Can excessive masturbation cause impotence?

Patient's question:

I have a sexual history of 7 years. After getting divorced, I often experienced weak erections and quickly lost my erection. When I saw a doctor, they said it was premature ejaculation. After taking medication to maintain it, it improved somewhat. However, "prescription drugs are" (the saying "prescription drugs are three parts poison"), I want to know if excessive masturbation can cause impotence?

Doctor's answer:

Erection of the penis is initiated by a specific irradiating nucleus in the brain. It forms a perinatal gonadal axis through the hypothalamus, pituitary gland, and testes, creating a conditioned reflex. Physical, psychological, and social factors are all very important for a man's penile erection. Apart from physical issues, which can lead to poor erection, testosterone elevation and hormonal disorders may also cause adverse reactions. Additionally, psychological disorders, marital disharmony, or a lack of libido in oneself can also result in poor erection. Even social problems, such as work-related stress, are not to be overlooked as significant factors. These issues can lead to oligospermia and asthenozoospermia, ultimately affecting fertility.

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