Masturbation does not lead to erectile dysfunction (ED) in its basic forms, the smooth muscle relaxation that underlies ED might be contributed to by masturbation practices. To most people it is a normal use for leisure time and is not detrimental to their sexual health. In any case, it could cause some temporary problems if a man masturbates too often or too frequently. The same thing can occur if a man becomes desensitized to the type of stimulation or over-reliant upon it, because then he may have an inherently more challenging time responding adequately in real-life situations that lead to ED-like symptoms. Another factor is psychological: sexual desire may be inhibited because of anxiety, guilt or stress, all of which may, directly or indirectly, cause low self-confidence levels that may cause ED. It is better not to smoke and use alcohol and drugs, do not suffer from stress and lead a healthy lifestyle, so that no temporary issues arise at all.