Breaking the Silence: Urologist Nathan Starke Explains Why Men’s Most Treatable Health Issues Go Ignored

It’s a familiar scenario in households across America: a woman schedules her annual women’s checkup, takes her kids to their pediatrician appointments, and reminds her partner, for the third time, that he really should see a doctor about an ache or pain he’s been complaining about for months. 

Why don’t men go to the doctor? 

Dr. Nathan Starke, a board-certified urologist and former Director of the Houston Methodist Men’s Health Center, has found some answers to that question throughout his career in men’s health. Through his work, he’s witnessed firsthand the cultural forces that keep men from seeking the care they need. Understanding why men avoid the doctor, and how to overcome this reluctance, could be the key to improving health outcomes for millions of American men.

The Stubborn Reality of Men’s Healthcare Avoidance

The statistics paint a concerning picture. Men are significantly less likely than women to visit a doctor for routine preventive care. They’re also more likely to delay seeking treatment when symptoms appear, often leading to diagnoses at more advanced stages of disease.

“Men are notoriously terrible at taking care of their own health,” Dr. Starke explains. He observes that women have historically been better stewards of household healthcare. “Women are usually in chargeof the household’s healthcare.”

This pattern starts early. While women are encouraged to establish relationships with gynecologists and prioritize preventive screenings as teenagers, and “most males don’t develop the habit of regular medical visits once they’re no longer dragged to the pediatrician by their mothers,” jokes Starke By the time they reach middle age, some haven’t seen a doctor in years or even decades. 

Breaking Down the Barriers

What keeps men away from the doctor’s office? According to Dr. Starke, several interconnected factors create a perfect storm of avoidance.

The Stigma of Vulnerability

Many men grow up in a culture that equates masculinity with strength, self-sufficiency, and stoicism. Admitting to health problems, especially those related to sexual function, urination, or hormonal issues, can feel like admitting weakness.

Dr. Starke has encountered countless patients whose partners noticed concerning symptoms, but the men themselves were reluctant to address them. “Even if they know they have an erection problem, they just kind of don’t want to talk about it because it makes them feel like less of a man,” he notes.

Embarrassment About Personal Issues

Discussing erectile dysfunction, urinary problems, or fertility issues requires a level of vulnerability that many men find uncomfortable, even with a medical professional whose job is to help.

Starke emphasizes the importance of normalizing these conversations. Medical professionals encounter these issues constantly and are prepared to discuss them with empathy and professionalism. “We do this all the time. We’re going to make an uncomfortable topic easier to talk about,” Starke says.

Lack of Awareness

Perhaps surprisingly, many men simply don’t realize that their symptoms are treatable. They may assume that erectile dysfunction, low energy, or urinary difficulties are just inevitable parts of aging—problems they’ll have to live with.

“The biggest misconception is that there’s nothing they can do about it,” Dr. Starke says. In reality, most male-specific health issues are “at minimum addressable, if not fixable.”

The Evolution of Men’s Health Awareness

There have been positive shifts in how society discusses men’s health issues. Dr. Starke points to the 1990s, when former Senator Bob Dole appeared in Viagra commercials discussing erectile dysfunction and treatment.

“That was the first time people talked about erection problems publicly,” Dr. Starke recalls. “Before that, people just kept quiet about it because it was this horribly embarrassing thing. You just didn’t talk about how your penis doesn’t work, and it wrecked your marriage or other intimate relationships, but you just kept quiet about it.”

Thanks to such efforts, erectile dysfunction has become a topic people can discuss “with a straight face and in polite company.” But many other men’s health concerns still carry significant stigma.

The price of silence is steep. Especially when so many viable treatments exist, even for some of the rarest conditions.

Dr. Starke points to Peyronie’s disease (PD), a condition categorized by severe curvature of the erection, as an example of an issue that could be embarrassing to tell a doctor about, despite its treatability. 

“It’s not new, but it’s something people don’t talk about. Just like with ED before the advent of Viagra and similar treatments, most men don’t realize PD is fixable. It’s a strange, undiscussed problem, it feels very embarrassing, and it ultimately harms their intimate relationships and causes psychological damage aside from the physical stuff.”

A Men’s Health Center Approach

When Dr. Starke served as director of men’s health at Houston Methodist, the facility was designed with these barriers in mind. The center aimed to create an environment where men felt comfortable seeking care.

“Many guys haven’t seen a doctor in ten years,” Dr. Starke notes. The Men’s Health Center served as an entry point, helping men connect with appropriate specialists and primary care providers. By addressing immediate concerns like low testosterone or sexual dysfunction, the center could then ensure patients received comprehensive care for other health issues.

The center also partnered with other departments, cardiology, internal medicine, and endocrinology, recognizing that men’s health problems often interconnect with broader health conditions. 

By treating men’s health concerns seriously, the center could identify and address underlying conditions that might otherwise go undetected until they became life-threatening.

Practical Steps: How Men Can Overcome Healthcare Avoidance

Dr. Starke offers straightforward advice for men who have been putting off medical care:

Start with a Primary Care Doctor

By your 30s—and definitely by your 40s—you should establish a relationship with a primary care physician. Even if you feel healthy, routine checkups can catch problems early when they’re most treatable.

“In your 20s, most people don’t go to the doctor because they feel healthy,” Dr. Starke says in an interview with KPRC 2 Click2Houston. “But by your 30s—and definitely by your 40s—you should have a primary care doctor.”

Prepare for Your Appointment

If discussing health concerns feels awkward, write down your questions before the appointment. This ensures you address everything that’s bothering you, even if you feel uncomfortable bringing it up spontaneously.

“It might sound simple, but writing your questions down before the appointment really helps,” Dr. Starke advises. “Make sure all your concerns are addressed.”

Choose a Doctor You Trust

Finding a physician who makes you feel comfortable discussing sensitive topics is crucial. Dr. Starke’s own approach involves meeting patients where they are—speaking directly and avoiding overly clinical language that can create distance.

Recognize That Treatment Options Exist

Understanding that most men’s health issues can be addressed should motivate men to seek care rather than suffer in silence. Whether through lifestyle changes, medication, or surgical interventions, solutions are available for the vast majority of concerns.

Looking Forward: Changing the Culture

If Dr. Starke could change one thing about how men’s urological health is addressed in American healthcare, it would be this: “Removing the stigma of men’s health-related issues and somehow getting men to be good stewards of their own health.”

The path forward requires both individual action and cultural change. Men need to prioritize their health and overcome embarrassment about seeking care. Healthcare systems need to create welcoming environments that address men’s unique concerns. And society needs to continue normalizing conversations about men’s health, just as it has begun to do with mental health and other previously “taboo” topics.

Dr. Starke remains optimistic. Through his years of practice, he’s seen countless men transform their quality of life by addressing health issues they’d been suffering with unnecessarily. “Helping men with male-specific problems and really improving the quality of life of urination or making babies or sexual function with their partners—it’s extremely gratifying and it’s a wonderful field. Former patients of mine still text or email me all the time when new babies are born or their health continues to be improved as a result of our work together. Those texts make my day every time.”

Men’s health matters, treatment options exist, and there’s no shame in seeking the care you deserve. The first step is often the hardest, but it’s also the most important.