Melanocortin Receptor Agonist · CNS-Acting

PT-141

Bremelanotide · Vyleesi® · FDA-Approved in Women · Off-Label in Men

PT-141 is the only sexual health peptide that works through the central nervous system, specifically the melanocortin receptors that govern sexual desire and arousal in the hypothalamus. It is FDA-approved as Vyleesi® for hypoactive sexual desire disorder (HSDD) in premenopausal women. It is used off-label in men and for other indications, which is fully disclosed at consultation. Its CNS mechanism of action may make it effective in patients where hormone therapy and vascular approaches have been insufficient.

Mechanism: Activates MC3R and MC4R receptors in the hypothalamus · Influences neurological pathways governing sexual motivation and arousal · Distinct from vascular mechanism of PDE5 inhibitors.

Typical Administration

Subcutaneous injection · As needed, approximately 45 minutes before intended use · Low-dose daily protocol also available

Hypothalamic Neuropeptide · Upstream Hormone Signaling

Kisspeptin

KISS1 Neuropeptide · GnRH Pulse Stimulator

Kisspeptin is a hypothalamic neuropeptide that sits at the top of the reproductive hormone cascade, stimulating GnRH release, which drives LH and FSH, which in turn regulate testosterone and estrogen production. For patients with centrally suppressed hormone signaling, kisspeptin therapy may address the problem upstream, supporting the biological signaling that initiates the entire reproductive hormone axis. It is investigational in the US and is fully disclosed at consultation.

Proposed mechanism: Activates KNDy neurons in the hypothalamus · May stimulate pulsatile GnRH release · Potential to support endogenous sex hormone production signaling.

• Investigational compound. Not FDA-approved. Compounding availability subject to current regulations. Full regulatory disclosure, evidence review, and informed consent required.

Typical Administration

Subcutaneous injection · Protocol design varies by indication and gender