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On-Demand Sexual Function (PT-141)

As-needed PT-141 (bremelanotide) dosing with BP safety checks — FDA-approved protocol for hypoactive sexual desire.

Sexual function Beginner Cycle: As-needed — no daily cycling

Overview

PT-141 (bremelanotide) is an FDA-approved melanocortin receptor agonist marketed as Vyleesi for HSDD in premenopausal women; it also has off-label use for male sexual function. Mechanism is central, not vascular — distinguishing it from PDE5 inhibitors. Use is strictly on-demand with a hard monthly cap.

Dose schedule

Phase	Dose & route	Notes
Initial dose	1.75 mg SC in the abdomen or thigh, ≥45 min before desired activity.	If 1.75 mg produces unacceptable nausea, reduce to 1.0 mg next time.
Timing	Effect window: 1–8 hours after injection. Peak around 3 h.	Food and alcohol do not need to be timed with the dose, but heavy alcohol can rebound hypotension.
Monthly cap	Maximum 1 dose per 24 h and 8 doses per month.	FDA label caps for cumulative BP effects. Do not exceed.

Bloodwork cadence

Timing	Panel
Baseline	Blood pressure (home cuff + clinic), lipid panel, HbA1c, testosterone/estradiol as clinically appropriate.
After 10 doses	Confirm BP has not drifted upward with recurrent use.

Expected timeline

45 min: Earliest effect window. Mild facial flushing common.
3 h: Peak effect for most responders.
8–24 h: Effect wears off. Nausea (if present) usually resolves by 4 h.

Red flags — stop and reassess

Uncontrolled hypertension (SBP >140 or DBP >90 at rest) — contraindicated.
Chest pain, severe headache, or vision changes after dosing — do not re-dose, seek evaluation.
Persistent focal skin darkening (melanocortin receptor-mediated) — reduce frequency.

Contraindications

Uncontrolled hypertension.
Known cardiovascular disease at the discretion of a prescriber.
Pregnancy.
Concurrent heavy alcohol within 4 hours.

Linked resources

Sources

Educational use only. This protocol summarises published trial schedules, FDA labelling, and widely-referenced research-community practice. Doses, cycle lengths, and bloodwork recommendations should be reviewed with a qualified prescriber before use in any human. Several peptides discussed are not approved for human administration in most jurisdictions.