Peptide Profile
PT-141 (Bremelanotide)
The first FDA-approved peptide that works through your brain to reignite sexual desire—think of it as flipping the 'on' switch for arousal rather than just boosting blood flow like traditional ED meds.
Dose Range
1.75-2mg
Frequency
As needed
Route
Subcutaneous injection
Cycle Length
Ongoing/indefinite
Onset
Rapid (hours to days)
Evidence
Strong
Compound Profile
Scientific & Efficacy Data
C50H68N14O10
Molecular Formula
1025.2 g/mol
Molecular Weight
Developed By · 2000
Palatin Technologies research team
Palatin Technologies, Inc.
Primary Benefits
Directly activates brain pathways controlling sexual motivation, with FDA approval based on significant improvements in desire scores
Works within 45-60 minutes and lasts several hours, providing flexibility without daily dosing commitment
One of the most thoroughly studied sexual health peptides, with Phase 3 trials, FDA approval, and long-term safety data
Amino Acid Sequence
Ac-Nle-cyclo[Asp-His-D-Phe-Arg-Trp-Lys]-OHDosing
How much
do I take?
Starting Dose
1 mg
Starting low helps you gauge your response to nausea, which is the most common side effect. If you tolerate 1mg well, you can increase to the standard dose. Never take more than one dose in 24 hours.
Standard Dose
1.75 mg
This is the FDA-approved dose for treating HSDD in women. Clinical trials showed this dose provides the best balance of effectiveness and tolerability. Don't exceed 8 doses per month.
Advanced Dose
2 mg
Some research protocols and clinicians use up to 2mg, though 1.75mg is the FDA-approved dose. Higher doses increase the risk of nausea without necessarily improving effectiveness. Stay within the 8 doses per month limit.
Timing
Best time to take
Take PT-141 at least 45 minutes before anticipated sexual activity. Effects typically begin within 45-60 minutes and can last several hours. Some people find it works better with 60-90 minutes lead time.
With food?
Taking PT-141 on an empty stomach may increase nausea. A light meal or snack beforehand can help reduce stomach upset without significantly affecting absorption.
If stacking
PT-141 is typically used as a standalone treatment. Its unique mechanism of action through melanocortin receptors means it doesn't directly interact with most other peptides, but consult your healthcare provider before combining with other treatments.
Adjusting Your Dose
Increase if
- +You tolerate the starting dose with minimal nausea
- +Effects feel insufficient after multiple tries at current dose
- +Your healthcare provider recommends adjustment based on your response
Decrease if
- -Nausea is severe or interferes with the experience
- -You experience significant blood pressure increases
- -Flushing or headaches are uncomfortable
- -Side effects outweigh the benefits
Signs of right dose
- ✓Noticeable increase in sexual desire within 1-2 hours
- ✓Manageable or no nausea
- ✓Enhanced arousal response during intimacy
- ✓No significant blood pressure changes
Dosing Calculator
Calculate Your Exact Dose
Amount to Draw
10
units
Suitability
Is this
right for me?
Best For
Women with Low Sexual Desire (HSDD)
PT-141 is FDA-approved specifically for premenopausal women with acquired, generalized hypoactive sexual desire disorder—when you used to have normal desire but it's faded, and it's causing real distress in your life. It's the only approved treatment that works through brain pathways rather than hormones.
Men Who Don't Respond to Viagra-Type Medications
While not FDA-approved for men, clinical research shows PT-141 may help men with erectile dysfunction who don't respond to PDE5 inhibitors like Viagra or Cialis. Because it works through the brain rather than blood vessels, it offers a completely different approach.
Those Wanting On-Demand Treatment
Unlike daily medications like flibanserin (Addyi), PT-141 is used only when you want it—take it 45 minutes before intimacy. This gives you control over timing without committing to daily pills.
People Seeking to Address the 'Wanting' Part of Intimacy
Many sexual health treatments focus on the physical mechanics (blood flow, lubrication). PT-141 is unique because it targets desire itself—the psychological 'wanting' that initiates intimacy. It works on your brain's arousal circuits.
Consider Alternatives If
Who Should Avoid
Do not use if
- ×You have uncontrolled high blood pressure—PT-141 causes temporary BP increases
- ×You have cardiovascular disease or history of heart attack/stroke
- ×You are pregnant or trying to become pregnant—effects on fetus unknown
- ×You are breastfeeding—the drug may pass into breast milk
- ×You take medications that strongly interact with melanocortin pathways
- ×You have had a severe allergic reaction to bremelanotide or any peptide
Use with caution if
- !You have controlled hypertension—monitor blood pressure before and after use
- !You take blood pressure medications—effects may compound or counteract
- !You have a history of depression or mental health conditions
- !You have liver or kidney disease—metabolism may be affected
- !You are taking naltrexone—it may reduce PT-141's effectiveness
- !You have dark skin—focal hyperpigmentation is more likely with repeated use
Administration
How do I
use it?
Reconstitution
What you need
- •Bacteriostatic water (BAC water)—contains preservative for multi-dose use
- •Insulin syringes (29-31 gauge) for injection
- •Alcohol swabs for cleaning vial tops and injection sites
- •Your PT-141 powder vial
Injection
Route
Subcutaneous injection (just under the skin)—this is how the FDA-approved Vyleesi autoinjector delivers the dose
Best sites
- •Abdomen (about 2 inches away from belly button)—FDA recommended site
- •Front or outer thigh (middle section)
- •Back of upper arm (if someone can help)
Technique
- 1.Wash your hands thoroughly with soap and water
- 2.Clean the injection site with an alcohol swab and let it dry completely
- 3.If using a syringe: pinch about an inch of skin to create a fold
- 4.Insert the needle at a 45-90 degree angle (45 if lean, 90 if more tissue)
- 5.Inject slowly and steadily over a few seconds
- 6.Wait 5 seconds before withdrawing the needle
- 7.Apply light pressure with a clean cotton ball if needed—don't rub
Storage
Signs of degradation
Sample Daily Schedule
Safety
Is it
safe?
Safety Profile
PT-141 has undergone rigorous FDA review and was approved in 2019 based on two large Phase 3 clinical trials involving over 1,200 women. The most common side effect is nausea (affecting about 40% of users), which typically decreases with repeated use. The drug causes transient increases in blood pressure (average 2-3 mmHg) and slight decreases in heart rate, which is why it's contraindicated in uncontrolled hypertension. Long-term safety data from the 52-week extension study showed no new safety concerns.
PT-141 (as Vyleesi) has strong safety data from FDA-required Phase 3 trials and ongoing post-marketing surveillance. It's one of the most thoroughly studied peptides for sexual health. The clinical trials were conducted by Palatin Technologies and AMAG Pharmaceuticals with FDA oversight.
Common Side Effects
Experienced by some users
Nausea
The most common side effect, affecting about 40% of users in clinical trials. It typically occurs within the first hour and resolves on its own.
Management: Eat a light snack before your dose. Start with a lower dose (1mg) to test tolerance. Anti-nausea medications like ginger or ondansetron may help. Nausea often decreases with repeated use.
Facial flushing
About 20% of users experience warmth and redness in the face. This is related to the melanocortin receptors affecting blood vessels.
Management: This is usually mild and temporary. Stay hydrated and avoid alcohol, which can worsen flushing. It typically subsides within 1-2 hours.
Headache
Reported by about 12% of users, headaches are usually mild and similar to a tension headache.
Management: Stay well-hydrated. Over-the-counter pain relievers like acetaminophen can help if needed. Headaches typically resolve within a few hours.
Injection site reactions
Redness, itching, or minor bruising at the injection site is common with any subcutaneous injection.
Management: Rotate injection sites between abdomen and thighs. Ensure proper technique with clean, appropriate-gauge needles. A cool compress can help.
Less Common
- •Skin darkening (hyperpigmentation)
These typically resolve with continued use or dose adjustment.
Stop and Seek Help If
- ×Severe nausea that makes the experience unpleasant or affects your health
- ×Significant blood pressure increases, especially if you feel chest discomfort or severe headache
- ×Noticeable skin darkening that concerns you (may be irreversible)
- ×Any signs of allergic reaction—hives, swelling, difficulty breathing
- ×The medication isn't providing the desired effect after multiple attempts
- ×You become pregnant or are trying to conceive
PT-141 (Vyleesi) is an FDA-approved medication, but it should be used under healthcare provider supervision. This information is educational—always consult your doctor about starting, stopping, or adjusting any medication. Report any unexpected side effects to your healthcare provider.
Interactions
With other peptides
- !Both act on melanocortin receptors. Combining them increases risk of side effects including nausea, blood pressure changes, and hyperpigmentation. Avoid using together.
- ✓May complement PT-141 by enhancing emotional bonding aspects of intimacy. Generally considered safe to combine, but research is limited.
- ✓No known direct interactions. BPC-157 works on different pathways (healing and gut health). Can likely be used in the same overall protocol.
With medications
- !Blood pressure medications - PT-141 affects blood pressure. Combining with antihypertensives may have unpredictable effects. Use only under medical supervision with monitoring.
- !Naltrexone - Naltrexone blocks opioid receptors and may reduce PT-141's effectiveness through overlapping neural pathways. Effectiveness may be diminished.
- !PDE5 inhibitors (Viagra, Cialis) - Both affect cardiovascular parameters. While sometimes combined in research for ED, this should only be done under medical supervision due to additive effects.
- !MAO inhibitors - PT-141 affects dopamine and norepinephrine release. MAOIs can dangerously amplify these effects. Avoid combining.
With supplements
- ✓Ginger - Can help manage PT-141's nausea side effect. Safe and potentially helpful to take before your dose.
- ✓Caffeine - Both can affect blood pressure and heart rate. Moderate caffeine is probably fine, but avoid large amounts close to your PT-141 dose.
- ✓Alcohol - Can worsen flushing and nausea, and may affect sexual response. Best to minimize alcohol when using PT-141.
- ✓L-arginine - Both affect blood flow mechanisms. No known dangerous interactions, but effects may add up. Monitor how you feel.
Effectiveness
Does it
work?
Evidence Level
Strong human trials
What to Expect
First dose (Day 1)
What you might notice
- •Nausea within 30-60 minutes (most common side effect)
- •Facial flushing or feeling warm
- •Sexual desire effects beginning around 45-60 minutes
- •Effects lasting several hours
What's normal
- •Mild to moderate nausea that resolves on its own
- •Warmth in face and chest area
- •Gradual increase in feelings of desire or arousal
- •Subtle changes—this isn't an instant 'switch flip' for everyone
What's next
- →Note your response to gauge future dosing
- →If nausea was severe, consider eating beforehand next time
- →Wait at least 24 hours before considering another dose
- →Many people find effects improve with experience
First few uses
What you might notice
- •Nausea often decreases with repeated use
- •You learn your optimal timing (some need 60-90 minutes)
- •Effects may feel more predictable
- •Better understanding of what to expect
What's normal
- •Some variation in effect from dose to dose
- •Learning what food/timing works best for you
- •Mild side effects that are manageable
- •Clearer sense of whether PT-141 is working for you
What's next
- →Establish your personal protocol based on experience
- →Discuss with your healthcare provider if effects are inadequate
- →Stay within 8 doses per month maximum
- →Monitor for any skin changes with ongoing use
Ongoing use (months)
What you might notice
- •Consistent effects if PT-141 works for you
- •Tolerance does not appear to develop significantly
- •Watch for potential skin hyperpigmentation
- •Continued manageable side effects
What's normal
- •Stable response pattern over time
- •Continued mild nausea/flushing with each dose
- •No need to increase dose for same effect
- •Possible slight skin darkening in some areas
What's next
- →Continue as prescribed by your healthcare provider
- →Regular check-ins to assess ongoing benefit vs. side effects
- →Report any concerning skin changes
- →Reevaluate periodically whether treatment is still needed
Signs It's Working
Sexual Desire Indicators
- ✓Increased spontaneous thoughts about intimacy
- ✓Greater interest in initiating sexual activity
- ✓Feeling more 'in the mood' than baseline
- ✓Reduced distress about low desire
- ✓More anticipation or excitement about intimacy
Physical Response Indicators
- ✓Enhanced physical arousal response
- ✓Improved natural lubrication (women)
- ✓Better erectile response (men, off-label use)
- ✓More satisfying intimate experiences overall
- ✓Body feels more 'responsive' to stimulation
Not Seeing Results?
Common reasons
- •Not waiting long enough—PT-141 needs at least 45-60 minutes to take effect, some people need 90 minutes
- •Nausea overwhelming the experience—try eating a light meal beforehand or starting with a lower dose
- •Relationship or psychological factors—PT-141 enhances desire but can't fix underlying relationship issues
- •Expectations too high—effects are often subtle and enhance rather than create desire from nothing
- •Inconsistent timing—finding your personal 'sweet spot' for timing takes experimentation
- •Medication interactions—naltrexone or other drugs may be blocking the effect
Key Research
"Bremelanotide for the Treatment of Hypoactive Sexual Desire Disorder: Two Randomized Phase 3 Trials"
Kingsberg SA, Clayton AH, Portman D, 2019
Finding: The landmark RECONNECT trials that led to FDA approval. Over 1,200 premenopausal women with HSDD showed statistically significant improvements in sexual desire and reduction in distress compared to placebo. The 1.75mg dose delivered real benefits where it mattered most.
View Study"Long-Term Safety and Efficacy of Bremelanotide for Hypoactive Sexual Desire Disorder"
Simon JA, Kingsberg SA, Portman D, 2019
Finding: The 52-week extension study showed PT-141 maintained its effectiveness over time without developing tolerance. No new safety signals emerged with long-term use, and improvements in desire and reduced distress persisted throughout.
View Study"Bremelanotide: First Approval"
Dhillon S, Keam SJ, 2019
Finding: This comprehensive review covered PT-141's journey from lab to FDA approval. It explained how the drug works on MC4 receptors in the brain's desire circuits—a completely novel mechanism compared to existing sexual health treatments.
View Study"The neurobiology of bremelanotide for the treatment of hypoactive sexual desire disorder in premenopausal women"
Pfaus JG, Sadiq A, Spana C, 2022
Finding: Deep dive into how PT-141 actually works in the brain. It activates MC4 receptors in the hypothalamus, triggering dopamine release in areas that control sexual motivation. This explains why it enhances desire itself, not just physical response.
View Study"The Patient Experience of Premenopausal Women Treated with Bremelanotide for Hypoactive Sexual Desire Disorder: RECONNECT Exit Study Results"
Koochaki P, Revicki D, Wilson H, 2021
Finding: Real-world feedback from clinical trial participants. Women reported meaningful improvements in their sexual experiences and quality of life. Most felt the benefits outweighed the side effects, particularly nausea.
View StudyFrequently Asked Questions