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Bremelanotide (PT-141) Injectable
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Bremelanotide (PT-141): Injection That Targets Desire at Its Source
The first and only sexual wellness medication that acts on the brain’s desire pathways, not blood flow.
Bremelanotide, also known as PT-141, is an injectable medication taken as needed before intimacy that works on the brain’s melanocortin receptors to increase sexual desire and arousal. Unlike sildenafil or tadalafil, which improve blood flow to enable physical response, bremelanotide addresses the part of sexual function that comes earlier: wanting to be there in the first place. The active ingredient bremelanotide is FDA-approved under the brand name Vyleesi for hypoactive sexual desire disorder in premenopausal women. Use for other patient groups, including men, is off-label and prescribed at physician discretion.
Physician-prescribed · FDA-approved active ingredient · Compounded by licensed US pharmacies · On-demand dosing
Bremelanotide (PT-141, Melanocortin-4 Receptor Agonist): Bremelanotide is a synthetic peptide that activates MC4 receptors in the hypothalamus, a region of the brain involved in the neural circuitry of sexual desire. By acting upstream of the vascular response, it can produce both increased subjective desire and improved physical response, particularly for people whose primary issue is low libido rather than mechanical erectile function. Onset is typically 45 minutes after the dose, with effects lasting several hours.
Best for: Adults seeking to address desire and arousal, not just performance, and for people who haven’t responded fully to PDE5 inhibitors like sildenafil or tadalafil alone. Particularly well-suited for those whose challenges include low libido, situational arousal difficulty, or the emotional dimension of intimacy.
Not recommended for: Anyone with uncontrolled hypertension or known cardiovascular disease (bremelanotide can transiently raise blood pressure), pregnant individuals, and people with a history of severe melasma or skin pigmentation concerns.
The most common side effects are nausea (reported by roughly 40% of users, typically improving after the first one to two doses), flushing, headache, and injection site reactions. A brief, transient rise in blood pressure is expected and is the main reason your provider confirms your baseline before prescribing. Less common but notable: focal hyperpigmentation (darkening of small skin patches, particularly the face, with repeated use) and changes in nausea tolerance over time.
¹ About 59% of women reported a meaningful benefit; sexual desire improved significantly vs placebo (RECONNECT) Kingsberg SA, Clayton AH, Portman D, et al. Bremelanotide for the Treatment of Hypoactive Sexual Desire Disorder: Two Randomized Phase 3 Trials (RECONNECT). Obstetrics & Gynecology, 2019;134(5):899-908. → PubMed
² Significantly reduced sex-related distress vs placebo Kingsberg SA, et al. RECONNECT (same source as ¹). Supporting long-term data: Simon JA, et al. Obstetrics & Gynecology, 2019;134(5):909-917. → PubMed
³ Acts on the brain’s desire pathway (central melanocortin mechanism) Pfaus J, Giuliano F, Gelez H. Bremelanotide: an overview of preclinical CNS effects on female sexual function. Journal of Sexual Medicine, 2007;4 Suppl 4:269-279. → PubMed
How it Works With EHRX
The entire process is online. No waiting rooms. Just straightforward, medically guided care.
Step 1
Choose your treatment and complete checkout
You'll receive a confirmation email with next steps.
Step 2
Complete a brief medical consultation
Check your email for a link to a short intake form and link to a virtual consult with a licensed physician.
Step 3
A licensed provider reviews your consultation
If approved, your prescription is written and sent to the pharmacy. If not, you receive a full refund.
Step 4
Your pharmacy ships within 3–5 business days
Your medication is shipped directly to your door in temperature-controlled packaging.
What to know before you start.
Bremelanotide (PT-141) Injectable is a compounded medication prepared by a licensed pharmacy for individual patient use.
It has not been reviewed by the FDA for safety or efficacy, and is prescribed based on the clinical judgment of a qualified healthcare provider. Compounded drugs are permitted to be prescribed but are not FDA-approved for safety and efficacy.
Clinical Evidence
Bremelanotide received FDA approval in 2019 (as Vyleesi) based on the RECONNECT Phase 3 trials, in which more than 1,200 premenopausal women with hypoactive sexual desire disorder showed statistically significant improvements in sexual desire and reduced distress versus placebo. Separate Phase 2 studies in men with erectile dysfunction, both as monotherapy and combined with PDE5 inhibitors, have shown statistically significant improvements in erectile function. This use remains off-label and is the subject of ongoing trials. (Source: Kingsberg et al., Obstetrics & Gynecology, 2019)
Frequently Asked Questions
We aim to provide absolute clarity regarding your biological data and personalized wellness protocols.
Sildenafil and tadalafil improve blood flow to enable physical response. Bremelanotide acts on the brain’s desire pathways, addressing the wanting, not just the mechanics. The two can be complementary.
45 minutes before anticipated intimacy. Effects typically last several hours. Maximum one dose per 24 hours and no more than 8 doses per month.
Nausea is the most common early side effect, usually mild and improving after the first one to two doses. A warming or flushing sensation is also common.
The FDA-approved indication (as Vyleesi) is for premenopausal women with HSDD. Use in men is off-label and at physician discretion. Phase 2 and Phase 3 trials in men are ongoing.
Yes. Baseline blood pressure is required, and self-monitoring during the first weeks is recommended.
You won’t be charged for the medication.
Generally no. Compounded sexual wellness medications are paid out of pocket.
Yes, at any time before your next shipment, with no long-term commitment.
Initial check-in at 4 to 6 weeks, with ongoing access to your care team.
This combination is increasingly common in clinical practice and is the subject of ongoing trials. Any combination is at your provider’s discretion and may require additional cardiovascular review.
Contact your care team. Dose adjustments or timing changes often resolve these.
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