Clinical evidence
Bremelanotide (Vyleesi)
Desire treatment·Sexual-dysfunction treatments
Effect across the cycle
DesireFacilitatory: Central melanocortin activation raises desire.
ArousalFacilitatory: Enhances arousal circuitry centrally.
PerformanceNeutral: Not primarily an erectile agent.
ClimaxNeutral: No direct orgasmic effect.
ExperienceFacilitatory: Improved desire and arousal experience.
MemoryNeutral: Not a memory factor.
Mechanism
Synthetic melanocortin agonist (high MC4R affinity) acting centrally in the paraventricular nucleus and medial preoptic area to modulate dopaminergic desire and arousal circuitry; in men melanocortin stimulation raises penile nitric oxide. FDA-approved (2019) for premenopausal HSDD.
Sex differences & notes
Side effects: nausea, transient blood-pressure elevation, flushing, focal hyperpigmentation.
Key sources
- FDA approval 2019; melanocortin mechanism reviews