Editors' note: This story contains language and descriptions not suited for younger readers.
Vicente is much more confident about sex these days, and he has a space-themed video game to thank for that.
The game, Myhixel Play, is part of a system from Spanish sexual health startup Myhixel that pairs a masturbation device with a simple, gamified program designed to help users overcome premature ejaculation. Using the app and the device in tandem, customers unlock new levels via real-life exercises that cultivate muscle awareness and control.
If you saw a Myhixel device sitting on a shelf, you might mistake it for a green silicone vase. Only you don't put flowers in it. No, the Myhixel is a self-heating, penetrable sleeve that delivers steady, gentle vibrations to the penis.
With the Myhixel device in hand (and on appendage), users progress through eight planets. On the first, called Kronos, they watch an animated video about the key role pelvic floor muscles play in ejaculation and then are asked to masturbate using the device while identifying the muscles they tense in the process.
"They are learning progressively to control their body and their mind," says Patricia López Trabajo, the 37-year-old founder and CEO of Myhixel.
Exercises become more challenging as users (astronauts in the game) progress. The ultimate goal: habituating the penis to maintain control during real penetration. After each exercise, players record their duration stats.
As they level up in the game, they level up their game. At least that's the idea.
Premature ejaculation, or PE, refers to ejaculation that happens sooner than a man or his partner would like. "Sooner" is subjective, of course, but from a medical perspective, PE generally describes lasting less than two to three minutes after penetration, says Dr. Michael Eisenberg, a professor of urology at Stanford University School of Medicine.
For some, PE is infrequent. Others are unable to delay ejaculation most or all of the time, which can diminish feelings of self-worth and make it difficult to establish or maintain intimate relationships.
While numerous studies have explored video games' potential detriments to mental and physical health, researchers and game developers are increasingly turning enthusiastic attention to the ways games can enhance wellness. Games help users achieve fitness goals, manage pain and chronic conditions, and understand and tackle mental health challenges like anxiety, depression, bipolar disorder, ADHD and PTSD. One game, Smokitten, even aims to help smokers quit, and another, horror title One Leaves, tries to scare teens off starting in the first place.
Myhixel Play, however, wades into uniquely personal territory.
The game's metaphors aren't subtle. Rockets stand for, well, personal rockets. There's a lot of taking off, counting down and conquering. The game's meant to be entertaining, but it also imparts serious educational information about a health concern that impacts an estimated one in three biological males between 18 and 59, according to the Urology Care Foundation.
Early blastoff, to stick with the space theme, doesn't necessarily have to be a problem. But if it bothers the team at mission control, it can lead to mental and emotional anguish, as well as considerable frustration.
Vicente knows that frustration well. The 38-year-old journalist from Madrid, who didn't want his last name used, turned to Myhixel because he found it tough to maintain control in two positions he and his partner especially enjoy. "I just exploded in a matter of seconds," he says. "I knew I had to learn to control it, for the [good] of our sex. … I wanted to both give and receive more pleasure."
PE may be the No. 1 male sexual dysfunction, but many who experience it don't fully understand the physiology, according to Trabajo. For that reason, before Myhixel Play users can journey to planets, they spend time on a virtual space station watching a video tutorial from a human-sexuality specialist, who explains in great detail, with diagrams, what goes on in the body during ejaculation. Didn't know what a urethral gate is? Now you do.
A number of apps -- including Pea (short for Premature Ejaculation App), Ejacontro, Stamena, Edge, GuyFit, Squeeze Time for Men and Kegel Nation, developed by UCSF urologists -- also attempt to combat sexual dysfunction by focusing on physical and mental exercises that help guys improve their performance. Video games like Myhixel won't ever compete with Fortnite or Call of Duty, but they do highlight the potential of games to bring fun and play to the realm of sexual well-being.
"Games are a natural language we are born with," says Jurriaan van Rijswijk, founder of Games for Health Europe, a nonprofit that advances the research and development of applied games and sponsors the annual Game for Health Europe conference. "Games are instruments for play. People play to learn the ability to adapt. That's the core essence of playing."
Trabajo is matter of fact, but not detached or clinical, when talking about male sexual health. Speaking over video chat, she's affable, with an easy smile, and comes across as genuinely passionate about helping men boost their sex lives -- and sense of self.
"Once they are learning to control their body and they are lasting more and more," she says, "they get more self-esteem."
A marketing professional in Seville, Spain, Trabajo left a position in the tourism industry for a job in European sales for Fleshlight, a US maker of male sex toys. During four years in that job, she learned that as few as 20% of men struggling with premature ejaculation seek professional treatment, largely due to shame.
Overall, Trabajo noticed that of the growing body of sex tech devices that market themselves as tools for health and wellness, more cater to women than men. There are notable exceptions, including Morari Medical's wearable little electrode-laden patch that promises to fight PE by interfering with the nerve signals from the penis to the brain to delay climax. Then there's Eddie, a wearable oval over-the counter device to treat erectile dysfunction by promoting better blood flow.
But Trabajo wanted to see even more sex tech products made for men. That's where she got the idea for pairing a pleasure device and gamification, with its inherent reward system, to help men below the belt. Myhixel, the entrepreneur says, "was a way to reach the 80% of men that don't want to go to an [in-person] consultation."
You won't find the word Myhixel in any dictionary, Spanish or otherwise. A branding agency came up with the name while toying with made-up words that "provoke masculinity," Trabajo says. The team liked that the word contains an X and a Y for the chromosomes that appear in male cells.
The company launched its system in 2019 after a successful Kickstarter campaign that tripled its goal, and has so far sold 6,000 devices, mostly in Spain and the US, with around 4,200 app activations. The Myhixel device comes in two versions and costs between $240 (£170 pounds, AU$305) and $300 (roughly 215 pounds, AU$380).
Users, Myhixel says, report lasting between four and seven times longer after completing the program.
"I think society wants us to be macho in bed," Vicente says, adding that men suffer a lot of guilt when they struggle against cultural expectations around sexual performance.
It's not surprising, then, that PE's effects can be so far-reaching.
"Men with PE show, among other negative effects, a general depressive mood related to sexual situations, more intense feelings of shame and guilt, worry and stress, and fear of failure," says Jesús E. Rodríguez, director of the Murcian Institute of Sexology in Murcia, Spain, and a member of Myhixel's science team. He has contributed to research studies, in the Journal of Sexual Medicine and elsewhere, on natural treatments for PE.
There's no FDA-approved therapy for PE, but along with topical numbing creams to decrease sensitivity, selective serotonin reuptake inhibitors such as Prozac, Zoloft, Paxil and Priligy are considered first-line therapies for delaying ejaculation. Some hesitate to take SSRIs, however, due to potential side effects or concern about having to stay on medication for life.
PE can have psychological origins, experts say, stemming from sexual abuse, poor body image, guilt about sex, or stress, which there's been no shortage of since the coronavirus pandemic hit last year. Erectile dysfunction, hormones and prostate inflammation can also be factors.
"There may also be genetic causes," Eisenberg says. "Studies have shown that certain changes in the receptors of neurotransmitters may alter one's risk of PE."
No matter the cause, it can lead to a self-defeating mental maelstrom.
"It becomes a self-fulfilling prophecy," says Zachary Zane, a Brooklyn-based sex columnist who answers sex questions on Myhixel's blog and serves as a sex expert for Promescent, which sells sexual health products including a Delay Spray for PE. "You get nervous about getting PE, and because you're nervous and thinking about it, you then ejaculate prematurely."
Video games let players survive the apocalypse, time-travel, leap off buildings and beat up bad guys, but by helping them rewire physical and psychological patterns, they also let them slay dragons, the personal kind.
Van Rijswijk of Games for Health Europe, who is not affiliated with Myhixel, is a big fan of sexual health getting gamified. And as health care continues to veer toward lifestyle intervention, he expects to see more and more such titles. "I strongly believe that this industry will grow and it will grow fast," he says.
Vicente tried other techniques before turning to Myhixel, including the classic distraction method -- trying to think of something unerotic (cleaning the garage, say, or fixing rain gutters) to slow the arousal train. It didn't help. Myhixel did, he says, because he found it entertaining and easy.
Because PE can play such maddening mind tricks, "anything that helps a man get out of his head when addressing it can be helpful," Zane says. "Making it a game is a way for men to relax and have fun while addressing their PE."
But no matter how men tackle their PE -- via behavioral therapy, medication, exercise apps or visiting digital planets -- Vicente wants to bust the stigma and help them let go of shame.
"First thing is accept you have something to improve and want to improve it," Vicente says. "I admitted it and now I'm feeling way better than I was."