Overview
PT-141 (bremelanotide) is a melanocortin receptor agonist FDA-approved as Vyleesi for hypoactive sexual desire disorder (HSDD) in premenopausal women. Unlike PDE5 inhibitors (Viagra, Cialis) which act on blood flow, PT-141 works through the central nervous system to increase sexual desire. It is the only FDA-approved treatment that targets the neurological component of sexual arousal.
Mechanism of action
PT-141 activates melanocortin-4 receptors (MC4R) in the hypothalamus, which are involved in sexual arousal and desire pathways. It is a cyclic heptapeptide analog of alpha-melanocyte stimulating hormone (α-MSH). Unlike its precursor Melanotan II, PT-141 was specifically developed to isolate the sexual function effects from the tanning effects, though some melanogenesis still occurs.
Dosing protocols
| Purpose | Route | Dosage | Frequency | Notes |
|---|---|---|---|---|
| sexual desire (women - FDA approved) | subcutaneous | 1.75–1.75 mg | as needed | Inject at least 45 minutes before anticipated activity. Max 1 dose per 24 hours, max 8 doses per month. |
| erectile dysfunction (men - off-label) | subcutaneous | 1–2 mg | as needed | Start with 1mg to assess tolerance (nausea is common). Inject 1-2 hours before activity. |
Dosing information is for educational purposes only. Consult a qualified healthcare professional before using any peptide.
Research summary
FDA approval was based on two Phase III trials (RECONNECT) showing significant improvement in sexual desire and reduction in distress scores versus placebo. Earlier Phase II trials in men showed efficacy for erectile dysfunction, including in patients who did not respond to sildenafil. Common side effects: nausea (40%), flushing, headache. Nausea typically decreases with repeated use.
Side effects
Side effects vary by individual. This is not an exhaustive list. Report unusual symptoms to a healthcare professional.
Legal status
FDA-approved as Vyleesi (2019) for HSDD in premenopausal women. Available by prescription. Also available from compounding pharmacies for broader use.
Where to get it
Prescription required
PT-141 is a prescription medication. Consult your healthcare provider or a licensed telehealth platform for access.