# Bremelanotide

A peptide that acts on arousal pathways in the brain, not on blood flow. It grew out of melanotan II and is approved in the US only for women. Online it is sold to men as PT-141.

Also called: PT-141, Vyleesi
Source page: https://peplogue.com/peptides/bremelanotide/
Reviewed: 2026-10-12. Not medical advice.

## How it works

- Where it acts: Melanocortin receptors in the brain, mainly MC4.
- What it changes: It is thought to act on desire pathways in the brain, though the exact mechanism is unknown. It is not a blood-flow drug like erection pills.
- What people notice: A modest rise in sexual desire in trials. Nausea is common, and blood pressure rises for up to about 12 hours.

## What the evidence shows

- **Low sexual desire in premenopausal women**: Proven. Approved in the US in 2019. The effect is small: desire scores rose 0.5 to 0.6 points against 0.2 on placebo, and the number of satisfying sexual events did not change.
- **Erections in men**: Early. Small placebo-controlled lab studies of a nasal spray showed erectile responses, with flushing and nausea. Development of the spray stopped in 2007 over rises in blood pressure. It was never approved for men.

## Side effects and risks

- common: Nausea in 40% of users. About one in eight needed anti-nausea medicine.
- serious: Blood pressure rises for up to 12 hours after a dose.
- common: Flushing in 20%, and headache.
- common: Dark patches on the face, gums or breasts, especially with frequent dosing. They may not fade.

Who should avoid it: Uncontrolled high blood pressure, heart disease, and daily use.

## How it is taken

A 1.75 mg injection under the skin at least 45 minutes before sex. At most one dose in 24 hours and eight a month.

## Legal status

- United States: undefined. Vyleesi autoinjector, for premenopausal women with hypoactive sexual desire disorder.
- European Union: undefined. No EU authorization found.
- Spain: undefined. No bremelanotide (Vyleesi) medicine in CIMA, so it is not authorised in Spain. Not lawful to sell to the public.
- Germany: undefined. No German or EU approval known (Vyleesi is US). A pharmacy may import it for one named patient on prescription (§ 73 Abs. 3 AMG).
- France: undefined. No EU or French authorisation found for Vyleesi. Online offers are unapproved medicines.
- Italy: undefined. Vyleesi has no EU authorisation, so it is not available in Italy. Online offers are unlicensed imports.
- Netherlands: undefined. No Dutch or EU marketing authorisation found (Vyleesi is a US product). Sale online as PT-141 is sale of an unlicensed medicine.
- United Kingdom: undefined. No UK license found.
- Canada: undefined
- Australia: undefined

## Questions people ask

**Does PT-141 work for men?**

It was never approved for men. Small placebo-controlled lab studies of a nasal spray showed erectile responses, but development of the spray stopped in 2007 over rises in blood pressure.

**How is bremelanotide different from erection pills?**

It acts on melanocortin receptors in the brain and is not a blood-flow drug like erection pills. It is thought to act on desire pathways, though the exact mechanism is unknown.

**How well does Vyleesi work for women?**

The effect is small: desire scores rose 0.5 to 0.6 points against 0.2 on placebo, and the number of satisfying sexual events did not change. It was approved in the US in 2019 for premenopausal women with low desire.

**What are the side effects of PT-141?**

Nausea affects 40% of users, and about one in eight needed anti-nausea medicine. Flushing (20%), headache, a rise in blood pressure for up to 12 hours, and dark patches on the face, gums or breasts that may not fade are also reported.

**Is PT-141 legal?**

In the US it is approved only as the Vyleesi autoinjector for premenopausal women with hypoactive sexual desire disorder, and FDA named PT-141 in warning letters to research-use-only sellers in August 2026. No EU authorization or UK license was found.

## Sources

- Vyleesi US prescribing information (DailyMed): https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f1d0c1b5-2f39-4bad-a6a4-0066e3ad5dcf
- Diamond et al. 2004: intranasal PT-141 in men: https://www.nature.com/articles/3901139
- ArentFox Schiff: FDA letters to research-use-only vendors (Sep 2026): https://www.afslaw.com/perspectives/alerts/ruo-ined-five-peptide-vendors-learn-research-use-only-not-legal-strategy