Detailed definition
Bremelanotide (Vyleesi) is a synthetic melanocortin receptor agonist (primarily MC4R) approved in 2019 for HSDD in premenopausal women. It is administered as a 1.75 mg subcutaneous autoinjection 45 minutes before anticipated sexual activity, with no more than one dose per 24 hours and no more than 8 doses per month. Mechanism: central melanocortin pathways are involved in sexual function, and MC4R agonism appears to enhance sexual desire and arousal in some women. Common side effects include nausea (40%), flushing, headache, transient hypertension and bradycardia, and focal skin hyperpigmentation with prolonged use. Like flibanserin, it is not approved for postmenopausal women.
Why it matters in menopause
Bremelanotide offers an as-needed alternative to daily flibanserin for HSDD, though side effects (notably nausea) are common. For postmenopausal HSDD, low-dose testosterone typically remains the first-line evidence-based option.
Related terms
Sources
External references: Wikipedia.