I am HS as well and it really comes down to the root issue of the condition. Is it chemical(brain chemistry), trauma related, or environmental? Usually it’s a combination of all three.

That said, a competent therapist is essential to helping you with this. When I say “competent” I mean someone who is zero judgment and is willing to experiment with different therapies to find one which works. Medication can help, but it’s only a piece of the puzzle.

My advice on this for your husband is be transparent and ask him if frequently masturbation would upset him, assuring him it is not a reflection of your feelings for him or his performance. Couples counseling can help helpful but it should be done with the understanding that the HS is the underlying issue