A major Australian study provides further evidence that erectile dysfunction may be a sign of fatal heart problems.

Erectile dysfunction (ED) may be a problem for your sex life, but it could also point to an equally important issue: heart disease.

An Austrialian study published this week in PLOS Medicineoffers new evidence than the common sexual condition is linked to the most pervasive killer in the Western world—cardiovascular disease.

Researchers from the Australian National University and other research facilities examined patients in the Australian data pool known as the 45 and Up Study. They looked into the connection between incidents of erectile dysfunction and cardiovascular disease in more than 95,000 men.

The research revealed that men who didn’t report any cardiovascular problems but experienced severe erectile dysfunction were 35 percent more likely to be hospitalized for cardiovascular problems within two years. Those men also had a startling 93 percent greater chance of death from any condition than those without ED.

Because erectile dysfunction is often a side effect of cardiovascular disease and many of its treatments, it’s no surprise that 64 percent of the men who already knew they had cardiovascular problems also experienced ED.

This research isn’t the first to connect erectile dysfunction to heart problems, but the scope and size of the study does lend validity to the theory that men with ED run a much higher risk of a cardiovascular event, such as a heart attack or stroke.

The researchers made a point of saying that their findings do not demonstrate that ED causes heart problems, but rather that the two conditions may share the same underlying cause, namely atherosclerosis, or hardening of the arteries.

The study authors say that erectile dysfunction should be considered a warning sign or risk factor for cardiovascular disease, which encompasses heart disease and other heart-related ills.

These results could lead to advances in men’s health screening techniques. Men are notorious for not going to the doctor, especially for problems related to the bedroom and the heart, so doctors should be on the lookout and begin screening for the two conditions at once.

The penis-heart connection may be the basis for Fifty Shades of Grey and other romance novels, but that’s not what we’re talking about. It’s not about dating advice, it’s about staying alive.

Not all causes of erectile dysfunction are immediately linked to heart health, although many are associated with behavior that’s bad for your heart. Causes of erectile dysfunction include:

  • drugs, smoking, and alcohol use
  • stress, anxiety, and other mental issues
  • physical injury affecting the nerves
  • hypogonadism or low testosterone (Low T)

Many behaviors, namely consuming drugs and alcohol, smoking, and living under stress, are bad for your heart anyway. Thankfully, certain lifestyle changes are good for both your heart and your, ahem, neither regions:

  • losing weight
  • getting regular exercise
  • cutting out the bad: smoking, alcohol, and drugs
  • reducing your stress through meditation or therapy