Erectile dysfunction (ED) affects between 15 to 30 million men in the United States, preventing them from being able to get or keep an erection. The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) explains that ED is sometimes called "impotence," but this term includes other sexual problems such as lack of sexual desire or premature ejaculation. To avoid confusion, the term ED does not include these other conditions.

Today, one of the most common ways to treat ED is with the drug Viagra® (sildenafil citrate). Only a decade ago "Viagra" wasn't a part of the lexicon. Now you can't get through 24 hours without seeing an advertisement on TV, on the web, or in a magazine. When the drug hit the market in 1998 it provided a much easier and less painful way for men to cope with ED.

Since the mid 1980s, the primary medical treatment for ED was an injection of phentolamine into the penis to relax smooth muscles, which play a role in erections. Viagra has the same effect on smooth muscles - without the "Ouch!" factor. The drug works by relaxing smooth muscles and increasing blood flow to the penis to achieve and maintain an erection.

Other ED medications have entered the market, such as Cialis® (tadalafil) and Levitra® (vardenafil), and provide men with more options to tackle ED, however, all ED drugs carry side effects. These can be mild, such as headaches and nasal congestion; or severe, including respiratory tract infections, abnormal vision, chest and abdominal pain, and prolonged erections (up to four hours or longer). They can also interact with other medications, like those containing nitrates, and protease inhibitors.

Drugs aren't the only ways to cope with ED. The first step in treatment is to get assessed-to determine if an underlying illness or injury, or side effect of a drug is to blame. Once you're diagnosed, there are a variety of treatments your doctor may recommend based on the cause, severity of your ED, and health considerations, among other factors. Here's a brief overview of current treatments:

Lifestyle and dietary changes. According to the Cleveland Clinic, ED is linked to obesity, high cholesterol, hypertension, diabetes and heart disease. They recommend eating a healthy diet, maintaining a healthy weight, exercise and lowering your cholesterol.

Complementary and alternative treatments. If you prefer a less invasive approach to start, discuss these options with your doctor. Some natural remedies that may improve your condition are herbs such as ginseng, yohimbe, gingko biloba, or propionyl-L-carnitine. However, some of these treatments do have side effects and may interact with other drugs you're taking. Other alternative treatments include acupuncture and nutritional supplements.

Vacuum constriction device. This cylinder is placed over the penis and the air is pumped out to draw blood into the penis and stimulate an erection. The erection is maintained by slipping a band off the bottom of the cylinder and onto the base of the penis. The band stays in place up to 20 minutes.

Injections. If ED drugs aren't effective, another option mentioned above is to inject medication directly into the penis. The three drugs most commonly used for this procedure are papaverine, prostaglandin E1 (alprostadil), and phentolamine. Your doctor will teach you how to do this procedure yourself.

Urethral suppository. In this treatment you use a plastic applicator to place a suppository containing alprostadil into the urinary tube. The drug is absorbed into the blood stream and helps the blood vessels to relax. The Cleveland Clinic indicates that this treatment is less effective than injection or vacuum therapy.

Implants. There are two types of implants: The inflatable model is a cylinder that's implanted into the penis and inflated by a hydraulic pump implanted in the scrotum; malleable implants are semi-rigid, flexible rods that are implanted into the penis and stimulated manually to achieve erection.

Vascular surgery. Penile revascularization (bypassing blocked veins an arteries) and venous ligations (binding and removing problem veins) are rarely performed. According to the Cornell University Center for Male Reproductive Medicine and Microsurgery, vascular surgery may be recommended for young men who suffer from primary ED, or when an injury is the underlying cause, and can potentially permanently cure ED. However, some sources state that the surgery is still in the experimental phase and can cause nerve damage, which may lead to impotence.

Sex therapy. If the underlying cause of erectile dysfunction is clearly psychological your doctor will refer you to a sex therapist before attempting any other type of treatment. A sex therapist is a professional who specializes in sex therapy and may be a psychologist, psychiatrist, marriage or family therapist, or social worker.

Sex therapy helps you (and your partner) to cope with the emotional and psychological causes of your ED, such as stress, financial problems, or relationship problems. It's usually short term involving about five to 20 sessions - about one hour every or every other week, states the Cleveland Clinic. When partners are involved, the success rate is between 50 to 70 percent. You should complete more than three sessions to increase the likelihood that the therapy will be successful.