PT-141 / B6
Bremelanotide, which acts on desire pathways in the brain rather than on blood flow, compounded with vitamin B6.
The basics
PT-141 is bremelanotide, a peptide that activates melanocortin receptors in the brain involved in sexual desire and arousal. That sets it apart from sildenafil and tadalafil, which act on blood vessels. You use it on demand, not daily.
Low desire and erectile trouble often point to a metabolic problem such as insulin resistance, low testosterone, poor sleep, or vascular disease, so we look at your labs and medications before reaching for a prescription.
We review the studies, the potential uses and benefits, and the open questions in our research post, PT-141 (Bremelanotide) for Sexual Desire, and What the Trials Found.
What the evidence looks like
Moderate. The FDA approved bremelanotide in 2019 as Vyleesi for premenopausal women with hypoactive sexual desire disorder, based on two phase 3 trials that showed modest improvements. Smaller trials exist in men with erectile dysfunction, and use in men is off-label.
Why patients ask about it
- Low sexual desire in women
- Erectile difficulties in men, including a partial response to sildenafil or tadalafil
- A treatment that works on desire rather than mechanics
Good to know
- The compounded PT-141 with B6 we prescribe is not FDA-approved.
- Nausea is common (about 40 percent in the phase 3 trials), along with flushing and headache.
- It raises blood pressure slightly for a few hours after a dose, so it's not for people with uncontrolled hypertension or known cardiovascular disease.
- Frequent use can darken patches of skin.
PT-141 (Bremelanotide) for Sexual Desire, and What the Trials Found
PT-141, or bremelanotide, raises sexual desire through melanocortin receptors in the brain instead of through blood flow. The trials show a real but modest effect, nausea in about 40 percent of users, and no evidence yet for the vitamin B6 that compounders add.
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