Sexual health.
A small class with a real human-effect signal on libido and arousal, anchored by PT-141 (bremelanotide). Side-effect profile is the binding constraint, not efficacy.
How this class moves the outcome.
Melanocortin receptor (MC3/MC4) agonism
PT-141 / bremelanotide acts centrally on melanocortin receptors to increase sexual desire and arousal, independent of vascular pathways targeted by PDE5 inhibitors.
Kisspeptin / GnRH axis stimulation
Kisspeptin peptides drive the upstream HPG axis, increasing endogenous LH and testosterone pulses in human studies.
Ranked by human-evidence strength.
- 01
PT-141
BremelanotideCyclic α-MSH analogue approved as Vyleesi for hypoactive sexual desire disorder in premenopausal women.
α-MSH analogue (MC4)t½ ~2.7 hHuman RCT - 02
Melanotan II
MT-IICyclic α-MSH analogue, the parent of bremelanotide. Unapproved; significant adverse-event profile.
α-MSH analogue (cyclic)t½ ~33 minPreclinical only
What the human data actually shows.
Each bar is the proportion of candidates on this brief at that evidence tier. RCT first, observational second, preclinical and anecdotal labeled and never inflated.
See full methodology →Where this class can hurt you.
- Transient nausea, flushing, and headache are the dominant dose-limiting effects.
- Documented blood-pressure rises and dizziness; cardiovascular caution.
- Melanotan-class products carry independent melanocyte and GI risks.
- Most rigorous data is in HSDD in women; men's data is sparser.
- Off-label dosing in lifestyle use exceeds studied ranges.
Decide between candidates.
Put the top 2 candidates side by side.
Mechanism · half-life · routes · evidence tier · safety signals. A decision matrix, not a leaderboard.
Current scientific consensus.
- Bremelanotide for HSDD (women)
- Mechanism via melanocortin axis
- Equivalent to or replacement for PDE5 inhibitors
- General libido enhancer in everyone
- Long-term cardiovascular safety in lifestyle use
- Optimal cadence to avoid tachyphylaxis
"A small, real-effect class. Side-effect profile and route-of-admin discipline matter more than dose."
Where this is heading.
A small, real-effect class. Side-effect profile and route-of-admin discipline matter more than dose.
We re-grade this brief quarterly. Confidence and outcome grades shift as new RCTs publish, safety data accumulates, and replication efforts read out. Changes are logged publicly on the evidence changelog.
Matched protocol templates.
Matching templates…