Peptide · Sexual health
PT-141 is a melanocortin-4 receptor agonist. FDA-approved as Vyleesi for hypoactive sexual desire disorder in premenopausal women, with widespread off-label use in men for erectile function.
PT-141 is a melanocortin-4 receptor agonist. FDA-approved as Vyleesi for hypoactive sexual desire disorder in premenopausal women, with widespread off-label use in men for erectile function.
PT-141 (bremelanotide) is a synthetic peptide melanocortin-4 receptor (MC4R) agonist. Unlike PDE-5 inhibitors (sildenafil, tadalafil) which work peripherally on vascular smooth muscle, PT-141 acts centrally in the brain to enhance sexual desire and arousal through dopaminergic pathways. This central mechanism makes it useful for low-libido conditions where vascular function is intact.
FDA-approved for HSDD in 2019. Off-label clinical use extensive.
Vyleesi is FDA-approved. Compounded PT-141 (often combined with tadalafil and oxytocin in custom blends) is prepared per-patient.
Common protocols:
Dosing in research and clinical-use contexts varies. Specific protocols should always be set by a prescribing clinician, not by patient-direct sources.
The most common side effects: nausea (40% in trials, often resolves with continued use), flushing, headache, and injection-site reactions. Less common: transient blood pressure increase (clinically significant in some patients with cardiovascular risk factors — pre-screening blood pressure is recommended), vomiting, focal hyperpigmentation with repeated use. Patients with uncontrolled hypertension or cardiovascular disease should not use PT-141.
The most common stack is PT-141 + tadalafil (or sildenafil) for combined central desire + vascular function in men. Some compounded formulations add oxytocin for emotional bonding and stress reduction effects. Avoid combining PT-141 with naltrexone (the MC4R agonism interaction is unfavorable).
Most peptides discussed on this page are compounded products requiring a prescription from a licensed clinician. Reputable telehealth peptide programs include physician-led oversight, accredited compounding pharmacies, and clear regulatory framing. For weight-management GLP-1 programs, see our provider reviews.
PT-141 is a melanocortin-4 receptor agonist. FDA-approved as Vyleesi for hypoactive sexual desire disorder in premenopausal women, with widespread off-label use in men for erectile function.
Vyleesi is FDA-approved. Compounded PT-141 (often combined with tadalafil and oxytocin in custom blends) is prepared per-patient.
Uses include: Sexual desire and arousal (FDA-approved as Vyleesi), Erectile function (off-label). This is research and clinical-use context, not a recommendation. Always work with a licensed clinician.
FDA-approved for HSDD in 2019. Off-label clinical use extensive.
Reported dosing: 1.25–1.75 mg subcutaneous, on demand. Actual dosing should always be determined by your prescribing clinician, not by online sources.
Onset is typically 30–60 minutes after subcutaneous injection. Effects last 4–8 hours.
Yes; the combination is common and addresses both central (desire) and peripheral (vascular) components. Talk to your prescriber about timing and dose.
About 40% of patients experience nausea on the first 1–2 doses. It typically resolves with subsequent use. Patients who stay through the first 2 doses usually tolerate it well.