Bremelanotide (Peptide PT-141)

What it is

PT-141 (also known by its drug name Bremelanotide) is a synthetic cyclic peptide that acts as an agonist at melanocortin receptors in the central nervous system.  

It is approved in the U.S. under the brand name Vyleesi for the treatment of hypoactive sexual desire disorder (HSDD) in pre-menopausal women.  

Off-label uses in men and in broader sexual wellness protocols are increasingly being offered (though evidence remains less robust in some areas).  

How it works

• PT-141 stimulates melanocortin receptors (notably MC3R & MC4R) in the hypothalamus and other brain regions which modulate sexual desire, arousal and behaviour.  
• Unlike PDE5 inhibitors (which predominantly work via vascular blood-flow pathways), PT-141 targets the neural/desire axis — enhancing libido, arousal and potentially orgasmic response.  
• Onset of action is relatively rapid in studies (often within ~30-60 minutes) in approved settings.  

What it treats & benefits

• Approved indication: HSDD (low sexual desire) in pre-menopausal women with no medical/relationship causes.  
• Off-label uses:
  • Men with erectile dysfunction or low libido (especially when vascular treatments are insufficient).  
  • Women (peri-/menopausal) seeking libido/sexual wellness support.  
• Benefits may include increased sexual desire, more frequent satisfying sexual events, improved arousal/sensation, and enhanced intimacy/confidence.

Treatment process & expectations

• Consultation & screening: Medical history, assessment of sexual dysfunction, exclusion of underlying pathologies (cardiovascular, psychiatric, hormonal, relationship factors).
• Administration: Typically subcutaneous injection (abdomen/thigh) about 45 minutes before sexual activity for women (approved use).  
• Dosage & frequency: For approved use in women: 1.75 mg dose as needed. In off-label settings and in men, protocols vary.  
• Onset & duration: Many experience effects within an hour; duration of effect may vary; repeat use may be needed (within safe limits).
• Monitoring & follow-up: For off-label or wellness usage, monitoring side effects, cardiovascular status, and realistic goals is critical.

Risks, side-effects & safety considerations

• Common side effects: flushing, nausea, headache, injection site reactions.  
• Contraindications include uncontrolled hypertension, cardiovascular disease, and other conditions (because PT-141 can modestly raise blood pressure and affect heart rate).  
• Long-term safety data in off-label populations (men, frequent use) remain limited. Patients should have realistic expectations and be under medical supervision.
• As with all sexual wellness treatments, psychological, relational and lifestyle factors should be addressed in parallel.