The millions of American men who experience erectile dysfunction (ED) may not need prescription medication to improve their sex life, an expert claims.

Urologist Dr. Jack Mydlo of Temple University tells men that the factors influencing ED are more subtle and complex than a simple physical problem.

“A certain part of the mechanism for erections is psychological,” he explained. “They have to be in the right mood, with the right person and take care of themselves.”

Among the health resources advised by Mydlo to address ED is to give up smoking, which he says is the “number one environmental cause” of the condition.

Once you have quit smoking and restored a healthier blood flow to the penis, you should expect improved performance within 12-24 months, he said.

High cholesterol and significant fat intake are two more factors that can lead to ED, according to Mydlo.

Cholesterol can lead to plaque buildup in the penis and arteries, which again restricts blood flow. Meanwhile, excess fat can cause a hormonal imbalance that results in impotence, he explained.

Research from the University of Hertfordshire has found a link between ED and an increased risk of heart attacks.