PT-141 (Bremelanotide)

Synthetic melanocortin receptor agonist acting primarily on MC3R and MC4R in the central nervous system. FDA-approved for hypoactive sexual desire disorder in premenopausal women (Vyleesi). Induces sexual arousal via hypothalamic pathways independent of vascular mechanisms. Does not require nitric oxide or PDE5 pathways.

Half-life

2.7 hours

Bioavailability

Systemic via subcutaneous injection

Route

subcutaneous

Evidence tier

T1 — Multiple RCTs

References

2 peer-reviewed

Dose ranges

Three tiers ordered by aggressiveness. Tier chips on every OPTIMIZE intervention let you filter the catalog by your evidence tolerance.

conservative

0.5–1 mg as needed

Initial tolerability

moderate

1.75 mg as needed

FDA-approved dose

aggressive

2 mg as needed

Maximum dose (not recommended >1.75mg)

Monitoring

blood-pressure

Contraindications

uncontrolled-hypertension
cardiovascular-disease

References

PMID:31141449Bremelanotide for the treatment of hypoactive sexual desire disorder — Expert Opin Pharmacother, 2019
PMID:27152895Bremelanotide: a melanocortin receptor agonist for female sexual dysfunction — Curr Opin Obstet Gynecol, 2016

Notes

PT-141 is the only FDA-approved peptide that works through central nervous system arousal. PDE5 inhibitors increase blood flow. PT-141 increases desire. Different pathway entirely. The nausea is the most common side effect and it is dose-dependent — start at half the approved dose to assess tolerance. The melanocortin system is one of the most underappreciated signaling networks in human pharmacology. PT-141 is the proof of concept.

This is not medical advice

Discuss with a licensed clinician before starting, stopping, or changing any compound. This page documents what the research literature describes — it is not a prescription.

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