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PT-141 Clinic

Desire, with the diagnosis left in.

The PT-141 reading list

The papers behind the detour, with the pivotal trials and label at its centre.

Start at the trial report, then turn the page

The two Phase 3 trials give the desire and distress findings in premenopausal women with HSDD. The companion long-term follow-up gives the sustained observations and tolerability record. The prescribing information holds the approved indication, limits, and formal warnings.

For the mechanism, the brain-scan study and neurobiology review are useful companions. For the awkward distinction between motivation and reward, put the female-rat solicitation experiment beside the female Syrian hamster place-preference result. They are animal studies, asking different questions.

I favour that pairing because the negative hamster result prevents a too-neat ending. The historical review of melanocortin therapeutics explains the tanning origins; the early development profile captures a programme that had not yet reached the later approved indication.

The arousal-and-orgasm report and the comparative treatment analysis below are conference abstracts with less detail than full peer-reviewed papers. Public community accounts are anecdotal and have no place in a list of published clinical evidence.

  1. Molinoff PB, Shadiack AM, Earle D, Diamond LE, Quon CY. PT-141: a melanocortin agonist for the treatment of sexual dysfunction. Ann N Y Acad Sci. 2003;994:96-102. ↗
  2. Pfaus J, Shadiack A, Van Soest T, Tse M, Molinoff P. Selective facilitation of sexual solicitation in the female rat by a melanocortin receptor agonist. Proc Natl Acad Sci U S A. 2004;101:10201-10204. ↗
  3. Kingsberg SA, Clayton AH, Portman D, Williams LA, Krop J, Jordan R, Lucas J, Simon JA. Bremelanotide for the Treatment of Hypoactive Sexual Desire Disorder: Two Randomized Phase 3 Trials. Obstet Gynecol. 2019;134(5):899-908. ClinicalTrials.gov NCT02333071. ↗
  4. Simon JA, Kingsberg SA, Portman D, Williams LA, Krop J, Jordan R, Lucas J, Clayton AH. Long-Term Safety and Efficacy of Bremelanotide for Hypoactive Sexual Desire Disorder. Obstet Gynecol. 2019;134(5):909-917. ClinicalTrials.gov NCT02333071. ↗
  5. Thurston L, Hunjan T, Mills EG, et al. Melanocortin 4 receptor agonism enhances sexual brain processing in women with hypoactive sexual desire disorder. J Clin Invest. 2022;132(19):e152341. ClinicalTrials.gov NCT04179734. ↗
  6. Pfaus JG, Sadiq A, Spana C, Clayton AH. The neurobiology of bremelanotide for the treatment of hypoactive sexual desire disorder in premenopausal women. CNS Spectr. 2022;27(3):281-289. ↗
  7. Simon JA, Kingsberg SA, Goldstein I, Lucas J, Jordan R, Spana C, Clayton AH. Prespecified and Integrated Subgroup Analyses from the RECONNECT Phase 3 Studies of Bremelanotide. J Womens Health (Larchmt). 2022;31(3):391-400. ↗
  8. Semple EA, Harberson MT, Xu B, Rashleigh R, Cho J, et al. (Hill JW). Melanocortin 4 receptor signaling in Sim1 neurons permits sexual receptivity in female mice. Front Endocrinol (Lausanne). 2023;14:983670. ↗
  9. Koochaki P, Revicki D, Wilson H, Pokrzywinski R, Jordan R, Lucas J, Williams LA. The Patient Experience of Premenopausal Women Treated with Bremelanotide for Hypoactive Sexual Desire Disorder. J Womens Health (Larchmt). 2021;30(4):587-595. ↗
  10. U.S. Food and Drug Administration / DailyMed. Bremelanotide Injection — US Prescribing Information. 2019. NDA 210557 (approved June 21, 2019). ↗
  11. Borland JM, Kohut-Jackson AL, Peyla AC, Hall MA, Mermelstein PG, Meisel RL. Female Syrian hamster analyses of bremelanotide, a US FDA approved drug for the treatment of female hypoactive sexual desire disorder. Neuropharmacology. 2025;110299. ↗
  12. Goldstein I, et al. (122) Positive Effects of Bremelanotide on Female Sexual Arousal and Orgasm in Premenopausal Women. J Sex Med. 2025 (conference abstract; lower evidence tier than peer-reviewed full text). ↗
  13. How A, Simon JA. Novel Pharmacologic Treatments of Female Sexual Dysfunction. Clin Obstet Gynecol. 2025. ↗
  14. Vereecken S, et al. (396) Comparative Analysis of Flibanserin, Bremelanotide, and Testosterone Therapy for Female Sexual Dysfunction. J Sex Med. 2025 (conference abstract; lower evidence tier than peer-reviewed full text). ↗
  15. Fuhrman J, et al. Practical considerations and emerging approaches for the management of vasomotor and sexual symptoms. Expert Rev Clin Pharmacol. 2025. ↗
  16. Dhillon S, Keam SJ. Bremelanotide: First Approval. Drugs. 2019;79:1599-1606. ↗
  17. White WB, Myers MG, Jordan R, Lucas J. Usefulness of ambulatory blood pressure monitoring to assess the melanocortin receptor agonist bremelanotide. J Hypertens. 2017;35(4):761-768. ↗
  18. Clayton AH, Lucas J, DeRogatis LR, Jordan R. Phase I Randomized Placebo-controlled, Double-blind Study of the Safety and Tolerability of Bremelanotide Coadministered With Ethanol in Healthy Male and Female Participants. Clin Ther. 2017;39(3):514-526.e14. ↗
  19. Clayton AH, Kingsberg SA, Portman D, Sadiq A, Jordan R, Lucas J, Spana C, Simon JA. Safety Profile of Bremelanotide Across the Clinical Development Program. J Womens Health (Larchmt). 2022;31(2):171-182. ↗
  20. National Institute of Diabetes and Digestive and Kidney Diseases (LiverTox). Bremelanotide - LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. NCBI Bookshelf (LiverTox). 2021. ↗
  21. Mestria S, Odoardi S, Frison G, Strano Rossi S. LC-HRMS characterization of the skin pigmentation and sexual enhancers melanotan II and bremelanotide sold on the black market of performance and image enhancing drugs. Drug testing and analysis. 2021. ↗
  22. Nelson ME, Bryant SM, Aks SE. Melanotan II injection resulting in systemic toxicity and rhabdomyolysis. Clinical toxicology (Philadelphia, Pa.). 2012. ↗
  23. Spana C, Jordan R, Fischkoff S. Effect of bremelanotide on body weight of obese women: Data from two phase 1 randomized controlled trials. Diabetes Obes Metab. 2022;24(6):1084-1093. ↗
  24. Bardhan M, Anand A, Javed A, Chilo MA, Khan N, Garg T. Polymorphism of Melanocortin Receptor Genes-Association with Inflammatory Traits and Diseases. Diseases (Basel, Switzerland). 2025. ↗
  25. Hadley ME, Dorr RT. Melanocortin peptide therapeutics: historical milestones, clinical studies and commercialization. Peptides. 2006. ↗
  26. Hedlund P. PT-141 Palatin. Current opinion in investigational drugs (London, England : 2000). 2004. ↗
  27. Al Shaer D, Al Musaimi O, Albericio F, de la Torre BG. 2019 FDA TIDES (Peptides and Oligonucleotides) Harvest. Pharmaceuticals (Basel, Switzerland). 2020. ↗