What happens in the bedroom typically stays in the bedroom, with one exception being when things aren't going well in there.

"In terms of sexual health, erectile dysfunction (ED) is the most common problem men report to their doctor," says Dr. Alexander Rozanski, urologist specializing in men's health at Houston Methodist. "Most often, men are prescribed an oral medication such as 'the blue pill' or one of its closely related alternatives."

But treating ED doesn't have to begin and end with oral medications, which can come with unwanted side effects. In addition, it's unsafe for some men to take these medications, including those who have severe heart disease/heart failure or low blood pressure, as well as those who take nitrate drugs to treat chest pain. And, finally, these medications fail to work in some men altogether.

"Fortunately, there are several other ways to treat ED," adds Dr. Rozanski.

5 ways to treat ED that eliminate the need to take a pill

For men who don't want to take a pill or those who simply can't, Dr. Rozanski is here to explain your options.

1. VED (Vacuum Erection Device)

Often called a penile pump, a VED works by manually pulling blood into your penis using suction. Once the erection is formed, a tension ring is slipped to the base of the penis, which helps maintain an erection for the duration of sexual activity.

"While many men do not love the concept of suction and ring compression to get and maintain erections, it is an option that works for some couples to restore erection function without medication," says Dr. Rozanski.

Side effects of using a penile pump include:

• Mild bruising
• Restriction of ejaculation
• The penis feeling cold to the touch when used for an extended period
  
  

2. Testosterone replacement

"ED is commonly caused by temporary stress or chronic cardiovascular conditions that reduce blood flow to the penis, but low testosterone can contribute to issues with forming and maintaining an erection," says Dr. Rozanski. "Your doctor can help you understand if your testosterone levels are low and whether starting testosterone treatment may help alleviate your ED symptoms."

Though testosterone replacement is not recommended as a first line, single treatment for ED, your doctor may recommend it or try it in combination with another ED treatment option, depending on your individual symptom profile.

3. Urethral suppository

Intraurethral therapy involves inserting a small drug pellet into the tip of the penis.

"With this therapy, it only takes about ten minutes for an erection to form — which can then last for the duration of sexual activity," says Dr. Rozanski. "However, side effects of using a urethral suppository can include urethral pain or burning or very minor bleeding from the tip of the penis."

4. Penile injections

"Though a potentially scary concept, penile injections involve a medicine that improves penile blood flow better than oral medicines. The medicine is injected into the penis using a very small needle. This is a self-injection, although we routinely teach patients proper technique and perform the first injection in the clinic," says Dr. Rozanski.

Side effects of this treatment, include:

• Minor pain or bleeding at the injection site
• Prolonged erection that can last longer than desired
• Formation of scar tissue within the deeper tissues of the penis, primarily seen in long-term users of this therapy
  
  

5. Penile implant

A penile implant involves an outpatient surgical procedure which places an inflatable device into the erection chambers of the penis, which enables you to reliably control exactly when and how long an erection lasts. Dr. Rozanski says this is the closest option to a cure that exists for ED.

"A penile implant does involve a short surgical procedure, so whether or not you're willing or able to undergo the procedure can be a determining factor in whether it is the right option for you," explains Dr. Rozanski. "For men who do choose an implant, the vast majority (greater than 90% of men and their partners) report great satisfaction with it."

(Related: 5 Things to Know If You're Considering a Penile Implant)

Addressing underlying health conditions and minimizing stress can also reduce symptoms of ED

"ED isn't always caused by increasing age, and it rarely occurs alone. In fact, it's often linked to — and even caused by — one or more underlying health conditions that a man may not even know he has," says Dr. Rozanski. "In particular, diabetes mellitus and cardiovascular disease commonly contribute to the symptoms of ED."

Aside from the various treatment options for ED, Dr. Rozanski points out that simply taking steps to better your heart health and mental health may help alleviate your symptoms.