Here is the translation of the provided text into English: "Self-abuse, impotence, premature ejaculation, lower back pain, and kidney yang deficiency with yin deficiency - what is the reason for this?"

Patient's question:

Right waist pain, long sexual history, legs feel weak, urination is weak, hardness is poor, impotence, premature ejaculation. To find out if you have kidney yang deficiency or kidney yin deficiency, what kind of medicine should you take?

Doctor's answer:

At the beginning of sexual activity, it generally leads to the manifestation of kidney yin deficiency; but if sexual activity continues for a long time, symptoms of kidney yang deficiency may appear. Therefore, your condition is likely a combination of both yin and yang deficiency. It is recommended that for kidney yin and yang deficiency, both kidney yin and kidney yang should be nourished simultaneously. For cases with a tendency towards yang deficiency, Jin Gui Shen Qi Wan can be used, as it can nourish both kidney yin and kidney yang. Alternatively, medications specifically for yang deficiency can also be used.
Since you have experienced premature ejaculation again, medications for treating premature ejaculation can be applied. For premature ejaculation patients, timely treatment can reduce the frequency of episodes. If left untreated, it may affect overall health. Therefore, patients should take medication promptly and avoid overexertion in daily life while paying attention to personal hygiene.