Both Sex and self-gratification activates the fight or flight response. An orgasm is the biggest rush of hormones and neurotransmitters that is available by legal means (the illegal ones being drugs like cocaine, heroine, etc). It is the dopamine rush that we like....not the actual sex. It's like chocolate times 1000.
Having mild adrenal fatigue as a teenager, I became addicted to the boost provided even by just fantasy. Even just sitting there thinking about sex to the point of an erection made me feel better from the boost in hormones.
I became extremely addicted to sex, p 0 r n and self-gratification......which made my adrenal fatigue much worse. These are all stressful activities.
In fact Dr Lam has told me several times "no sex"
Calm, slow sex, without orgasm is not too bad for you.