Your heart health may be the biggest predictor of your sex life.

Nearly 1 in 5 men in the U.S. has difficulty achieving or maintaining an erection, a condition known as erectile dysfunction (ED). The new study, which appears this week in the Archives of Internal Medicine, suggests that ED drugs such as Viagra aren’t the only solution and aren’t always enough to address the problem, says coauthor Dr. Stephen Kopecky, M.D., a cardiologist at the Mayo Clinic in Rochester, Minnesota.