The one approval, and what it actually showed
Bremelanotide acts on melanocortin receptors in the brain rather than on blood flow, which is why it was studied for desire rather than erectile function. In the two RECONNECT phase 3 trials, premenopausal women with acquired, generalised hypoactive sexual desire disorder reported small but statistically significant improvements in desire scores and reductions in distress compared with placebo over 24 weeks. Nausea occurred in about 40% of treated women, and the label warns about transient blood-pressure increases and focal skin darkening.
What is not established
- Men and erectile dysfunction: early-2000s studies of bremelanotide (then intranasal) in men with ED showed erectile responses, but the programme was halted over blood-pressure concerns and the drug was never approved for men. Online marketing of PT-141 for men draws on those older, small studies.
- Postmenopausal women: not included in the approval; evidence is limited.
- "Libido enhancement" in people without a diagnosed disorder: not studied.
Regulatory note
Bremelanotide is a prescription drug in the U.S. Products sold online as "PT-141 for research" are not the approved product, and their identity and purity are not verified — see our analysis of certificates of analysis.