Erectile dysfunction can be devastating to a man's sex life and self-esteem. Not only does it prevent him from enjoying intercourse with his partner, but it also creates a tremendous amount of shame. But there are myriad causes for ED — from stress and fatigue to medications and obesity. In fact, ED will affect up to a third of men at some point in their lives.
Fortunately, there are more ways to treat ED today than ever before, with pills, natural supplements, and even unconventional approaches like PT 141. Medications like Viagra and Cialis are staples in conversations about male sexual health, but PT 141 may be new to you. That's why we've created this guide to familiarize you with its potential and help you decide if it's right for you.
At Innerbody Research, we extensively test each health service we review. All told, we’ve spent hundreds of hours testing and researching ED treatments. Over the past two decades, we have helped tens of millions of readers like you make more informed decisions to live healthier lives.
We try our best to give you, our readers, unbiased exploration of at-home health services, free of marketing jargon or gimmicks. We evaluate the service based on our adherence to quality, the latest medical evidence and health standards, and a simple question: would we buy the product or service ourselves if it weren’t part of our job, and would we recommend it to family and friends?
Additionally, like all health-related content on this website, this assessment of PT 141 was thoroughly vetted by one or more members of our Medical Review Board for accuracy.
PT 141, sometimes referred to as bremelanotide, gained traction in the early 2000s as a potential treatment for erectile dysfunction after scientists tested analogs of melanocyte receptor stimulators as potential tanning agents. They saw spontaneous erections occur in trials. Erection onset time and duration appeared dose-dependent, but researchers couldn't draw definite conclusions until they conducted more trials with ED as the target.
In the years that followed, researchers isolated a peptide from Melanotan II that they believed was the primary driver of the erection side effects. This peptide, PT 141, then entered trials to treat erectile dysfunction.
Several studies support PT 141's potential as an ED treatment, particularly for men who may have heart or blood pressure conditions that prohibit them from taking specific PDE5 inhibitors like sildenafil (generic Viagra) or tadalafil (generic Cialis). There is also potential for PT 141 to act in conjunction with PDE5 inhibitors, but this would require extensive study that does not exist at this point.
It's telling that studies on PT 141 as an ED treatment have slowed since 2005. Its efficacy was apparent, but the window of effectiveness in ED patients (what period of time the treatment would allow men to reliably achieve an erection) could not compete with sildenafil's average four-hour duration. Combined with a side effect profile that was too significant for most men, it was difficult for the product to be commercially viable. Still, there is a small niche market for the peptide.
After reviewing the research, we believe that most men should exhaust other avenues of treatment before considering PT 141. The peptide can be dangerous and expensive and is much harder to access than PDE5 inhibitors that you can find from convenient online sources like BlueChew, Hims, and Roman or through your in-person healthcare provider. We recommend BlueChew as your top choice in this category because they provide a one-month free trial – if you’re a suitable candidate for the treatment, there isn’t a more convenient, private, and economical way to try it.
Technically, PT 141 is a cyclic heptapeptide melanocortin analog. That means that it's a synthetic version of a substance that your body can create, albeit in sometimes insufficient quantities. PT 141 can activate melanocortin receptors without the tanning effects that were the goal of early Melanotan II trials. That activation has a specific impact on the central nervous system, resulting in reliable erections and improved sexual function.
By acting on the central nervous system instead of the circulatory system, PT 141 could serve as a substitute ED medication for men with heart or blood pressure issues that prevent them from taking PDE5 inhibitors.
PT 141 takes a little longer to work than the typical PDE5 inhibitor, even at high doses. Those higher doses (10-20mg) often fail to produce erections that last as long as a PDE5 inhibitor can provide. Some purveyors of PT 141 will speak of erections lasting several hours, but that research was conducted in healthy males without ED. ED patients rarely saw erections last more than an hour.
PT 141 is only available by prescription, though some less scrupulous websites offer it to anyone over 18. It's worth noting that those sites explicitly state that PT 141 is not intended for human consumption. Such websites say that they intend their products for research purposes only. A glance at their customer reviews shows that individuals purchase and take the peptides themselves, ignoring the site's disclaimers.
Other sites at least try to provide a safety net and a resource to contact in the event of adverse reactions. They have doctors on staff who will prescribe PT 141 for you to buy it through the site. These are not necessarily reputable companies, however. Other companies in the telehealth space have gained the medical community's trust. Sites like Lemonaid and Nurx are legitimate medical providers. But they don't trade in peptides. Providers specializing in ED treatments like BlueChew or Hims are also trustworthy. They don't deal in peptides either.
Online sources for PT 141 that offer prescription services also bear a significant markup for their nasal spray and injectables. Take a look at the cost per dose of PT 141 compared to sildenafil or tadalafil from BlueChew:
*Providers will often compound nasal sprays based on prescribed strength. Most spray bottles contain eight administrations, which is the recommended maximum for one month. The cost per dose of the nasal spray is based on ⅛ the price of a bottle. **Tadalafil will not create an erection that lasts for 36 hours, but it allows sexual arousal to result in an erection as needed for up to 36 hours.
Researchers have looked at PT 141 administered as a subcutaneous injection and a nasal spray. The nasal spray is the far more convenient delivery method, and it tends to produce milder side effects, but it requires slightly higher doses than the injections. That makes the nasal spray more expensive per use than the injectable peptide.
The chart below illustrates the potential benefits of PT 141, but it also shows the significant risk of adverse effects. You'll also notice that it takes 2-3 times the dosage for the nasal spray to be as effective as the subcutaneous injection.
For this chart, an erection is defined as having at least 60% rigidity as measured by RigiScan.
PT 141 studies are not extensive enough to draw definitive conclusions about its safety. Still, the studies that have been conducted point toward significant issues with flushing, nausea, and vomiting.
When you look at the field of research that has gone into PDE5 inhibitors like sildenafil and tadalafil, it's clear that those products have a pronounced research advantage over PT 141. With that much more data, the safety of PDE5 inhibitors is well-established. There are still too many unknowns and too many red flags in PT 141 research to assume it's safe. Certainly it requires a discussion with your doctor first, which is why PT 141 is available for human consumption only via prescription.
The FDA approved an injectable version of PT 141 for women in 2019. Branded Vylessi, this drug is intended to treat hypoactive sexual dysfunction in premenopausal women. It is not approved for use by men in the treatment of ED.
Side effects from PT 141 were generally more severe in its subcutaneous injection form than its nasal spray. That said, both had rates of adverse reactions that do not bode well for their overall safety. Its injection and nasal spray saw the following side effects with increasing frequency and intensity at higher dosages:
The most concerning side effect was delayed-onset vomiting associated with higher doses of the subcutaneous injection. Study subjects who experienced this adverse effect often vomited 6-15 hours after administration. This indicates a toxicity level that implies more significant danger with long-term use. Vomiting was significantly less common with the nasal spray and only at the highest dose.
Given the safety concerns, side effect profile, accessibility challenges, and high cost, we don't consider PT 141 recommendable for the vast majority of men who have trouble achieving an erection. We understand the allure – a “peptide” sounds more natural and innocent than a pharmaceutical drug may sound, though PT 141 is synthetic – but that's not enough to justify the risks or cost associated with it.
Instead of opting for a riskier, more expensive, and less effective medication, we recommend starting your ED treatment journey with something proven safe and effective. Sildenafil and tadalafil are among the most effective and well-researched treatments available. And with modern telemedicine, you can receive a prescription from a board-certified physician and have your medication shipped discreetly to your home in a matter of days. No ED treatment route is more private and discreet than this.
Our top recommendation for ED treatment is BlueChew. Having the ability to consume a chewable tablet without water up to 36 hours before sexual activity is undeniably convenient. Because the pills come in individual packets, you can carry one with you on dates or when you travel. But best of all: BlueChew lets you take advantage of a one-month free trial of ED medication (either sildenafil or tadalafil). This is a true value for men who have never tried these medications.
If you're curious about BlueChew, you can read all about them and their free trial offer exclusive to Innerbody readers in our comprehensive review. You can also learn about other ED treatment options in our complete ED treatment guide.
At Innerbody Research, we customize our evaluation criteria depending on the type and nature of the health-related service or product. For health products like PT 141, we have five areas that we use for our evaluations, including:
Quality: How well does a product serve the customer? Is it effective to a high enough degree that we would recommend it to our loved ones before other options, without hesitation? If not, why not?
User-friendly: How intuitive, user-friendly, and convenient are the product and any associated services?
Value: Are you getting your money’s worth? Are there any hidden costs or charges? Are there discount opportunities?
Safety: Are there risks associated with using a product or service? These might include risks of bodily harm or a breach of privacy.
Customer support: Particularly in situations where ‘one size fits all’ doesn’t make sense, how well can a product or service be tailored to best suit your needs?
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