Most men don’t like to talk about it, but erectile dysfunction (ED) is surprisingly common. More than 30% of men between the ages of 40 and 70 have trouble getting or keeping an erection.

Many men believe that ED is a psychological problem. However, research shows that underlying vascular (blood vessel) issues are the most common cause of erectile dysfunction. And these underlying issues can also put men at risk for other serious medical issues.

Here are 5 things you need to know about erectile dysfunction and your health.

Erectile dysfunction and heart disease are linked

Erectile dysfunction is a common occurrence in men with coronary heart disease. Coronary artery disease occurs when plaque builds up in the arteries, reducing blood flow to the heart and obstructing the functioning of blood vessels. Healthy blood circulation is also essential for erectile function. Also, some medications used to treat high blood pressure can contribute to ED.

Erectile dysfunction can be a warning sign

One of the early stages of coronary heart disease is endothelial dysfunction, a condition in which blood vessels cannot dilate (open) properly. Endothelial dysfunction often first affects the penile blood vessels. In many cases, ED can be the first clue that something is wrong. ED is often a sign of underlying heart disease.

Erectile dysfunction also linked to diabetes

ED is also closely associated with type 2 diabetes. High blood sugar can damage the blood vessels and nerves responsible for erectile dysfunction. A study by researchers at the Johns Hopkins Bloomberg School of Public Health found that almost half of the men with diabetes studied also suffered from erectile dysfunction.

It’s important to connect the dots

ED can be embarrassing. Many men don’t talk about it, even to their doctor. On the other hand, men who see a doctor may be so focused on their distress in the bedroom that they fail to mention other troubling symptoms. Many men are unaware of the symptoms of heart disease like shortness of breath or chest pain. If you have ED, talk to your doctor about screening for risk factors such as high blood pressure, diabetes, and heart disease, especially if you’ve noticed other symptoms.

Lifestyle choices matter

The good news is that healthy lifestyle choices can have an effect. Eating a nutritious diet, exercising regularly, avoiding smoking, and controlling high blood pressure, high cholesterol, and diabetes can reduce your risk of heart attack and stroke and improve sexual function in the process.

Many things are involved in the cardiovascular system. Controlling some of these risk factors can really make a difference.