only because both brands fell.

Presence contracted alongside coverage. Defy Medical appeared in 53.6% of July answers and 47.7% in September, while its top-three rate slipped from 23.9% to 19.7%. Valid recommendations fell from 102 to 89.

The distinction to notice: Defy Medical's decline is broad-based rather than concentrated in one placement tier. Presence, top-three rate, and rank-one rate all moved down together, suggesting a shift in which prompts surface the brand rather than how prominently it ranks.

Highest-priority diagnostic: Whether the September question set differed materially from July in ways that reduced Defy Medical's relevance, and which surfaces drove the 13-recommendation loss.

Henry Meds: the category's largest decline against baseline

Henry Meds posted the sharpest movement in the September series, falling 14.3 points from 23.9% coverage in July to 9.6% in September. This decline has now run for two consecutive months.

The August observation captured the steepest single-month drop of 10.0 points, while September added a further 4.3-point decline. Valid recommendations fell from 50 in July to 29 in August to 21 in September.

Presence also contracted steadily, from 26.8% of July answers to 20.6% in September. The top-three rate dropped from 11.5% to 5.5%, a decline large enough to stand out from typical variation in its own right.

The distinction to notice: Henry Meds has lost ground at every level of the recommendation funnel. Presence, top-three placement, and overall coverage all declined across the full series, with the brand now holding just 21 valid recommendations.

Highest-priority diagnostic: Which competitor captures the recommendation when Henry Meds drops out of the shortlist, and whether this pattern is concentrated in specific prompt clusters.

Low T Center: sustained decline to the bottom of the field

Low T Center has declined for two consecutive months, falling from 7.7% coverage in July to 1.4% in September. The 6.3-point drop against baseline stands out from typical month-to-month variation.

The August observation showed the sharper collapse of 5.3 points, with September adding a further 1.0-point decline. Valid recommendations fell from 16 in July to 5 in August to 3 in September.

At 3 valid recommendations across 218 qualified answers, the small counts mean a change of just a few recommendations materially moves the percentage.

The distinction to notice: Low T Center's decline combines a real loss in presence with a collapse in recommendation quality. The brand moved from 7 rank-one placements in July to 1 in September.

Highest-priority diagnostic: Which evidence sources stopped supporting Low T Center, and whether the loss of rank-one placements traces to a specific prompt cluster.

Maximus and Marek Health: stability at different levels

Maximus has held the steadiest position among the top tier, moving just 1.2 points from 28.7% coverage in July to 27.5% in September. Its raw presence actually rose from 31.6% to 36.7%, and its top-three rate improved from 14.3% to 20.6%, yet valid coverage held nearly flat.

Marek Health declined 3.6 points from 20.6% to 17.0%, staying within normal variation. Its rank-one rate slipped from 2.4% to 1.4%, and valid recommendations fell from 43 to 37.

The distinction to notice: Maximus is converting more presence into top-three placements while overall coverage holds steady, whereas Marek Health is losing ground across placement tiers. The two brands are moving in different shapes despite occupying adjacent positions.

Highest-priority diagnostic: Whether Maximus's improving top-three rate is concentrated on specific surfaces, and which prompts Marek Health lost in September.

Buyer-Intent Interpretation

All 218 qualified observations in September 2026 fell into the discovery and consideration stage, where buyers are identifying and evaluating TRT clinic options. The benchmark's public metrics therefore speak to which brands surface and get recommended during initial research, not to how clinics fare when buyers explicitly compare options or weigh pricing.

Because no qualified observations landed in the pricing, value, or head-to-head comparison clusters, the public benchmark cannot yet answer questions about price sensitivity, cost-driven recommendation patterns, or direct competitive matchups. Those dynamics would require a deeper, prompt-level inspection of individual answers where pricing and comparison language appears.

Brand Opportunity Summary

The benchmark identifies where attention is warranted; a company-level analysis is needed to explain why.

Evidence Behind the Benchmark

The aggregate metrics are built from prompt-level observations covering the query, the AI surface, the recommendation outcome, the rank, sentiment, and citations where exposed. Company-level analysis can go deeper into prompt, competitor, surface, and evidence patterns. Source presence is not automatically treated as proof of causation.

About This Benchmark

This report is part of the LLM Authority Index AI Market Discovery research program.

• AI Industry Market Discovery
• AI Industry Market Discovery Methodology
• AI Industry Market Discovery Metrics
• AI Industry Market Discovery Standards

Report-Specific Interpretation Notes

• Small-count movement: Low T Center, Craft Concierge, BioTE, and Renew Vitality operate on 5 or fewer valid recommendations; a change of one or two answers moves their percentages materially, so their month-to-month shifts should be read with that base in mind.
• Qualified denominator vs raw collection: the public percentages use the 209 qualified observations in July and August and the 218 in September, not the 800 prompt-surface observations collected each month, and the funnel between them is disclosed in the Benchmark Context table.
• Directional analysis: month-over-month movement identifies changes worth investigating; it does not by itself establish the cause of those changes.

Next Step

The Public Benchmark Shows Where a Brand Is Winning or Losing. A Company-Level Audit Shows Why.

Beneath the aggregate percentages sit the questions that determine whether a movement is a trend or a one-off: which high-intent prompts a brand wins, which competitor takes the recommendation when a brand loses, what attributes AI systems associate with each clinic, and which external sources shape those answers. The benchmark flags the movement, but it cannot explain the mechanism from the summary metrics alone.

A company-specific AI visibility audit maps those prompt, surface, competitor, ranking, sentiment, and evidence-source patterns into a prioritized visibility strategy. It isolates the specific queries where a brand's position is eroding, identifies the competitor capturing those recommendations, and pinpoints the evidence gaps that need attention.

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