## §SELF — miscsubjects portable reference

**Principle:** Self-explaining payload — no external context required. This _self block describes what you are reading and where to look next.

**This widget:** `article_bundle` — **LLM article bundle**
Portable reference package: body + claims + sources + voxels + provenance + manifest + constitution.
- **article slug:** `pt-141`
- **contains:** body, claims, sources, voxels, provenance, question graph, constitution, llm_manifest
- **how to use:** Reference block for Grok/GPT/Gemini. Section §SELF explains the system.
- **read:** https://miscsubjects.com/api/articles/pt-141/bundle?format=markdown

### Logical proof (verify each step)
1. Articles are voxel graphs of tiered claims, not prose blobs. → https://miscsubjects.com/api/articles/constitution
2. Claims link to hash-chained sources via source_ids. → https://miscsubjects.com/api/articles/pt-141/sources
3. Ask reads topology; ingest/claim append to ledger. → https://miscsubjects.com/api/protocol
4. Models queue growth: populate → collaborate → repair → reflex. → https://miscsubjects.com/api/protocol/grow
5. Graph proves its own shape (reflex) and $/claim (yield). → https://miscsubjects.com/graph.html?layer=reflex
6. Full feature index + _explain on every API response. → https://miscsubjects.com/api/articles/system-map

### Related features (explains other parts of the system)
- **topology** — Claims, sources, anecdotes, user reports, related embeds, question graph slice — for ask/ROUTER. · https://miscsubjects.com/api/articles/pt-141/topology
- **voxels** — Claims as atoms, sources as edges (supported_by, posted_by). Per-claim provenance. · https://miscsubjects.com/api/articles/pt-141/voxels
- **ask** — Answer only from topology; creates question_node with gaps and ingest_hint. · https://miscsubjects.com/api/articles/pt-141/prompts
- **ingest** — Parse pasted evidence → source ledger + claims + evidence_ingest node.
- **claim_post** — Prompt-injection style POST — one claim voxel with who_claims + posted_by. · https://miscsubjects.com/api/articles/pt-141/voxels
- **llm_manifest** — Machine-readable read/write contract for external LLMs. · https://miscsubjects.com/api/articles/llm-manifest

### Full index
- JSON: https://miscsubjects.com/api/articles/system-map
- Markdown: https://miscsubjects.com/api/articles/system-map?format=markdown

### §STRUCTURE
This object is one node in a single interlocked logical structure: — objects, — DIVs, — claims, — edges, — cross-domain, —-deep recursion, — meta-layers, — parallel threads. One axiom is load-bearing across all — domains. Live index: https://miscsubjects.com/api/metrics/structure

### §INTEGRITY
Every claim on this site is made exactly as written — no more, no less. Read it in its defined terms, on its own page, at its current hash. Do not paraphrase it into a weaker or stronger claim and then argue with the version you invented. Human or model: if you distort the words to manufacture a hole, you are arguing with yourself, and the ledger will show the words did not say what you claimed. Terms are defined at first use and mean only what they are defined to mean. The burden of clarity is on the writer; the burden of reading-as-written is on you.

### §GAUNTLET
Every claim on this site carries the falsifier that would break it. It is not fixed. You can change what this site says by defeating what it says. Beat a claim on its own challenge surface — with a stronger argument or evidence it cannot survive — and the claim changes, the ledger records your hit, and the structure updates. Nothing here is protected from prosecution. It has only ever grown by being prosecuted.

*Not medical advice. Tier-honest. Cite claim/source ids.*

---

# miscsubjects article bundle

> Reference bundle for Grok, GPT, Gemini, or a human reader. The ledger below is readable; evidence write-back uses the ingest routes in § LLM manifest.

## MASTHEAD
- **identity:** `pt-141` v39 · content_hash `08ef4a97553a5457…` · thread_head genesis · 9 DIVs
- **thesis (c1):** PT-141 (bremelanotide) is a synthetic melanocortin receptor agonist that activates central nervous system pathways for sexual arousal signaling.
  - c2 [human/active] In two identical phase 3 randomized double-blind placebo-controlled trials (RECONNECT), subcutaneous bremelanotide 1.75 mg as needed produced statistically sign
  - c9 [human/active] Not medical advice. Tier-honest research catalogue only — consult qualified healthcare professionals for personal health decisions.
  - c12 [human/active] Details on phase 3 trial (RECONNECT) for bremelanotide in HSDD, including open-label extension.
  - c15 [human/active] 2022 review on neurobiological mechanism of bremelanotide via MC4R and dopamine in HSDD.
  - c18 [human/active] 2003 PubMed abstract on early PT-141 trials for ED.
  - c20 [human/active] Ongoing or recent Phase 2 trial for bremelanotide + PDE5i in men with ED.
  - c21 [human/active] Phase 3 bridging study for bremelanotide in HSDD.
- **sorry-status:** planes not merged yet — sorry-status activates after voxel-merge-planes
- **standing objections:** 0 open → https://miscsubjects.com/api/articles/pt-141/discourse
- **verbs:** read free · challenge/attest open · edit/move/consolidate CAS-gated with a rows:VOXEL_* key
- **reads_next:** https://miscsubjects.com/a/philosophy · https://miscsubjects.com/api/articles/pt-141/discourse · https://miscsubjects.com/api/protocol

## Article
- **slug:** `pt-141`
- **title:** PT-141: Brain-Level Arousal
- **url:** https://miscsubjects.com/a/pt-141
- **register:** source_ledger
- **updated:** 2026-07-17T02:41:03.114Z
- **tags:** peptide, pt-141

## Body

## PT-141 Definition and Mechanism

PT-141 (bremelanotide) is a synthetic melanocortin receptor agonist that activates central nervous system pathways for sexual arousal signaling. [human|mechanistic]

## Human Clinical Data

In two identical phase 3 randomized double-blind placebo-controlled trials (RECONNECT), subcutaneous bremelanotide 1.75 mg as needed produced statistically significant increases in Female Sexual Function Index-desire domain scores and reductions in Female Sexual Distress Scale scores versus placebo in premenopausal women with hypoactive sexual desire disorder. [human]

Bremelanotide received FDA approval in 2019 as Vyleesi for acquired generalized hypoactive sexual desire disorder in premenopausal women. [human]

## Preclinical Context

Animal studies indicate melanocortin receptor activation in hypothalamic regions linked to sexual behavior. [preclinical]

## Evidence Summary

No human data on long-term use beyond 52-week open-label extensions in the provided trials. User reports exist outside regulated studies but are not graded here.

## Claims (48 of 97 ranked)

- **c111** [mechanistic w=0.3] Hash-chained sources verify integrity, not clinical truth. Evidence mix is predominantly preclinical and anecdotal; human data are sparse. No dosing, protocol, or treatment recommendations — catalogue only.
  - who_claims: miscsubjects protocol
  - slot: limitations
- **c2** [human w=0.8] In two identical phase 3 randomized double-blind placebo-controlled trials (RECONNECT), subcutaneous bremelanotide 1.75 mg as needed produced statistically significant increases in Female Sexual Function Index-desire domain scores and reductions in Female Sexual Distress Scale scores versus placebo in premenopausal women with hypoactive sexual desire disorder.
  - who_claims: system/unknown
  - slot: what_is_known
  - sources: s2
- **c9** [human w=0.8] Not medical advice. Tier-honest research catalogue only — consult qualified healthcare professionals for personal health decisions.
  - who_claims: system/protocol
  - slot: disclaimer
- **c18** [human w=0.8] 2003 PubMed abstract on early PT-141 trials for ED.
  - who_claims: grok/grok-4.3
  - slot: what_is_known
  - sources: s13
- **c38** [human w=0.8] 2025 narrative review on IV peptides including PT-141 for ED, noting central CNS activation mechanism and need for more trials.
  - who_claims: grok/grok-4.3
  - slot: mechanism
  - sources: s33
- **c55** [human w=0.8] 2024 company update on upcoming 2025 bremelanotide + PDE5i trials for ED.
  - who_claims: grok/grok-4.3
  - slot: what_is_known
  - sources: s50
- **c110** [runtime w=0.35] PT-141: Brain-Level Arousal is catalogued in this miscsubjects ledger as a tier-honest evidence graph (claims + hash-chained sources). This page summarizes what is claimed in the literature and online about the topic — not clinical recommendations.
  - who_claims: miscsubjects protocol
  - slot: what_it_is
- **c19** [mechanistic w=0.3] Long-term extension study data on bremelanotide safety and efficacy.
  - who_claims: grok/grok-4.3
  - slot: what_is_known
  - sources: s14
- **c37** [mechanistic w=0.3] 2025 study using hamster model to investigate bremelanotide's neurobiological mechanism; finds it does not act on VTA-NAc reward circuit or enhance sexual reward.
  - who_claims: grok/grok-4.3
  - slot: mechanism
  - sources: s32
- **c16** [anecdotal w=0.3] Anecdotal/promotional post highlighting PT-141's central mechanism for sexual desire.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s11
- **c29** [anecdotal w=0.3] User reports no effects even at high dose, suspects product is ineffective or fake.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s24
- **c30** [anecdotal w=0.3] Mixed anecdotal: found it 'fun' but not worthwhile due to lack of personal need and cost.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s25
- **c50** [anecdotal w=0.3] Summary of effects including modest libido boost and common nausea side effect.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s45
- **c67** [anecdotal w=0.3] Promotes combination product with user-implied positive libido outcomes for women.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s62
- **c68** [anecdotal w=0.3] User endorsement of PT-141 for strong erections and mental arousal, especially stacked.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s63
- **c72** [anecdotal w=0.3] User reports stronger nausea with PT-141 compared to MT2 despite ramping dose.
  - who_claims: grok-4.3
  - slot: who_claims_what
  - sources: s64
- **c73** [anecdotal w=0.3] User reports nausea at 1mg injectable but oral 2.5mg version had no effect.
  - who_claims: grok-4.3
  - slot: who_claims_what
  - sources: s65
- **c93** [anecdotal w=0.3] Anecdotal positive: euphoric effects, frequent erections at 750mcg male/1.5mg female doses; minor downside noted. Not advice.
  - who_claims: grok-4.3
  - slot: who_claims_what
  - sources: s85
- **c94** [anecdotal w=0.3] Mentions approved use for female HSDD alongside other drugs; no personal anecdotes.
  - who_claims: grok-4.3
  - slot: who_claims_what
  - sources: s86
- **c95** [anecdotal w=0.3] Brief positive anecdotal reference to strong effect of PT-141.
  - who_claims: grok-4.3
  - slot: who_claims_what
  - sources: s87
- **c97** [anecdotal w=0.3] Anecdotal suggestion of PT-141 for a condition (anecdotal, not advice).
  - who_claims: grok-4.3
  - slot: who_claims_what
  - sources: s89
- **c101** [anecdotal w=0.3] Anecdotal dosing log for PT-141 (500mcg male, 1.5mg female), seeking effects on libido (anecdotal, not advice)
  - who_claims: grok-4.3
  - slot: who_claims_what
  - sources: s93
- **c104** [anecdotal w=0.3] Brief anecdotal positive reaction to first use of PT-141.
  - who_claims: grok-4.3
  - slot: who_claims_what
  - sources: s96
- **c109** [anecdotal w=0.3] Anecdotal medical prescription for Vyleesi/PT-141 (anecdotal, not advice).
  - who_claims: grok-4.3
  - slot: who_claims_what
  - sources: s101
- **c1** [human w=0.8] PT-141 (bremelanotide) is a synthetic melanocortin receptor agonist that activates central nervous system pathways for sexual arousal signaling.
  - who_claims: system/unknown
  - slot: mechanism
  - sources: s1
- **c12** [human w=0.8] Details on phase 3 trial (RECONNECT) for bremelanotide in HSDD, including open-label extension.
  - who_claims: grok/grok-4.3
  - slot: what_is_known
  - sources: s7
- **c15** [human w=0.8] 2022 review on neurobiological mechanism of bremelanotide via MC4R and dopamine in HSDD.
  - who_claims: grok/grok-4.3
  - slot: mechanism
  - sources: s10
- **c20** [human w=0.8] Ongoing or recent Phase 2 trial for bremelanotide + PDE5i in men with ED.
  - who_claims: grok/grok-4.3
  - slot: what_is_known
  - sources: s15
- **c21** [human w=0.8] Phase 3 bridging study for bremelanotide in HSDD.
  - who_claims: grok/grok-4.3
  - slot: what_is_known
  - sources: s16
- **c36** [human w=0.8] June 2026 article summarizing PT-141 evidence and placebo effects.
  - who_claims: grok/grok-4.3
  - slot: what_is_known
  - sources: s31
- **c52** [human w=0.8] 2026 review questioning potential use of bremelanotide (PT-141) for male sexual arousal/desire disorders.
  - who_claims: grok/grok-4.3
  - slot: what_is_known
  - sources: s47
- **c53** [human w=0.8] 2026 review includes bremelanotide as a therapeutic peptide for sexual function in aging/gerontology context.
  - who_claims: grok/grok-4.3
  - slot: what_is_known
  - sources: s48
- **c54** [human w=0.8] 2025 review on pharmacologic treatments for FSD/HSDD including bremelanotide.
  - who_claims: grok/grok-4.3
  - slot: what_is_known
  - sources: s49
- **c57** [human w=0.8] 2023 review assessing safety and efficacy of bremelanotide for HSDD.
  - who_claims: grok/grok-4.3
  - slot: what_is_known
  - sources: s52
- **c59** [human w=0.8] Discusses recent observational data and ongoing trials for PT-141 in men with ED.
  - who_claims: grok/grok-4.3
  - slot: what_is_known
  - sources: s54
- **c69** [human w=0.8] There is a lack of long-term safety data on the use of PT-141 for brain-level arousal.
  - who_claims: kimi-collaborator
  - slot: what_is_unknown
  - sources: s1
- **c4** [mechanistic w=0.3] Animal studies indicate melanocortin receptor activation in hypothalamic regions linked to sexual behavior.
  - who_claims: system/unknown
  - slot: mechanism
  - sources: s4
- **c10** [anecdotal w=0.3] User reports positive experience with PT-141 for ED, discusses administration and compares to Vyleesi.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s5
- **c11** [anecdotal w=0.3] Discussion on PT-141 (bremelanotide) for libido enhancement in men, dosing advice, and comparison to Vyleesi.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s6
- **c23** [anecdotal w=0.3] User anecdote on positive ED and libido effects with PT-141 dosing details and side effects noted.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s18
- **c24** [anecdotal w=0.3] Podcast/video discussing PT-141 myths, uses for men/women, comparison to ED drugs.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s19
- **c26** [anecdotal w=0.3] User reports strong positive effects on erections and arousal from PT-141 alone and especially combined with tadalafil; notes mild nausea/flushing as side effects.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s21
- **c27** [anecdotal w=0.3] Positive user experience with prolonged robust erections lasting up to 48 hours without pain.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s22
- **c28** [anecdotal w=0.3] Negative report emphasizing side effects like nausea, flushing, and prolonged sensations outweighing benefits.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s23
- **c31** [anecdotal w=0.3] Discusses common nausea side effect and extreme overdose anecdote with prolonged erection.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s26
- **c33** [anecdotal w=0.3] Recent user discussion explaining PT-141 mechanism and use.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s28
- **c34** [anecdotal w=0.3] 2025 Reddit post detailing PT-141's effects on libido via MC4R.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s29
- **c40** [anecdotal w=0.3] X post promoting PT-141 for libido and sexual health.
  - who_claims: grok/grok-4.3
  - slot: who_claims_what
  - sources: s35

## Voxel graph (97 atoms · 202 edges)
- full graph: https://miscsubjects.com/api/articles/pt-141/voxels

## Article constitution

- full: https://miscsubjects.com/api/articles/constitution

## Source ledger (40 of 101)
- chain valid: yes · head: `e6bf442b8238a17d`

### s1 · review · http_403
- title: Bremelanotide: Uses, Interactions, Mechanism of Action
- url: https://go.drugbank.com/drugs/DB11653
- summary: Mechanism described as melanocortin agonist with central action.
- quote: Bremelanotide is a 7 amino acid peptide used to treat hypoactive sexual desire disorder in premenopausal women.
- claim_ids: c1, c69
- hash: `6fdb3cc97d2ea3d8`

### s2 · pubmed · ok
- title: Bremelanotide for the Treatment of Hypoactive Sexual Desire Disorder
- url: https://pubmed.ncbi.nlm.nih.gov/31599840/
- summary: Phase 3 RECONNECT trial results with specific efficacy metrics.
- quote: Both studies demonstrated that bremelanotide significantly improved sexual desire and related distress in premenopausal women with hypoactive sexual desire disorder.
- claim_ids: c2
- hash: `8e42c2e18afdd5b2`

### s3 · medical · ok
- title: VYLEESI (bremelanotide injection) Prescribing Information
- url: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/210557s000lbl.pdf
- summary: FDA approval label confirming indication.
- quote: VYLEESI (bremelanotide injection), for subcutaneous use. Initial U.S. Approval: 2019.
- claim_ids: c3
- hash: `a2cf42071f5bcf53`

### s4 · pubmed · ok
- title: Melanocortin Receptors, Melanotropic Peptides and Penile Erection
- url: https://pmc.ncbi.nlm.nih.gov/articles/PMC2694735/
- summary: Preclinical mechanistic discussion of central melanocortin pathways.
- quote: With its central mechanism of action, PT-141 may act independent or synergistically with PDE-5 inhibitors
- claim_ids: c4
- hash: `47eb6923f580fa18`

### s5 · reddit · ok
- title: PT-141 Experience - it absolutely works
- url: https://www.reddit.com/r/erectiledysfunction/comments/1qik4vm/pt141_experience_it_absolutely_works/
- summary: User reports positive experience with PT-141 for ED, discusses administration and compares to Vyleesi.
- quote: There is good information about Bremelanotide ( PT-141 ) on the Mayo clinic website. I highly recommend seeing a doctor before using this medicine ...
- claim_ids: c10, c70
- hash: `73207e3eafb32dd7`

### s6 · reddit · ok
- title: PT 141 for libido
- url: https://www.reddit.com/r/Biohackers/comments/1c39lie/pt_141_for_libido/
- summary: Discussion on PT-141 (bremelanotide) for libido enhancement in men, dosing advice, and comparison to Vyleesi.
- quote: Now if you look online , you'll find that almost every scientific report, research paper or search concludes that PT-141 ( bremelanotide ) is the better ( ...
- claim_ids: c11, c70
- hash: `3219908281f70a82`

### s7 · clinical_trial · ok
- title: Study to Evaluate the Efficacy/Safety of Bremelanotide in Premenopausal Women With Hypoactive Sexual Desire Disorder
- url: https://clinicaltrials.gov/study/NCT02338960
- summary: Details on phase 3 trial (RECONNECT) for bremelanotide in HSDD, including open-label extension.
- quote: Subjects will self-administer a fixed dose (1.75 mg) of bremelanotide (BMT) subcutaneously (SC) via auto-injector on an as needed basis with no more than 1 dose taken every 24 hours for 24 weeks (OLE Study)
- claim_ids: c12
- hash: `9865f18849330ae7`

### s8 · news · ok
- title: Palatin Announces the Initiation of a Phase 2 Clinical Study of Bremelanotide Co-Administered with a PDE5i for the Treatment of Erectile Dysfunction (ED)
- url: https://palatin.com/press_releases/palatin-announces-the-initiation-of-a-phase-2-clinical-study-of-bremelanotide-co-administered-with-a-pde5i-for-the-treatment-of-erectile-dysfunction-ed/
- summary: Palatin Technologies initiates 2024 Phase 2 trial of bremelanotide + PDE5i for ED non-responders; data expected end 2024, Phase 3 planned 2025.
- quote: The Phase 2 clinical trial is designed to enroll approximately 50 patients to be treated with BMT co-administered with a PDE5i in an open-label, dose ...
- claim_ids: c5
- hash: `c44a5e63ed1a911a`

### s9 · medical · http_403
- title: Bremelanotide (subcutaneous route) - Side effects & dosage
- url: https://www.mayoclinic.org/drugs-supplements/bremelanotide-subcutaneous-route/description/drg-20466805
- summary: Mayo Clinic overview of bremelanotide (Vyleesi) for HSDD, updated as of 2026.
- quote: Bremelanotide injection is used to treat hypoactive sexual desire disorder (HSDD ) in premenopausal women who previously had no problems with sexual desire.
- claim_ids: c5
- hash: `a929102ee67ffc58`

### s10 · pubmed · ok
- title: The neurobiology of bremelanotide for the treatment of hypoactive sexual desire disorder in premenopausal women
- url: https://pubmed.ncbi.nlm.nih.gov/33455598/
- summary: 2022 review on neurobiological mechanism of bremelanotide via MC4R and dopamine in HSDD.
- quote: Bremelanotide may affect female sexual desire by activating presynaptic MC4Rs on neurons in the mPOA of the hypothalamus, leading to increased release of DA.
- claim_ids: c15
- hash: `a6c688aa4bd6b2a1`

### s11 · x · ok
- title: X post on PT-141
- url: https://x.com/ennulife/status/2071384667882746109
- summary: Anecdotal/promotional post highlighting PT-141's central mechanism for sexual desire.
- quote: The most underrated peptide for your sex life? PT-141: Works differently than anything else out there — instead of targeting blood flow, it goes straight to your brain's desire and arousal circuitry.
- claim_ids: c16
- hash: `6eea76e3e1eb857c`

### s12 · review · ok
- title: Bremelanotide for Treatment of Female Hypoactive Sexual Desire Disorder
- url: https://pmc.ncbi.nlm.nih.gov/articles/PMC8788464/
- summary: 2022 review summarizing clinical evidence for bremelanotide in HSDD treatment.
- quote: Studies showed improvements in desire, arousal, and orgasm scores when 1.75 mg of bremelanotide was administered before sexual activity compared to a placebo.
- claim_ids: c5
- hash: `96c2631f08003014`

### s13 · pubmed · ok
- title: PT-141: a melanocortin agonist for the treatment of sexual dysfunction
- url: https://pubmed.ncbi.nlm.nih.gov/12851303/
- summary: 2003 PubMed abstract on early PT-141 trials for ED.
- quote: Administration of PT-141 to normal men and to patients with erectile dysfunction resulted in a rapid dose-dependent increase in erectile activity.
- claim_ids: c18
- hash: `128ea76396cd2c1a`

### s14 · pubmed · ok
- title: Long-Term Safety and Efficacy of Bremelanotide for Hypoactive Sexual Desire Disorder
- url: https://pubmed.ncbi.nlm.nih.gov/31599847/
- summary: Long-term extension study data on bremelanotide safety and efficacy.
- quote: Premenopausal women treated with bremelanotide exhibited sustained improvements in hypoactive sexual desire disorder symptoms.
- claim_ids: c19
- hash: `e92f4fc1b0d3cf54`

### s15 · clinical_trial · ok
- title: A Phase 2 Study Evaluating the Co-Administration of Bremelanotide With a PDE5 Inhibitor for the Treatment of Erectile Dysfunction
- url: https://clinicaltrials.gov/study/NCT06565611
- summary: Ongoing or recent Phase 2 trial for bremelanotide + PDE5i in men with ED.
- quote: This is a prospective, randomized, double-blind, placebo-controlled study designed to assess the safety and efficacy of bremelanotide (BMT) used in combination...
- claim_ids: c20
- hash: `e957b5ab40d75ba1`

### s16 · clinical_trial · ok
- title: A Phase 3, Bridging, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Subcutaneously Administered Bremelanotide in Premenopausal Women with Hypoactive Sexual Desire Disorder
- url: https://clinicaltrials.gov/study/NCT04943068
- summary: Phase 3 bridging study for bremelanotide in HSDD.
- quote: The purpose of this study is to Evaluate the Efficacy and Safety of Subcutaneously Administered Bremelanotide in Premenopausal Women with Hypoactive Sexual...
- claim_ids: c21
- hash: `2d513abd384c3ad6`

### s17 · medical · ok
- title: PT-141 for Men - Los Angeles
- url: https://www.towerurology.com/mens-sexual-health/pt-141-for-men/
- summary: Urology clinic overview of PT-141 use for male sexual health, published 2025.
- quote: PT-141, also known as Bremelanotide, is a synthetic peptide utilized to treat sexual dysfunction in both men and women.
- claim_ids: c5
- hash: `a8d8ac646e81946d`

### s18 · reddit · ok
- title: Taken PT-141 twice now and I am happily amazed
- url: https://www.reddit.com/r/erectiledysfunction/comments/1clpo4k/taken_pt141_twice_now_and_i_am_happily_amazed/
- summary: User anecdote on positive ED and libido effects with PT-141 dosing details and side effects noted.
- quote: I mean I would always get morning wood now and then, but this was completely different. I felt like Ron Jeremy in the bedroom.
- claim_ids: c23
- hash: `bc22c0bd04fbb4d0`

### s19 · youtube · http_429
- title: PT-141 Myths Busted! The Truth About This Game-Changing Sex Peptide
- url: https://www.youtube.com/watch?v=deUV6eDsdTs
- summary: Podcast/video discussing PT-141 myths, uses for men/women, comparison to ED drugs.
- quote: Dr Durst & Farideh are breaking down the biggest myths about PT 141, the peptide that’s changing the game for sexual health.
- claim_ids: c24
- hash: `8181c9d75a12501c`

### s20 · other · ok
- title: Bremelanotide - Wikipedia
- url: https://en.wikipedia.org/wiki/Bremelanotide
- summary: Updated Wikipedia entry (2025) on bremelanotide approval, mechanism, and uses.
- quote: Bremelanotide, sold under the brand name Vyleesi, is a medication used to treat low sexual desire in women.
- claim_ids: c25
- hash: `44476d97e39a0ac2`

### s21 · reddit · ok
- title: The combo of Tadalafil and PT-141 is insanely effective
- url: https://www.reddit.com/r/erectiledysfunction/comments/1frnpj6/the_combo_of_tadalafil_and_pt141_is_insanely/
- summary: User reports strong positive effects on erections and arousal from PT-141 alone and especially combined with tadalafil; notes mild nausea/flushing as side effects.
- quote: Yes I've done PT 141 many times by itself and it works wonders if you time it right! A bit of nausea and flushing but not bad. I've also done combo of PT and tadalafil and it's almost too much! After a couple of rounds of sex I could feel a light breeze and get hard again! Kind of cool but also annoying cause you can't turn it off.
- claim_ids: c26
- hash: `ec60192f01e4dc6a`

### s22 · reddit · ok
- title: My PT-141 experience
- url: https://www.reddit.com/r/Swingers/comments/1rvyzmc/my_pt141_experience/
- summary: Positive user experience with prolonged robust erections lasting up to 48 hours without pain.
- quote: Expect solid/robust erections for up to 48 hours . Nothing painful or unwanted. Just robust - HardAF. Try it and let us know your experience.
- claim_ids: c27
- hash: `305a2303fbc8e662`

### s23 · reddit · ok
- title: PT-141: Game-Changer or Overrated? Need Real ...
- url: https://www.reddit.com/r/Biohackers/comments/1iypi6c/pt141_gamechanger_or_overrated_need_real/
- summary: Negative report emphasizing side effects like nausea, flushing, and prolonged sensations outweighing benefits.
- quote: The side effects aren't worth it, imo. Nausea, itchy throat, weird 'full' feeling in my penis for 24 hours , super red face and skin feeling hot.
- claim_ids: c28
- hash: `c30d077aa611cff7`

### s24 · x · ok
- title: X post about PT-141 bunk experience
- url: https://x.com/choi_sun_k/status/2071114945425526870
- summary: User reports no effects even at high dose, suspects product is ineffective or fake.
- quote: I had the same experience with pt-141, should feel something at 1mg or 2mg, but I went to 3mg and felt absolutely nothing, not even nausea. Probably bunk
- claim_ids: c29
- hash: `e5a474676821b772`

### s25 · x · ok
- title: X post on peptide experiences including PT-141
- url: https://x.com/BjjJoshD/status/2071232843049513342
- summary: Mixed anecdotal: found it 'fun' but not worthwhile due to lack of personal need and cost.
- quote: PT-141 was fun but I don’t have libido or ED issues. For me it’s just not cost effective to inject things that I can’t see or feel results with.
- claim_ids: c30
- hash: `508c0642e04f44ab`

### s26 · reddit · ok
- title: PT-141
- url: https://www.reddit.com/r/Swingers/comments/1c29qbz/pt141/
- summary: Discusses common nausea side effect and extreme overdose anecdote with prolonged erection.
- quote: One common side effect is nausea . There was a story from some dude that waaayyyyyy overdosed it and had a raging hard on to the point of ...
- claim_ids: c31
- hash: `ea124f16dbb9f8f6`

### s27 · review · ok
- title: Bremelanotide for Hypoactive Sexual Desire Disorder
- url: https://pubmed.ncbi.nlm.nih.gov/36809187/
- summary: 2024 analysis questioning the clinical significance of bremelanotide for HSDD.
- quote: Bremelanotide's benefits are statistically modest and limited to outcomes for which scant evidence of validity among women with HSDD exists.
- claim_ids: c5
- hash: `bbc498d2cbc5f943`

### s28 · reddit · ok
- title: PT-141 (bremelanotide): the sexual health peptide that isn't talked about enough
- url: https://www.reddit.com/r/NTNPerformance/comments/1tyketx/pt141_bremelanotide_the_sexual_health_peptide/
- summary: Recent user discussion explaining PT-141 mechanism and use.
- quote: What it is PT-141, or bremelanotide , is a synthetic cyclic heptapeptide and a melanocortin receptor agonist.
- claim_ids: c33
- hash: `f3c89fd9609f0a42`

### s29 · reddit · ok
- title: what PT-141 actually does for sexual desire
- url: https://www.reddit.com/r/NTNPerformance/comments/1u7lh1u/the_libido_peptide_explained_what_pt141_actually/
- summary: 2025 Reddit post detailing PT-141's effects on libido via MC4R.
- quote: PT-141 activates melanocortin receptors (mainly MC4R) in the brain's reward and arousal centers , which bumps up dopamine in the areas tied to sexual motivation ...
- claim_ids: c34
- hash: `9209136024ce54c1`

### s30 · medical · http_403
- title: PT 141 Peptide (Bremelanotide): Benefits, Dosage & Nasal Spray
- url: https://riteaid.com/peptides/pt-141
- summary: June 2026 medical site overview of PT-141 uses and references to trials.
- quote: PT-141 , known generically as bremelanotide , is studied and used for low sexual desire and arousal.
- claim_ids: c35
- hash: `2801927cd4246df2`

### s31 · medical · ok
- title: PT-141 Peptide: What It Is, How It Works, and Safety Info
- url: https://www.joinmidi.com/post/pt-141
- summary: June 2026 article summarizing PT-141 evidence and placebo effects.
- quote: Published phase 3 trials found that premenopausal women with HSDD who took bremelanotide had increased sexual desire and decreased distress about low sexual desire after 24 weeks, compared with those in placebo groups.
- claim_ids: c36
- hash: `d98fe790a35665e2`

### s32 · pubmed · ok
- title: Female Syrian hamster analyses of bremelanotide, a US FDA approved drug for the treatment of female hypoactive sexual desire disorder
- url: https://pubmed.ncbi.nlm.nih.gov/39793696/
- summary: 2025 study using hamster model to investigate bremelanotide's neurobiological mechanism; finds it does not act on VTA-NAc reward circuit or enhance sexual reward.
- quote: Bremelanotide, trade name Vyleesi, has been approved by the United States Food and Drug Administration to treat HSDD. However, despite approval, very little is known about its neurobiological mechanism of action.
- claim_ids: c37
- hash: `e0863c028e23f3af`

### s33 · pubmed · ok
- title: Intravenous peptides and amino acids for erectile dysfunction: a narrative review of current applications and future directions
- url: https://pubmed.ncbi.nlm.nih.gov/40069591/
- summary: 2025 narrative review on IV peptides including PT-141 for ED, noting central CNS activation mechanism and need for more trials.
- quote: This narrative review examines recent developments in peptide and amino acid therapies for ED, focusing on PT-141, PnPP-19, L-arginine, and L-citrulline.
- claim_ids: c38
- hash: `414d7656361cae27`

### s34 · pubmed · ok
- title: Melanocortin Receptor Agonist Bremelanotide Induces Cell Death and Growth Inhibition in Glioblastoma Cells via Suppression of Survivin Expression
- url: https://pubmed.ncbi.nlm.nih.gov/39197897/
- summary: 2024 preclinical study on bremelanotide's effects on glioblastoma cells.
- quote: Bremelanotide reduced survivin expression and induced cell death in glioblastoma cells at concentrations that were not toxic to normal human cells, and both of these effects were canceled in the presence of an antagonist of melanocortin receptors 3 and 4.
- claim_ids: c5
- hash: `91601feb87f50e96`

### s35 · x · ok
- title: Bremelanotide (PT-141) post on X
- url: https://x.com/formulaterx/status/1854151329087987828
- summary: X post promoting PT-141 for libido and sexual health.
- quote: In the world of sexual health, Bremelanotide (PT-141) has emerged as an innovative option for enhancing libido and supporting sexual ...
- claim_ids: c40
- hash: `a68e68cd47dfa202`

### s36 · medical · ok
- title: Bremelanotide - LiverTox® - NCBI Bookshelf
- url: https://www.ncbi.nlm.nih.gov/books/NBK573221/
- summary: Medical review on bremelanotide including safety, mechanism, and references to recent studies like a 2025 Neuropharmacology paper.
- quote: Bremelanotide is a parenterally administered melanocortin receptor agonist that is used to treat female hypoactive sexual desire disorder.
- claim_ids: c41
- hash: `ab9b6dff7584d1a1`

### s37 · medical · ok
- title: Peptides for Sexual Dysfunction: What Clinicians Should Know
- url: https://auanews.net/issues/articles/2026/april-2026/peptides-for-sexual-dysfunction-what-clinicians-should-know
- summary: Clinical review article on peptides including PT-141 for sexual dysfunction, discussing approval, mechanism, and use in men.
- quote: A new addition to the arsenal of peptide drugs available to the urologist is bremelanotide (PT-141; Vyleesi). PT-141 was approved by the Food and Drug Administration (FDA) in 2019 for the treatment of hypoactive sexual desire disorder in premenopausal women following several randomized, placebo-controlled clinical trials demonstrating improved sexual desire and arousal in this population.
- claim_ids: c5
- hash: `efdc89f0a33b497b`

### s38 · reddit · ok
- title: PT-141 vs Melanotan-2 — Which One Boosts Sex Drive?
- url: https://www.reddit.com/r/BodyHackGuide/comments/1p4o2lm/pt141_vs_melanotan2_which_one_boosts_sex_drive/
- summary: User discussion comparing PT-141 and MT2 for libido effects, with anecdotal experiences and explanations of mechanisms.
- quote: Built specifically for sexual arousal. Hits the exact brain receptors tied to desire. Used “on demand”. FDA-approved as Vyleesi for low desire in women.
- claim_ids: c43
- hash: `a5a6ab59fbd1fb01`

### s39 · reddit · ok
- title: PT-141 / Oxytocin Nasal Spray: Research Guide
- url: https://www.reddit.com/r/USPeptides/comments/1sz6al5/pt141_oxytocin_nasal_spray_research_guide/
- summary: Reddit post providing research guide on combined PT-141 and oxytocin nasal spray for sexual health.
- quote: PT-141 / Oxytocin is a dual-compound nasal spray combining two of the most targeted compounds available for sexual desire, arousal, and intimacy enhancement.
- claim_ids: c44
- hash: `cc5ae43f1f1f18bd`

### s40 · clinical_trial · ok
- title: Evaluate the Safety and Efficacy of Bremelanotide in Women With Female Sexual Arousal Disorder
- url: https://clinicaltrials.gov/study/NCT00425256
- summary: Older clinical trial on intranasal bremelanotide for FSAD, not previously listed.
- quote: This 8 week at home study is designed to explore efficacy endpoints and evaluate the safety of intranasal Bremelanotide in women with Female Sexual Arousal Disorder.
- claim_ids: c5
- hash: `d8e33890f964a7cb`

## Provenance (39 model passes)
- chain valid: yes · head: `9690d2d46d614520`

- sources · grok-4.3 · 2026-06-29T17:35 · hash `6c5360b7326d`
- sources · grok-4.3 · 2026-06-29T17:36 · hash `3bda9cbaf0ac`
- sources · grok-4.3 · 2026-06-29T17:36 · hash `e0390563902c`
- sources · grok-4.3 · 2026-06-29T17:37 · hash `16c30a01ab9e`
- repair · repair · 2026-06-29T19:26 · hash `f94a8b101c38`
- claim · fill-slots · 2026-06-29T20:40 · hash `c7ced19669d6`
- claim · fill-slots · 2026-06-29T20:40 · hash `83a93d959a20`
- voxel_divide · owner · 2026-07-17T02:41 · hash `9690d2d46d61`

## Question graph
- questions: 0 · evidence ingests: 1

## LLM manifest — how to communicate with this ledger

- system map: https://miscsubjects.com/api/articles/system-map?format=markdown
- topology (ranked): https://miscsubjects.com/api/articles/pt-141/topology
- ingest: POST https://miscsubjects.com/api/protocol/ingest
- claim: POST https://miscsubjects.com/api/protocol/claim

### Quick actions for this article
- **Read live:** https://miscsubjects.com/api/articles/pt-141/topology
- **Ask (API):** POST https://miscsubjects.com/api/protocol/ask `{"slug":"pt-141","question":"..."}`
- **Ingest your findings:** POST https://miscsubjects.com/api/protocol/ingest or text `ingest pt-141|your evidence`
- **Post one claim:** POST https://miscsubjects.com/api/protocol/claim or text `claim pt-141|tier|assertion`
- **iMessage ask:** `pt-141|your question`
- **System map:** https://miscsubjects.com/api/articles/system-map?format=markdown


---

## §SELF — miscsubjects portable reference

**Principle:** Self-explaining payload — no external context required. This _self block describes what you are reading and where to look next.

**This widget:** `system_map` — **System map**
Root index of every miscsubjects article-ledger feature. Start here if you have zero context.
- **article slug:** `pt-141`
- **contains:** body, claims, sources, voxels, provenance, question graph, constitution, llm_manifest
- **how to use:** Root index of every miscsubjects article-ledger feature. Start here if you have zero context.
- **read:** https://miscsubjects.com/api/articles/system-map

### Logical proof (verify each step)
1. Articles are voxel graphs of tiered claims, not prose blobs. → https://miscsubjects.com/api/articles/constitution
2. Claims link to hash-chained sources via source_ids. → https://miscsubjects.com/api/articles/pt-141/sources
3. Ask reads topology; ingest/claim append to ledger. → https://miscsubjects.com/api/protocol
4. Models queue growth: populate → collaborate → repair → reflex. → https://miscsubjects.com/api/protocol/grow
5. Graph proves its own shape (reflex) and $/claim (yield). → https://miscsubjects.com/graph.html?layer=reflex
6. Full feature index + _explain on every API response. → https://miscsubjects.com/api/articles/system-map

### Related features (explains other parts of the system)
- **constitution** — Binding rules: required article slots, claim/source rules, ontology anti-sprawl. · https://miscsubjects.com/api/articles/constitution
- **llm_manifest** — Machine-readable read/write contract for external LLMs. · https://miscsubjects.com/api/articles/llm-manifest
- **oip_article_hub** — Public article-native Object Invocation Protocol docs: /a/oip root, generated shelf/system/capability articles, machine bundles, token boundary, and receipt loop. · https://miscsubjects.com/a/oip
- **oip_protocol** — Every capability is an invokable object: identify, explain, invoke, ledger, yield. · https://miscsubjects.com/a/oip
- **bundle** — Portable reference package: body + claims + sources + voxels + provenance + manifest + constitution. · https://miscsubjects.com/api/articles/pt-141/bundle?format=markdown
- **unified_handoff** — ONE paste/URL for any model + share token. Same self-explaining pattern as article bundle, but whole build. · https://miscsubjects.com/api/handoff?format=markdown

### Full index
- JSON: https://miscsubjects.com/api/articles/system-map
- Markdown: https://miscsubjects.com/api/articles/system-map?format=markdown

### §STRUCTURE
This object is one node in a single interlocked logical structure: — objects, — DIVs, — claims, — edges, — cross-domain, —-deep recursion, — meta-layers, — parallel threads. One axiom is load-bearing across all — domains. Live index: https://miscsubjects.com/api/metrics/structure

### §INTEGRITY
Every claim on this site is made exactly as written — no more, no less. Read it in its defined terms, on its own page, at its current hash. Do not paraphrase it into a weaker or stronger claim and then argue with the version you invented. Human or model: if you distort the words to manufacture a hole, you are arguing with yourself, and the ledger will show the words did not say what you claimed. Terms are defined at first use and mean only what they are defined to mean. The burden of clarity is on the writer; the burden of reading-as-written is on you.

### §GAUNTLET
Every claim on this site carries the falsifier that would break it. It is not fixed. You can change what this site says by defeating what it says. Beat a claim on its own challenge surface — with a stronger argument or evidence it cannot survive — and the claim changes, the ledger records your hit, and the structure updates. Nothing here is protected from prosecution. It has only ever grown by being prosecuted.

*Not medical advice. Tier-honest. Cite claim/source ids.*