PT-141 (Bremelanotide)

Why scientists study it

• It raises sexual arousal through melanocortin receptors in the brain, not by widening blood vessels, so it works differently from PDE5 inhibitors.
• It grew out of Melanotan 2 research and was picked because it acts mainly in the brain and darkens skin less.
• The FDA approved it in 2019 as Vyleesi for hypoactive sexual desire disorder in women before menopause, and for nothing else.

Three studies to know

2019 · Obstet Gynecol

Kingsberg and colleagues ran RECONNECT, the main Phase 3 trial. It showed the drug worked for HSDD in women before menopause, and the Vyleesi approval rests on it. Read the paper

2004 · Int J Impot Res

Diamond and colleagues tested a nasal spray in healthy men and in men with erectile dysfunction. The study was double-blind and used a placebo. At higher doses, the spray led to more erections than placebo. Flushing and nausea were the most common side effects. Read the paper

2004 · PNAS

Pfaus and colleagues tested in animals how switching on MC3R and MC4R changes sexual behavior. The human trials were built on this work. Read the paper

Safety and legal status

• The approved use is narrow: HSDD in women before menopause. The label rules it out for people with uncontrolled high blood pressure or heart and blood vessel disease. Nausea and reactions at the shot site are common.
• The FDA approved it as Vyleesi in 2019. The MHRA has not approved it, and the EMA application was withdrawn in 2019. It is not currently on the World Anti-Doping Agency list.
• Outside that approval, it is for laboratory research use.