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# PT-141

High Evidence 

A melanocortin receptor agonist FDA-approved for hypoactive sexual desire disorder in premenopausal women.

Aliases Bremelanotide +1 more 

Evidence High Evidence 

Last Updated  2026-07-21 

Reading Time  2 min 

## Table of Contents

1.  [What It Is](#what-it-is)
2.  [Regulatory Status](#regulatory-status)
3.  [Why Researchers Study It](#why-researchers-study)
4.  [Proposed Mechanisms](#proposed-mechanisms)
5.  [Evidence Snapshot](#evidence-snapshot)
6.  [Commonly Discussed Benefits](#benefits)
7.  [Safety & Cautions](#safety)
8.  [Comparisons](#comparisons)
9.  [Calculator Tools](#calculator)
10.  [Citations](#citations)

## What It Is

PT-141 (bremelanotide, brand name Vyleesi) is a synthetic melanocortin peptide and the only FDA-approved treatment that targets the central nervous system to address sexual desire. Unlike PDE5 inhibitors such as sildenafil or tadalafil, which act peripherally on blood flow, PT-141 engages MC3R and MC4R receptors in the hypothalamus and brainstem — brain regions that regulate appetite, sexual behavior, and arousal. The FDA approved bremelanotide in June 2019 for acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. It is administered as a subcutaneous injection at least 45 minutes before anticipated sexual activity. In pivotal Phase 3 trials (RECONNECT), 34% of bremelanotide-treated participants reported clinically meaningful improvement in desire compared to 9% on placebo. Nausea was the most common adverse event, affecting up to 40% of trial participants, though only 8.1% discontinued due to nausea. Bremelanotide causes a transient increase in blood pressure (approximately 6 mmHg systolic, 3 mmHg diastolic) and is contraindicated in patients with uncontrolled hypertension or cardiovascular disease. As of 2026, there is no FDA-approved indication for PT-141 in men, though preclinical and early clinical data demonstrated efficacy in male erectile dysfunction via the same central melanocortin pathway. The FDA's April 2026 Category 2 removal does not apply to PT-141, as it is already an approved drug. Ongoing research is exploring melanocortin receptor agonists for broader applications including eating disorders and social cognition.

Also known as:  Bremelanotide, Vyleesi 

## Regulatory Status

FDA-Approved 

Approved June 2019 as Vyleesi for acquired, generalized HSDD in premenopausal women. Subcutaneous injection, prescribed by licensed providers. Not approved for use in men.

Effective: June 2019

[View FDA Source](https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/210557s000lbl.pdf)

## Why Researchers Study It

PT-141 is unique among sexual health compounds because it acts on brain circuits rather than vascular mechanisms. Its melanocortin receptor agonism provides a mechanistically distinct approach to desire disorders, making it a valuable research tool for understanding the neurobiology of sexual motivation and arousal.

## Proposed Mechanisms

-   Activates MC3R and MC4R melanocortin receptors in the hypothalamus and brainstem
-   Modulates dopaminergic pathways involved in sexual motivation and reward
-   Influences oxytocin release, which plays a role in arousal and bonding
-   Acts centrally on desire circuits rather than peripheral vascular targets

## Evidence Snapshot

High Evidence 

Low 

Medium 

High 

Study Type

Model

Outcome

Link

Phase 3 RCT (RECONNECT)

Premenopausal women with HSDD

34% of bremelanotide group reported meaningful improvement vs 9% placebo; statistically significant increase in desire and reduction in distress

[Source](https://pubmed.ncbi.nlm.nih.gov/31286093/)

Phase 2 RCT

Men with erectile dysfunction

51 subjects (34%) in bremelanotide group achieved erections sufficient for intercourse vs 9% placebo

[Source](https://pubmed.ncbi.nlm.nih.gov/12851303/)

Phase 1

Healthy males and females co-administered with ethanol

No clinically significant pharmacokinetic interaction with ethanol; safety profile maintained

[Source](https://www.sciencedirect.com/science/article/pii/S0149291817300565)

## Commonly Discussed Benefits

[Sexual Health](/benefits/sexual-health)

Researching PT-141 ? Track it, set reminders, and keep notes in the free app.

[Track in App](https://app.peptrackerpro.com/?add=pt-141)

## Safety & Cautions

-   FDA-approved only for HSDD in premenopausal women
-   Common side effects include nausea and flushing
-   May increase blood pressure temporarily
-   Must be prescribed and supervised by a physician
-   Not for use in men (off-label use not recommended here)

## Comparisons

See how PT-141 compares to related peptides:

[PT-141 vs Difelikefalin](/compare/pt-141-vs-difelikefalin) [PT-141 vs Kisspeptin-10](/compare/pt-141-vs-kisspeptin-10) [PT-141 vs MT-2 (Melanotan II)](/compare/pt-141-vs-mt-2) [PT-141 vs Oxytocin](/compare/pt-141-vs-oxytocin) [PT-141 vs Setmelanotide](/compare/pt-141-vs-setmelanotide)

## Calculator Tools

Use our research tools to explore dosing and reconstitution data:

[Reconstitution Calculator](/calculators)

## Citations

1.  \[1\]  Kingsberg SA. et al. — Bremelanotide for HSDD in premenopausal women: RECONNECT Phase 3 trials. Obstet Gynecol. 2019 [PubMed](https://pubmed.ncbi.nlm.nih.gov/31286093/)
2.  \[2\]  FDA Approval — Vyleesi (bremelanotide) prescribing information. 2019 [PubMed](https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/210557s000lbl.pdf)
3.  \[3\]  Diamond LE. et al. — PT-141 for erectile dysfunction: a melanocortin receptor agonist. Int J Impot Res. 2004 [PubMed](https://pubmed.ncbi.nlm.nih.gov/12851303/)

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## Related Peptides

### Difelikefalin

High Evidence 

Difelikefalin (Korsuva in the U.S., Kapruvia in Europe) is a synthetic tetrapeptide built entirely from D-amino acids - D-Phe-D-Phe-D-Leu-D-Lys capped with a 4-aminopiperidine-4-carboxylic acid - that acts as a selective agonist at the kappa opioid receptor. Its defining property is what it cannot do: the molecule is hydrophilic and bulky enough that it does not meaningfully cross the blood-brain barrier, so it reaches kappa receptors on peripheral sensory nerve endings, keratinocytes and immune cells while leaving the central kappa receptors that produce dysphoria and hallucinations largely untouched. It has no activity at the mu opioid receptor, so it carries neither euphoria nor respiratory depression. In the Phase 3 KALM-1 and KALM-2 trials in hemodialysis patients with moderate-to-severe chronic-kidney-disease-associated pruritus, roughly 40-51% of difelikefalin-treated patients achieved a clinically meaningful (>=3-point) reduction on the 10-point Worst Itching Intensity NRS at 12 weeks versus roughly 20-28% on placebo. The FDA approved intravenous difelikefalin in August 2021; the EU approved it as Kapruvia in April 2022.

[Pain Relief](/benefits/pain-relief)[Inflammation](/benefits/inflammation)[Skin](/benefits/skin)[disease-modification](/benefits/disease-modification)+1 more 

[View Details](/peptides/difelikefalin) [\+ Compare](/compare?select=difelikefalin)[](https://app.peptrackerpro.com/?add=difelikefalin)

### Kisspeptin-10

Medium Evidence 

A neuropeptide that stimulates GnRH release, studied for fertility and reproductive hormone regulation.

[Fertility](/benefits/fertility)[Hormone Support](/benefits/hormone-support)[Sexual Health](/benefits/sexual-health)

[View Details](/peptides/kisspeptin-10) [\+ Compare](/compare?select=kisspeptin-10)[](https://app.peptrackerpro.com/?add=kisspeptin-10)

### MT-2 (Melanotan II)

Medium Evidence 

A melanocortin receptor agonist studied for tanning, sexual function, and appetite suppression.

[Pigmentation](/benefits/pigmentation)[Sexual Health](/benefits/sexual-health)[Fat Loss](/benefits/fat-loss)

[View Details](/peptides/mt-2) [\+ Compare](/compare?select=mt-2)[](https://app.peptrackerpro.com/?add=mt-2)

### Oxytocin

High Evidence 

A neuropeptide involved in social bonding, mood regulation, and reproductive functions.

[Mood](/benefits/mood)[Anxiety Relief](/benefits/anxiety-relief)[Hormone Support](/benefits/hormone-support)

[View Details](/peptides/oxytocin) [\+ Compare](/compare?select=oxytocin)[](https://app.peptrackerpro.com/?add=oxytocin)

### Setmelanotide

High Evidence 

A once-daily subcutaneous cyclic octapeptide melanocortin-4 receptor (MC4R) agonist, FDA-approved for several rare genetic and acquired forms of obesity that act through the leptin-melanocortin pathway.

[rare genetic obesity](</benefits/rare genetic obesity>)[appetite regulation](</benefits/appetite regulation>)[weight management](</benefits/weight management>)

[View Details](/peptides/setmelanotide) [\+ Compare](/compare?select=setmelanotide)[](https://app.peptrackerpro.com/?add=setmelanotide)

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