In this episode, Dr. Brandon & Dr. Morgentaler talk about the off-label use of bremelanotide (Vyleesi/PT-141) in men—its potential benefits for libido/erections, origins, side effects (notably nausea), and how patients often access it via compounding pharmacies.
Chapters
00:05 – Dr. Brandon & Dr. Morgentaler dive into Bremelanotide and share how the Goldsteins have been pioneering its research.
02:08 – They laugh about the iconic Katz’s Deli “When Harry Met Sally” scene and its connection to sexual medicine history.
03:06 – The doctors explain how Bremelanotide works, how it’s used by both women and men, and why refills tell an important story.
08:43 – They tackle the criticism that women take these meds “for men,” pushing back and stressing women’s right to pleasure.
19:48 – Wrapping up, they encourage listeners to talk with their doctors or compounding pharmacies if they want to explore this option.
here's a comprehensive overview of the bremelanotide (PT-141) information discussed on the site:
What is Bremelanotide (PT-141)?
Bremelanotide (PT 141) is a synthetic melanocortin compound that is a 'melanocortin receptor agonist'- activates melanocortin receptors in the body PT - 141 (Bremelanotide) for Improved Sex Drive (Libido) and Erections - Excel Male Men's Health Forum. This synthetic peptide works differently from traditional ED medications like Viagra or Cialis, targeting the nervous system rather than the vascular system The Amazing Bremelanotide PT-141 (Vyleesi) - Excel Male Health Forum.How It Works
Bremelanotide PT-141 activates melanocortin receptors in the brain, specifically MC3-R and MC4-R The Amazing Bremelanotide PT-141 (Vyleesi) - Excel Male Health Forum, leading to increased sexual desire and arousal through the nervous system rather than just increasing blood flow.User Experiences and Dosing Strategies
Standard Dosing Results
Many users report mixed results with standard dosing protocols. Like many, I have experimented with bremelanotide at the recommended doses, which range from a few hundred micrograms up to a couple milligrams in one subcutaneous injection. And also like many, I found the results to be disappointing A different dosing strategy with bremelanotide (PT-141) yields dramatically better results - Page 3 - Excel Male Men's Health Forum.Innovative Micro-dosing Approach
One particularly detailed experiment involved multiple daily micro-doses:Phase 1 (20 mcg, 5x daily): Compared to a lackadaisical baseline, libido was high, even excessive and distracting. This began on the first day and continued for the entire phase. The "itch" was nearly constant, and erections came easily in response to sexual ideation A different dosing strategy with bremelanotide (PT-141) yields dramatically better results - Page 3 - Excel Male Men's Health Forum.
However, The two negatives during this phase were a reduction in average sleep duration by 30-40 minutes and a slight feeling of overstimulation throughout A different dosing strategy with bremelanotide (PT-141) yields dramatically better results - Page 3 - Excel Male Men's Health Forum.
Lower doses (10-15 mcg): Results were less impressive, with rapid return to near-baseline conditions.
Clinical Study Results
A total of 91% experienced improvements in sexual function, all with improved erectile function. 100% of those with complaints of low sexual desire and/or complaints of anxiety around sex reported improvement Use of Bremelanotide (Vyleesi) PT-141 in Men with Sexual Dysfunctions - Excel Male TRT Forum. The study found that 69% of participants were prescribed bremelanotide for erectile dysfunction Use of Bremelanotide (Vyleesi) PT-141 in Men with Sexual Dysfunctions - Excel Male TRT Forum.Common Side Effects
Users frequently report several side effects:- Side effects included flushing (36%), nausea (36%), headache (27%), bothersome spontaneous erections without sexual stimulation for about 24 hours after injection (27%) Use of Bremelanotide (Vyleesi) PT-141 in Men with Sexual Dysfunctions - Excel Male TRT Forum
- Bremelanotide or Vyleesi or PT 141 as it's called, is a very effective drug for ED and improving libido. The stuff works extremely well. However, it also has some significant side effects, nausea, body aches, headaches, sinus congestion, and flushing are the predominant ones PT-141 Bremelanotide - Excel Male TRT Forum
Dosing and Administration
- Inject 1.75 mg subcutaneously via the autoinjector to the abdomen or thigh, as needed, at least 45 minutes before anticipated sexual activity Use of Bremelanotide (Vyleesi) PT-141 in Men with Sexual Dysfunctions - Excel Male TRT Forum (FDA approved dosing)
- I take around 300mcg twice a week and I think it is one of the best erection promoters there is PT-141 Bremelanotide - Excel Male TRT Forum (user experience with lower doses)
Important Considerations
Effectiveness Concerns
Bremelanotide does not survive in the stomach Has anyone used: Bremelanotide/Oxytocin/Tadalafil 1 mg/100IU/10 mg Troche - Excel Male Health Forum, making sublingual troches potentially less effective than injections.Individual Variation
I have micro-dosed it and I find it to be beneficial. In watching the discussion on it over the years, my observation is that it is a nice boost for people who are already generally healthy, but it does not work permanent miracles for people who are not Why so little info on Bremelanotide (PT-141-Vyleesi)? - Excel Male TRT Forum.The forum discussions suggest that while bremelanotide can be effective for sexual dysfunction, results vary significantly between individuals, and many users experience notable side effects that may limit its practical use. The micro-dosing approach shows promise but requires more research to optimize protocols.
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