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The Peptide Effect
approvedSexual Health

PT-141

Also known as: Bremelanotide, Vyleesi

PT-141 (bremelanotide) is a melanocortin receptor agonist FDA-approved under the brand name Vyleesi for hypoactive sexual desire disorder (HSDD) in premenopausal women. Unlike PDE5 inhibitors such as Viagra, PT-141 acts centrally in the brain to enhance sexual desire rather than working peripherally on blood flow. It is the first and only FDA-approved on-demand treatment for low sexual desire.

Key Facts

Mechanism
PT-141 is a selective agonist of the melanocortin-4 receptor (MC4R) in the central nervous system. By activating MC4R in the hypothalamus and limbic system, it modulates dopaminergic and oxytocinergic pathways involved in sexual arousal and desire. This central mechanism of action distinguishes it from PDE5 inhibitors, which act peripherally on vascular smooth muscle. PT-141 also has some affinity for MC1R and MC3R, though its sexual effects are primarily MC4R-mediated.
Research Status
approved
Half-Life
~2.5 hours
Molecular Formula
C₅₀H₆₈N₁₄O₁₀
Primary Use
Sexual Health

Benefits

  • Treats hypoactive sexual desire disorder (HSDD) in premenopausal women — statistically significant improvement in desire and distress in Phase 3 trialsstrong
  • Centrally acting mechanism — works on brain pathways rather than requiring physical arousal to functionstrong
  • Effective for male erectile dysfunction, including cases unresponsive to PDE5 inhibitorsmoderate
  • On-demand dosing — used as needed rather than daily, providing flexibilitystrong
  • May improve both desire and arousal in women, addressing multiple aspects of female sexual dysfunctionmoderate

Dosage Protocols

RouteDosage RangeFrequencyNotes
Subcutaneous injection (FDA-approved)1.75 mgAs needed, at least 45 minutes before anticipated sexual activityMaximum 1 dose per 24 hours. FDA labeling recommends no more than 8 doses per month.
Subcutaneous injection (male off-label)1.0–2.0 mgAs needed, 1–2 hours before sexual activityNot FDA-approved for men. Doses above 2 mg do not appear to increase efficacy but do increase nausea.
Intranasal (investigational)10–20 mgAs neededEarlier clinical development used intranasal delivery, but bioavailability was poor and inconsistent. Subcutaneous injection is the approved route.

Medical disclaimer

Dosage information is provided for educational reference only. Always follow your prescriber's instructions and consult a qualified healthcare provider before starting any peptide protocol.

Side Effects

  • Nausea — occurs in over 40% of patients and is the most commonly reported side effect; usually subsides within hourscommon
  • Facial flushing and warmth — typically begins 30–60 minutes after injection and resolves spontaneouslycommon
  • Headache — reported in approximately 11% of patients in clinical trialscommon
  • Injection site reactions — redness, bruising, or itching at the subcutaneous injection sitecommon
  • Transient blood pressure increase — small, temporary rise in systolic and diastolic blood pressure; contraindicated in uncontrolled hypertensionrare
  • Skin hyperpigmentation — darkening of skin, gums, or breasts with repeated use due to residual MC1R activityrare

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Frequently Asked Questions

How is PT-141 different from Viagra?
PT-141 and Viagra work through completely different mechanisms. Viagra (sildenafil) is a PDE5 inhibitor that increases blood flow to the genitals — it helps with the physical mechanics of erection but does not affect desire. PT-141 works in the brain by activating melanocortin-4 receptors, directly enhancing sexual desire and arousal. PT-141 can be effective in men who do not respond to Viagra, and it is the only approved drug that targets sexual desire in women.
Can men use PT-141?
Yes, though it is only FDA-approved for premenopausal women with HSDD. Clinical trials in men with erectile dysfunction showed significant improvement in erection quality and sexual satisfaction. Many clinics prescribe PT-141 off-label for men, particularly those who cannot take PDE5 inhibitors due to cardiovascular concerns or who have not responded to them.
How do you manage the nausea from PT-141?
Nausea is the most common side effect, affecting about 40% of users. Strategies to reduce it include: starting with a lower dose (0.5–1.0 mg) and titrating up, taking an anti-nausea medication (ondansetron/Zofran) 30 minutes before injecting, injecting on a partially full stomach rather than fasting, and ensuring proper hydration. Most users report that nausea diminishes with subsequent uses.
How long do the effects of PT-141 last?
While the half-life of PT-141 is approximately 2.5 hours, the pro-sexual effects typically last 6–12 hours after injection, with some users reporting residual effects up to 24–36 hours. Peak effects are generally felt 1–3 hours after subcutaneous injection. The duration varies significantly between individuals.
How much does PT-141 (Vyleesi) cost?
The branded Vyleesi auto-injector has a list price of approximately $900–$1,000 per dose without insurance, making it one of the most expensive on-demand sexual health treatments. However, compounding pharmacies offer bremelanotide at significantly lower prices, typically $30–$80 per dose with a prescription. Some telehealth clinics include it in monthly subscription plans.

References

  1. 1
    Bremelanotide for Hypoactive Sexual Desire Disorder: A Randomized Clinical Trial (RECONNECT)(2019)PubMed ↗
  2. 2
    Bremelanotide: New Drug for Hypoactive Sexual Desire Disorder — FDA Approval Summary(2019)PubMed ↗
  3. 3
    Melanocortin receptor agonists, penile erection, and sexual motivation: human studies with bremelanotide(2008)PubMed ↗
  4. 4
    An evaluation of bremelanotide for the treatment of hypoactive sexual desire disorder(2018)PubMed ↗

Last updated: 2026-02-14