Unfortunately there is no way to tell advertisers, "No, I'm not interested in your product. I never will be. Don't waste your money."
The top offender is Hims. No, I don't have hair loss. I don't want hair loss supplements. I also don't have ED, and I object strongly to ads for that showing up unexpectedly when I'm showing a YouTube video to someone else.
The second top offender is whoever it is (they keep changing their name) who thinks that I need some kind of Christian motivational course to get control of "the P-word". (Their phrase, not mine.) No, I don't have a problem with pornography. I am very rarely interested in it. And when it comes up every few months, I don't feel any guilt about it afterwards. Furthermore I'm an atheist. A Christian motivational course isn't going to work well for me regardless.
Yes, Google does offer a report function, and a block function, for ads. The report function seems to have gotten rid of the unwanted ED ads. The block really doesn't work when the ads are all very similar AI slop that is rotated frequently. Block this ad, and then next unwanted ad from the same source will be coming along soon enough. (The reason why I particularly dislike Hims is that they are more aggressively rotating their ads.)