Why Men Avoid the Doctor and What It Costs Them

Medically reviewed by David Shusterman, MD · Updated September 11, 2026

Most of the men who walk into our office did not come in when the problem started. They came in when it became impossible to ignore, or when someone else made the appointment for them. In two decades of practice, Dr. Shusterman has come to see this delay as the single most expensive habit in men's health, and he can name the seven things men most reliably put off. What follows is that list, with an explanation of what each one costs.

Why men wait

There is no single reason. Some men were raised to treat symptoms as weakness. Some had one bad experience with a rushed doctor and decided the whole enterprise was pointless. Many simply have no relationship with a physician; they had a pediatrician, then a college health center, then nothing, and by forty-five there is no one to call. Add embarrassment about the parts of the body a urologist deals with, and the result is predictable: men show up a decade late.

Waiting is not free. The conditions below are all easier, cheaper and less invasive to treat early, and several of them are warning signs for something bigger.

1. Cardiovascular and vascular disease

Heart attack and stroke remain the things most likely to kill a man, and the process behind them, plaque building in the arteries, begins decades before it announces itself. Blood pressure, cholesterol particles, blood sugar and body composition can all be measured in one visit, and each of them can be changed. A man who learns at forty-two that his blood pressure is high has twenty years to protect his arteries. A man who learns it in an emergency room at sixty has already spent them.

2. Erectile dysfunction is a vascular warning, not an embarrassment

This is the one Dr. Shusterman emphasizes most. The arteries that fill the penis are smaller than the arteries that feed the heart, so when the lining of the arteries begins to fail, erections often falter first. Erectile dysfunction in a man in his forties or fifties, especially with no obvious cause, should be treated as an early sign of vascular disease and evaluated as one. Men hide it instead, or buy pills online, and lose the warning. We treat the erection, but we also check the heart. Sometimes the erection problem is how a man learns his cholesterol is high, and that discovery is the most valuable thing that happens at the visit.

3. Prostate symptoms left until the bladder is damaged

An enlarged prostate narrows the outlet, and the bladder responds by working harder. For a while it compensates; the muscle thickens and pushes through. Eventually it cannot, and the bladder stretches, stops emptying fully, and in some men never completely recovers even after the obstruction is relieved. The stream that took a little longer at fifty-five is the moment to act, not the retention episode at sixty-eight. Early evaluation is simple: a flow test, a bladder scan, a conversation. Early treatment is often medication or a minimally invasive procedure such as prostate artery embolization. Late treatment can mean catheters and surgery.

4. Low testosterone treated by clinics without evaluation

Low testosterone is real, and treating it can make a real difference. The problem is how it is being treated. A growing number of men arrive on testosterone prescribed by a clinic that ran one blood test, or none, and asked no questions about sleep, weight, fertility, or why the level was low. Testosterone replacement shuts down the body's own production and can end sperm production. It thickens the blood. It requires monitoring. A man with sleep apnea or obesity may have low testosterone because of those conditions, and treating the cause can restore the level without the trade-offs. We are not against testosterone therapy. We are against skipping the evaluation.

5. Sleep and nocturia

Getting up at night to urinate is so common that men treat it as a fact of age. It is not. Nocturia fragments sleep, and poor sleep worsens blood pressure, weight, mood and testosterone, which then worsen the nocturia. The causes are often outside the bladder: fluid retained in the legs during the day and released at night, sleep apnea, evening drinking habits, or the heart. Untangling it is one of the most useful things we do, and it starts with something as simple as a three-day bladder diary.

6. Mental health

Men are less likely to name depression or anxiety, and more likely to describe it as fatigue, irritability, poor sleep or low libido. Those are the words we hear in the exam room, and part of our job is to ask the next question. Mood affects every other item on this list: a man who is depressed does not exercise, does not sleep, and does not keep his appointments. We do not treat psychiatric illness ourselves, but we screen for it, we talk about it plainly, and we refer to people who do.

7. Skipped screening

Colon cancer, prostate cancer, skin cancer and the metabolic conditions above are all more treatable when found early, and every one of them has a screening pathway. Men skip them because the test is unpleasant, because no one told them when to start, or because they have heard that screening leads to overtreatment. That last objection deserves an answer: at this practice, low-risk prostate cancer is watched rather than treated, so the cost of knowing is small and the benefit of knowing is large. Screening should be keyed to how many years a man has ahead of him, not to his birthday.

What it costs

Each item on this list has an early version and a late version. The early version is usually a blood test, a conversation and a change in habits. The late version is a hospital. The difference between them is often nothing more than a man deciding, at forty or forty-five, to make one appointment.

How to start

Our men's health program was built to make that appointment easy: one visit, one physician, a lab and ultrasound on site, and a plan that covers the urologic, hormonal and cardiovascular questions together instead of sending you to three offices. Cardiovascular risk is measured through our heart and stroke risk factor screening, and men with questions about testosterone can read more at AndroMD, our men's hormone site. Bring the symptom you have been ignoring. It is almost certainly something we have seen before.