I know you were addressing Michael, so hopefully it's not rude to add my own two cents in response to your questions as well. We're another 24/7 chastity couple.
My wife and I do still have sex. I am allowed orgasms at a rate of approximately one per month, not counting the occasional ruined orgasm. Maybe 1/3 of my full-blown orgasms are from traditional, penetrative sex. I am also sometimes allowed to be inside her for as long as I can last without cumming, and then finish her off orally. This provides the closeness and intimacy of lovemaking but doesn't relieve any of the tension and desire she's worked to build up in me. The rest of the time, our "lovemaking" is 100% focused on her.
There is some type of play several nights a week, whether it's me going down on her, being told to edge for her (sometimes while she masturbates), her taking off my cage to wash me and/or apply lotion or oil before stuffing me back in my cage, squeezing my balls while using her vibrator, having me wash and worship her feet before giving her a pedicure, giving her full body massages with lots of ass worship, etc., etc., etc. So my desire is always at max, but I actually have more intimate nights with my wife than I would if we weren't doing this.
I don't worry about the physical effects you talk about, because all she has to do to get me back into shape so I can get firmer erections or last longer is take me out more often and have me get hard for longer periods of time. Sometimes she gives me relentlessly patient, start-and-stop handjobs but strictly forbids cumming, or has me stroke for her and plays "red light, green light." Normally, a lot of maintenance is barely necessary, since the humiliation of looking small or cumming to fast is a regular part of our play, but since quarantine started and she's not having sex with other men, I've had more chances to get hard and work on my stamina (coincidence?). Thinking about it now, I'm pretty sure I've had fewer orgasms, though. I can only remember 2 in the last three months, even though teasing has gotten far more relentless.
So yes, I regularly wish I could get off, because I'm always kept horny and full of lust and desire for her, but after many, many years of this kind of play, I definitely do not wish to go back to "normal" anytime soon. I absolutely love being hers and having her fully in control.