PT-141 (Bremelanotide): The New Libido / Sexual-Response Peptide
What is PT-141?
PT-141, commercially known as bremelanotide (brand name Vyleesi), is a synthetic peptide and a melanocortin receptor agonist developed to treat problems of sexual desire. Unlike drugs that act on blood flow, PT-141 works centrally in the brain to stimulate neural pathways of sexual desire and arousal. The FDA approved bremelanotide in 2019 for acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women.
How PT-141 Works — Mechanism of Action
PT-141 targets melanocortin receptors (notably MC3R and MC4R) in brain regions that regulate sexual motivation, reward, and arousal—such as the medial preoptic area and hypothalamus. Activation of these receptors modulates neurotransmitter systems (including dopamine) that are key to sexual desire. Because PT-141 acts on central neural circuits, it is mechanistically distinct from PDE5 inhibitors (e.g., sildenafil) that primarily increase genital blood flow. Animal and human studies support this central mechanism. Read More
Evidence from Clinical Trials
The efficacy and safety of bremelanotide were established in two large randomized, double-blind, placebo-controlled Phase III trials (the RECONNECT program) that enrolled premenopausal women with acquired, generalized HSDD. These studies demonstrated statistically significant improvements in sexual desire measures and reductions in distress related to low desire versus placebo. Follow-up and open-label studies suggest benefits can be sustained with on-demand dosing. Read More
A 2019 review and FDA clinical summary detail trial outcomes, responder rates, and recommended dosing (1.75 mg subcutaneous injection as needed, up to once per 24 hours, and no more than 8 doses per month). Clinicians should counsel patients to discontinue after 8 weeks without benefit. Read More
Typical Use & Dosing
For approved use in premenopausal women with HSDD, bremelanotide is given as a 1.75 mg subcutaneous self-injection approximately 45 minutes prior to anticipated sexual activity. It is prescribed on an on-demand basis rather than as continuous daily therapy. The FDA label and product information outline administration details, contraindications, and monitoring recommendations. Read More
Safety Profile & Side Effects
Common side effects reported in trials include nausea, flushing, injection-site reactions, headache, and transient increases in blood pressure. Because of potential blood-pressure effects, bremelanotide is contraindicated in patients with uncontrolled hypertension or known cardiovascular disease. The FDA label provides detailed safety guidance, recommended monitoring, and contraindications. Overall, most adverse events were mild to moderate, and serious adverse events were uncommon in trial populations. Read More
Research Gaps & Future Directions
Open questions include long-term safety in broader populations, effectiveness in men and postmenopausal women, combination strategies (with hormonal or psychotherapeutic approaches), and mechanistic refinements to target receptor subtypes. Ongoing research continues to explore melanocortin pathways and their broader role in sexual behavior and metabolic regulation. Read More
How Dr. Dubroff Effectively Resolves Common PT-141 Challenges
Dr. Dubroff helps patients overcome common PT-141 issues by personalizing dosing, reducing nausea through gradual titration, monitoring blood pressure closely, and identifying underlying hormonal or metabolic imbalances. He also adjusts timing, provides supportive therapies, and ensures patients are properly screened to avoid side effects. Through careful follow-up and individualized protocols, Dr. Dubroff maximizes PT-141 effectiveness while minimizing discomfort, helping patients achieve safer and more consistent libido-enhancing results.