PJSIP was indeed lacking the “externhost” functionality which is a major bummer for using Asterisk with dynamic IPs behind NAT. Fortunately, Joshua Colp has become the Hero of the NATion and implemented it (https://gerrit.asterisk.org/#/c/6069/)
The functionality of using dynamic host adresses for external_media_address and external_signaling_address should therefor soon be available. Looks like Asterisk 14.7 and 13.18 are the versions that will come with this feature.
From what I understand the refresh time will be configurable in /etc/asterisk/dnsmgr.conf (like the “externrefresh” in chan_sip).