PT-141: Bremelanotide — melanocortin agonist
A melanocortin receptor agonist that acts in the brain to increase sexual desire — FDA-approved (as Vyleesi) for premenopausal HSDD.
What is PT-141?
PT-141 (bremelanotide) is a melanocortin receptor agonist that works centrally in the brain to increase sexual desire and arousal. Unlike PDE5 inhibitors (which act on blood flow), it targets the melanocortin system in the hypothalamus. As Vyleesi, it is FDA-approved for hypoactive sexual desire disorder (HSDD) in premenopausal women; use in men or for erectile function is off-label.
How PT-141 works (mechanism)
By activating melanocortin receptors (notably MC4R) in the central nervous system, bremelanotide modulates the brain pathways involved in sexual desire and arousal [1]. This central mechanism is distinct from erectile-dysfunction drugs that act on peripheral blood vessels.
Why it's studied / reported uses
Hypoactive sexual desire disorder (approved)
The Phase 3 RECONNECT trials in premenopausal women with HSDD showed statistically significant improvements in sexual desire and in distress over low desire with 1.75 mg used as needed; the average real-world benefit was modest [1]. This is the FDA-approved indication (Vyleesi).
Off-label use
PT-141 is also used off-label by men and for erectile/libido support. These uses are not FDA-approved and are less well characterised.
Dosing reported in studies
Route: subcutaneous
FDA-approved bremelanotide dose for HSDD in premenopausal women.
Sources: Kingsberg et al. (2019) — Obstet Gynecol
Can transiently raise blood pressure; an approved human dose exists. These figures reflect what studies or protocols reported — not a recommendation and not tailored to you.
Calculate a dose in the reconstitution calculator →Safety & side effects
The most common effects are nausea, flushing and headache. Bremelanotide can cause a transient increase in blood pressure and decrease in heart rate after each dose, so it is not recommended for people with uncontrolled hypertension or cardiovascular disease, and the approved label limits it to once per day and 8 times per month. It can also cause focal skin/gum hyperpigmentation with repeated use. Discuss with a licensed physician.
Studies & references
- Bremelanotide for hypoactive sexual desire disorder (RECONNECT Phase 3 trials) — PubMed 30969214 (Kingsberg et al., Obstet Gynecol 2019)
Frequently asked questions
Is PT-141 FDA-approved?
Yes — as bremelanotide (Vyleesi) for hypoactive sexual desire disorder in premenopausal women. Use in men or for erectile function is off-label.
How does PT-141 work?
It activates melanocortin receptors in the brain to increase sexual desire and arousal — a central mechanism, unlike Viagra-type drugs that act on blood flow.
How is PT-141 dosed?
The approved dose is 1.75 mg subcutaneously as needed, about 45 minutes before activity, with a limit of once per day and 8 times per month (see the dosing section).
What are the side effects?
Commonly nausea, flushing and headache; it can transiently raise blood pressure, so it's avoided in uncontrolled hypertension or cardiovascular disease. Repeated use can cause skin pigmentation changes.
⚠ Research & educational use only. This page is compiled from published research and does not constitute medical advice. PT-141 is FDA-approved as bremelanotide (Vyleesi) for premenopausal HSDD; other uses are off-label. Nothing here is a recommendation to use or a prescription. Safe use can only be determined by a licensed physician. Last updated 2026-07-06.