Men develop heart disease 10 years earlier, on average, than women do. They also have an early warning sign that few can miss: Erectile Dysfunction(ED). “It’s the canary in the coal mine,” says a Johns Hopkins expert. “Sexual problems often foretell heart problems.”

On the plus side, any risk factor, even ED that gets your attention can put you on a path to better preventive care.

Heart Risk Factor: Erectile Dysfunction

“A lot of people think erectile dysfunction is the inability to get an erection at all, but an early sign of the condition is not being able to maintain an erection long enough to have satisfactory sexual intercourse,” says a Johns Hopkins expert. Erectile problems are not a normal part of getting older as many people think; rather, they almost always indicate a physical problem.

A key reason erectile dysfunction is considered a barometer for overall cardiovascular health is that the penis, like the heart, is a vascular organ. Because its arteries are much smaller than the heart’s, arterial damage shows up there first—often years ahead of heart disease symptoms. Men in their 40s who have erection problems (but no other risk factors for cardiovascular disease) run an 80 percent risk of developing heart problems within 10 years.

Treatment tends to be successful when started as soon as you notice erection problems over more than a couple of months. An ED workup by your health care physician will address heart disease risk factors, such as prediabetes, high blood pressure or excess weight, hopefully, long before they result in a heart attack or stroke.

Heart Risk Factor: Stress

Stress, anger and anxiety raise levels of blood pressure and stress hormones, and they can restrict blood flow to the heart. Some damage can be immediate. In the two hours after an angry outburst, for example, your risk of a heart attack is nearly five times greater and your risk of stroke three times higher, research has shown.

What is more, the effects of chronic stress can build over time, damaging arteries. Men who have angry or hostile personalities have a higher risk of developing heart disease. Sexual problems related to heart disease can cause added anxiety or relationship stress. Stress can also affect sleep, which in turn affects heart health.

“Physical, emotional and psychological factors are all related when it comes to heart health,” says a Johns Hopkins expert. “When someone has chronic stress, depression or anxiety, they should have a basic evaluation of all of the risk factors for heart disease.”

Heart Risk Factor: Low Testosterone

Having a low testosterone level is often thought of as just a diminished sex drive, but it is increasingly seen as being linked to heart disease and type 2 diabetes, the expert says. He notes that a growing body of research indicates that “low T” can be considered a cardiovascular and metabolic risk factor.

“These ideas are still being studied, but we know, for example, that people with abdominal obesity [so-called ‘belly fat’] or Metabolic Syndrome have low testosterone,” the expert says. Metabolic syndrome (which includes high blood sugar levels, unhealthy cholesterol levels, and too much weight in the midsection) and diabetes are leading risk factors for heart disease.

Low testosterone is simply one part of an overall picture of heart risk, the John Hopkins expert shares. But it can be motivating, even lifesaving, to know that changes in your sexual function are closely interrelated to the rest of your body. It is worthwhile to get yourself checked out when something does not seem right.

“Men often don’t connect this problem to or get evaluated for stroke or heart attack risk until it happens,” he says. “But sexual problems are a message they listen to.”

Improving your Testosterone

The single best thing you can do to improve your level is be healthier. Avoid stress, get more sleep, and lose weight, Thinking of T strictly as “the male sex hormone” oversimplifies the complex hormonal interactions that make our bodies work.

Eat well

Don’t just chow down on testosterone pills and expect your work to be done. Cutting your calorie intake when crash dieting is one of the worst things you can do. When you do this, your brain goes into starvation mode and shuts down testosterone production until the famine is over. This is because high levels of testosterone burn more fat – and fast. Your body requires a steady supply of calories to produce testosterone, so regularly skipping meals may cause levels to nose-dive.

Reduce your body fat

Excess body fat increases the production of the female sex hormone oestrogen, which can cause testosterone levels to dip. Lose the chub, incorporating core exercises such as planks, burning body fat and building muscle. The best way to burn body fat is through cardio exercises such as running, walking, elliptical training, and bicycling. With these exercises, burning stomach fat, shedding love handles, and building a six pack is completely do-able.

Go easy on the alcohol

Ever wondered why excess drinking causes you to go limp at the moment of truth? Binge drinking kills testosterone, so give yourself a two-drink limit, and stick to it. Stay natural and get all the benefits without the risks.