AI and wearables: The new age of smart sex

Smerina is an OMS-3 at the Dr. Kiran C. Patel College of Osteopathic Medicine at Nova Southeastern University in Fort Lauderdale, Florida. Pearlman is a urologist and co-founder of the Prime Institute in Coral Gables, Florida.

"AI is now being used as a screening tool to help men assess penile lesions for potential STIs," write the authors.

Artificial intelligence (AI) and wearable devices are increasingly being used in health care, and more recently, technologies have emerged within sexual medicine. These innovative tools are being used to help educate, evaluate, and even treat sexual health concerns globally. We recently wrote a review on the intersection of AI, wearable devices, and sexual health, and the purpose of this article is to highlight some of the commercially available products currently being used by consumers and healthcare providers in the United States.¹

Let’s begin with the use of AI for sexually transmitted illnesses (STIs). Early diagnosis of STIs is crucial for optimal patient outcomes and reduction of transmission, however poor access to care and lack of personalization when it comes to information on the internet are common barriers. Changes in the penis, particularly after a sexual encounter and, even more so if penile sensation or new lesions appear, are anxiety-provoking in many men. AI is now being used as a screening tool to help men assess penile lesions for potential STIs. The HeHealth smartphone application is able to provide rapid feedback after users upload photos and provide information regarding recent exposures, with a physician then reviewing the photos within 24 hours. HeHealth expanded the use of its technology during the monkeypox (Mpox) outbreak of 2022, compiling more than 10,000 Mpox and STI images, making it one of the largest and most comprehensive data sets globally.²

Wearable devices are increasingly being used to understand and improve male sexual dysfunctions. The TechRing by FirmTech is an erection ring that may be worn during any type of sexual activity to improve firmness and duration of the erection, as well as allow for data collection during and unrelated to sexual activity. The device uses a pressure sensor and strain gauge to measure number, firmness, and duration of erections. Its ability to track nocturnal erections in the comfort of one’s home using non-invasive technology is particularly exciting given the current limitations when it comes to objective erectile function measurements. Researchers are currently investigating the use of this device in trials using doppler ultrasound and penis pumps and in men with premature ejaculation (PE), post-prostatectomy, and testosterone deficiency on testosterone therapy. Notably, the device has been shown to be safe with overnight use.³

A masturbation aid device, MYHIXEL, is being used in combination with behavioral therapy to treat premature ejaculation (PE) and track progress during treatment. MYHIXEL is an electric handheld device that mimics penetrative vaginal intercourse. Combining the MYHIXEL with behavioral Sphincter Control Training (SCT) using a gamified program, AI, and machine learning to allow for a personalized experience for users has been shown to be an effective treatment for patients with PE based on improved intravaginal ejaculatory latency times (IELT) with no reported side effects.⁴

The literature surrounding wearables in sexual medicine for vagina-owners is particularly limited. Lioness has developed a vibrator with an application to track orgasms in real time (lioness.io). The Lioness vibrator collects information such as pressure, temperature, and gyroscope measurements, and transmits the information to the application, from which the user may then look at their pelvic floor contractions and output. Though we were unable to find research on this technology in the peer-reviewed literature at the time of this paper, this technology may allow for a better understanding of one’s orgasms and enhanced sexual pleasure and confidence as one learns about their ideal orgasm conditions.⁵

Conclusion

It is an exciting time in the field of sexual medicine as more interventions are incorporating AI and wearable technologies. It is important, however, to acknowledge the ethical considerations of the intimacy of the data being collected and the paramount responsibility to protect and utilize it appropriately. Survey data suggest that device users desire clear and concise privacy policies, so they feel more comfortable using these products.⁶ Additionally, although these devices are commercially available without need for a prescription, people of lower socioeconomic status will have limited access to these devices, as they do with health care in general.⁷ This may further divide medical management of marginalized communities. Our hope is that increasing consumer trust and education of these technologies may not only lead to more use recreationally, but a more thorough understanding of normal and abnormal sexual function, as well as more objective ways of evaluating treatment efficacy for sexual dysfunctions.

References

1. Smerina DR, Pearlman AM. The intersection of artificial intelligence, wearable devices, and sexual medicine. Curr Urol Rep. 2024;26(1):14. doi:10.1007/s11934-024-01244-2

2. Tan RKJ, Perera D, Arasaratnam S, Kularathne Y. Adapting an artificial intelligence sexually transmitted diseases symptom checker tool for Mpox detection: the HeHealth experience. Sex Health. 2024;21:SH23197. doi:10.1071/SH23197

3. Winter AG, Gross K, Dubin J, Justin E. Safety of an elastomer-based hook-and-loop configuration “smart” penile constriction device worn overnight - aka: is it ok to fall asleep with this cockring? J Urol. 2024;211(suppl_5S):e769. do:i:10.1097/01.JU.0001008880.11564.10.15

4. Rodríguez JE, Picazo JA, Marzo JC, et al. Efficacy of Sphincter Control Training and medical device in the treatment of premature ejaculation: A multicenter randomized controlled clinical trial. PloS One. 2021;16(9):e0257284. doi:10.1371/journal.pone.0257284 e0257284

5. Pfaus J, Hartmann D, Wood E, Wang J, Klinger E. Women's orgasms determined by autodetection of pelvic floor muscle contractions using the Lioness “smart” vibrator. J Sex Med. 2022;19(8_suppl 3):S2-S3. doi:10.1016/j.jsxm.2022.05.011

6. Segura Anaya LH, Alsadoon A, Costadopoulos N, Prasad PWC. Ethical implications of user perceptions of wearable devices. Sci Eng Ethics. 2018;24(1):1-28. doi:10.1007/s11948-017-9872-8

7. Canali S, Schiaffonati V, Aliverti A. Challenges and recommendations for wearable devices in digital health: Data quality, interoperability, health equity, fairness. PLOS Digit Health. 2022;13;1(10):e0000104. doi:10.1371/journal.pdig.0000104