PT-141 (Bremelanotide)
PT-141 (bremelanotide) is FDA-approved under the brand name Vyleesi as an on-demand subcutaneous injection for hypoactive sexual desire disorder (HSDD) in premenopausal women, while its use in men for erectile dysfunction or libido is off-label and not an FDA-approved indication.
This page is a research-orientation summary, not a dosing guide. For anything beyond general background, read the primary literature or talk to a qualified clinician — specifics like amount, frequency, or administration aren't something we publish here.
What it does & how it works
Bremelanotide is a synthetic cyclic heptapeptide analog of alpha-melanocyte-stimulating hormone (α-MSH) that acts as a nonselective agonist at melanocortin receptors, with primary activity at MC4R and MC3R in the central nervous system, particularly hypothalamic circuits. Activation of MC4R on hypothalamic neurons is believed to increase dopaminergic tone in mesolimbic reward pathways associated with sexual arousal and desire, a mechanism distinct from the vascular, nitric-oxide-based action of PDE5 inhibitors used for erectile dysfunction.
Typical results seen in research
In the pivotal RECONNECT phase 3 trials supporting FDA approval, bremelanotide produced statistically significant improvements in self-reported sexual desire and reductions in distress related to low desire compared with placebo in premenopausal women with HSDD, with effects on desire but not necessarily on frequency of satisfying sexual events. In men, early-phase clinical studies of the melanocortin agonist approach (including work that led to bremelanotide's development) showed it could induce erections independent of sexual stimulation and increase measures of sexual desire, but this use has not been evaluated in FDA-approved trials for a male indication. Common effects reported in trials include nausea, flushing, and transient increases in blood pressure.
How it’s commonly used
Vyleesi is self-administered by subcutaneous injection using a single-dose auto-injector, used on an as-needed basis in anticipation of sexual activity rather than on a fixed daily schedule; off-label formulations are also compounded as subcutaneous injections or nasal sprays.
- Annals of the New York Academy of Sciences · 2003 PT-141: a melanocortin agonist for the treatment of sexual dysfunction
- International Journal of Impotence Research · 2004 Double-blind, placebo-controlled evaluation of the safety, pharmacokinetic properties and pharmacodynamic effects of intranasal PT-141, a melanocortin receptor agonist, in healthy males and patients with mild-to-moderate erectile dysfunction
Curated from published literature for research orientation. Not an exhaustive review, and not a substitute for reading primary sources.