Home Compounds Sexual Health & Hormonal Bremelanotide (PT-141 injectable)
Sexual Health & Hormonal Research High Evidence

Bremelanotide (PT-141 injectable)

Cyclic melanocortin peptide (same active compound as PT-141 but characterized in injectable research context). FDA-approved as Vyleesi for HSDD in premenopausal women. Studies in male sexual dysfunction ongoing.

bremelanotideMC4Rsexual arousalHSDDVyleesifemale sexual dysfunctionCNS
Half-life
2.7 hours; on-demand dosing 45 minutes before activity
SKUs
1
Evidence
High Evidence

Bremelanotide is a melanocortin receptor agonist that has been FDA-approved under the name Vyleesi for hypoactive sexual desire disorder (HSDD) in premenopausal women. It is one of two currently approved medications for this condition. It works in the brain rather than in the reproductive organs, targeting desire pathways rather than blood flow.

Female Sexual Desire Disorder
Bremelanotide was studied in the RECONNECT trials — two phase 3 randomized controlled trials in premenopausal women with HSDD. The trials showed statistically significant improvements in the number of satisfying sexual events and reductions in distress related to low desire compared to placebo.
Male Sexual Dysfunction
Earlier research examined bremelanotide in men for erectile dysfunction. While it did produce some effect, the development focus shifted to female HSDD. Some continued research interest exists in male applications but no approved use has followed.
Melanocortin System Research
The melanocortin system influences a wide range of functions including appetite, inflammation, and sexual behavior. Bremelanotide's development has contributed to a broader research interest in how melanocortin receptors in the brain regulate motivation and desire.
  • FDA-approved for hypoactive sexual desire disorder in premenopausal women based on phase 3 trial data.
  • RECONNECT trials showed increased satisfying sexual events and reduced desire-related distress compared to placebo.
  • Effects are centrally mediated — works through brain receptors, not local genital blood flow.
  • Earlier work showed effects in men but development for male indications did not advance to approval.

Bremelanotide is approved only for premenopausal women with HSDD — not for postmenopausal women, men, or as a general sexual enhancement compound. It causes transient increases in blood pressure following dosing, which limits its use in people with cardiovascular disease. Nausea is a common side effect that affected a notable portion of participants in trials. It is taken before anticipated sexual activity, not daily.

Sexual desire involves specific circuits in the brain, not just hormones or blood flow. Melanocortin receptors — particularly MC4R — are found in brain regions that regulate motivation and desire. Bremelanotide activates these receptors, which appears to turn up the signal in desire-related circuits. It is not increasing hormone levels or affecting genital blood flow directly. This is why it is described as a central treatment — it acts on brain chemistry rather than the physical mechanics of arousal. The medication is injected under the skin about 45 minutes before anticipated activity and the effect lasts for a limited window.

FDA-approved with a known safety profile. The main concerns are a transient increase in blood pressure after dosing (lasting roughly 12 hours) and nausea, which affected a significant number of participants in trials. It is contraindicated in people with high cardiovascular risk because of the blood pressure effect. It should not be taken more than once every 24 hours or more than one dose per expected sexual event.

High Evidence

This compound has been studied in multiple large randomized controlled trials with human subjects. The evidence base is strong and consistent across independent research groups.

Published Research Ranges
1.75mg SC on-demand (approved female HSDD dose); 2mg studied in males
Research Context Only: These are ranges reported in published scientific studies for educational reference. They are not dosing recommendations. This is not medical advice. Always consult a qualified healthcare professional.

Sources listed here are from the platform research library. All links open the original publication. No citations are generated by AI.

Bremelanotide for Hypoactive Sexual Desire Disorder in Women: RECONNECT Trials
Obstetrics & Gynecology • 2019  • DOI: 10.1097/AOG.0000000000003382
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Bremelanotide — An FDA-Approved Treatment for Hypoactive Sexual Desire Disorder
Drugs • 2019  • DOI: 10.1007/s40265-019-01187-w
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Melanocortin-4 Receptor Agonism and Sexual Function: Mechanism of Bremelanotide
Pharmacology & Therapeutics • 2019  • DOI: 10.1016/j.pharmthera.2019.01.005
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Phase 3 Efficacy and Safety of Subcutaneous Bremelanotide in Premenopausal Women
Journal of Sexual Medicine • 2018  • DOI: 10.1016/j.jsxm.2018.06.014
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Cognitive-behavioral group therapy for women with hypoactive sexual desire: A pilot randomized study
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Melanocortin 4 receptor agonism enhances sexual brain processing in women with hypoactive sexual desire disorder
 • 2022  • DOI: 10.1172/jci152341
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Responder Analyses from a Phase 2b Dose-Ranging Study of Bremelanotide
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Clinical Practice Strategies to Address Sexual Health in Female Cancer Survivors
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The neurobiology of bremelanotide for the treatment of hypoactive sexual desire disorder in premenopausal women
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Management of Hypertension with Female Sexual Dysfunction
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An insight into the recent developments in anti-infective potential of indole and associated hybrids
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Ligands for Melanocortin Receptors: Beyond Melanocyte-Stimulating Hormones and Adrenocorticotropin
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MC4R biased signalling and the conformational basis of biological function selections
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Hypoactive Sexual Desire Disorder in Women: Physiology, Assessment, Diagnosis, and Treatment
 • 2021  • DOI: 10.1111/jmwh.13283
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Systematic Review of l-Arginine for the Treatment of Hypoactive Sexual Desire Disorder and Related Conditions in Women
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Expert opinion on existing and developing drugs to treat female sexual dysfunction
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Understanding the Role of Serotonin in Female Hypoactive Sexual Desire Disorder and Treatment Options
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Recent Developments in Psychopharmaceutical Approaches to Treating Female Sexual Interest and Arousal Disorder
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Flibanserin for hypoactive sexual desire disorder: place in therapy
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Advances in the treatment of erectile dysfunction: what's new and upcoming?
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The Female Sexual Response: Current Models, Neurobiological Underpinnings and Agents Currently Approved or Under Investigation for the Treatment of Hypoactive Sexual Desire Disorder
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Leveraging melanocortin pathways to treat glomerular diseases
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Animal Models for the Study of Female Sexual Dysfunction
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Sexuality and breast cancer: prime time for young patients
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Usefulness of ambulatory blood pressure monitoring to assess the melanocortin receptor agonist bremelanotide
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Quality of life improvements following one year of setmelanotide in children and adult patients with Bardet-Biedl syndrome: phase 3 trial results
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Diabetes and its complications: molecular mechanisms, prevention and treatment
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Multiple Sclerosis in Women: Impact of Different Life Stages on Treatment Decisions
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The effect of melanocortin-4 receptor agonist drugs on obesity and metabolic risk factors: a systematic review and meta-analysis
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Electrophysiological and biophysical perspectives on the clitoral corpus cavernosum and its role in female sexual arousal disorder
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Overcoming Oral Cavity Barriers for Peptide Delivery Using Advanced Pharmaceutical Techniques and Nano-Formulation Platforms
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A glimpse into the pipeline of anti-obesity medication development: combining multiple receptor pathways
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Neuropeptidergic Control of Feeding: Focus on the Galanin Family of Peptides
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HPA Axis Interactions with Behavioral Systems
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Sexual health in hematopoietic stem cell transplant recipients
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Bisphenol A Interaction With Brain Development and Functions
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60 sources · Platform research library · Not generated by AI

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Research Education Only: This profile is for educational purposes only. All information is sourced from published scientific literature. This is not medical advice. Not for human consumption. Consult qualified medical professionals for any health decisions.