PT-141 (Bremelanotide) is a synthetic peptide of 7 amino acids developed from Melanotan II to treat sexual dysfunction. Approved by the FDA in 2019 (Vyleesi®) for Hypoactive Sexual Desire Disorder (HSDD) in premenopausal women. Unlike Viagra/Cialis which act on the vascular system, PT-141 works directly on the central nervous system, activating brain pathways of sexual arousal.

Main Benefits:

• Significant increase in sexual desire and libido (men and women)

• Treatment of erectile dysfunction, especially in non-responders to PDE-5 inhibitors

• Intense and frequent erections (lasting 2-6 hours)

• Improved genital arousal and sexual satisfaction

• Overcoming psychological barriers to intimacy

• Reducing performance anxiety

• Direct brain action - acts on the source of desire.

• Quick start (30-60 minutes) with extended duration (12 hours-3 days)

• Non-hormonal, effective for both sexes

Typical Dosages:

• Women (FDA-approved): 1.75 mg subcutaneously, 45 minutes before sexual activity.

• Men (off-label): 0.5-3 mg subcutaneously, 30-60 minutes before sexual activity.

• Administration: Subcutaneous injection (abdomen/thigh) or nasal spray.

• Frequency: As needed (on-demand)

Mechanism of Action:

PT-141 is an agonist of melanocortin receptors (MC1R, MC4R, MC3R, MC5R, MC2R). It activates MC4R receptors in the central nervous system, stimulating dopamine in the medial preoptic area and releasing nitric oxide. Result: increases sexual desire via the brain AND improves genital blood flow simultaneously – a unique dual mechanism compared to conventional treatments.

Clinical Evidence:

• 2006 Study: More women with moderate/high sexual desire vs. placebo (P=0.0114)

• Phase IIB Trial: Significant improvement in IIEF scores in men with ED due to diabetes

• 33% of non-responders to Viagra achieved adequate erection with PT-141

• PT-141 + Sildenafil combination superior to Sildenafil alone

• FDA approved for women with HSDD based on multiple clinical trials

Common Combinations:

• PT-141 + Sildenafil/Tadalafil: Synergism (complementary mechanisms)

• PT-141 + Trimix/Quadmix: Ideal for refractory cases

• Compatible with testosterone therapy

Side Effects:

• Common (temporary): Mild nausea, facial flushing, headache

• Less common: Slight changes in pigmentation, darkening of moles

• Generally mild, dose-dependent, and resolve quickly.

Contraindications:

• Uncontrolled cardiovascular disease/hypertension

• Pregnancy and breastfeeding

• Use with naltrexone

Legal Status:

• FDA-approved ONLY for women with HSDD (USA)

• Use in men is OFF-LABEL (legal but not officially approved)

• Medical prescription required

• It is NOT a controlled substance

• WADA: Not prohibited in sports

Important Note: PT-141 represents a revolutionary advance in sexual medicine by working directly on the brain's arousal pathways. It offers an option for cases refractory to conventional treatments and addresses the psychological component of sexual dysfunction. Requires a medical prescription and professional supervision. Avoid the black market for peptides (risk of adulterated product).