Bremelanotide for Men: Exploring Off-Label Use for Male Hypoactive Sexual Desire Disorder

Bremelanotide, marketed as Vyleesi, gained FDA approval in 2019 specifically for the treatment of hypoactive sexual desire disorder (HSDD) in women. Although it has not yet received approval for use in men, there is growing interest in its off-label potential to treat male hypoactive sexual desire disorder (MHSDD). Urologist Dr. Irwin Goldstein, renowned for his extensive work in male sexual health and sexual dysfunction, has been a prominent advocate for using Bremelanotide to address MHSDD in men. His expertise in understanding sexual desire and sexual function makes him a key figure in exploring this treatment option.

Dr. Goldstein’s advocacy for Bremelanotide as a treatment for MHSDD is grounded in his broader understanding of male sexual health.

He has long emphasized the importance of maintaining healthy circulation to ensure optimal sexual function, a perspective he refers to as the vascular model of erectile dysfunction. This model highlights the critical role of blood flow in achieving and sustaining erections, which is essential for a satisfying sex life. Bremelanotide, however, offers a different approach by targeting sexual desire through neurochemical pathways. This presents an intriguing complementary pathway to improve male sexual health, especially for those experiencing decreased sexual desire and lack of sexual interest.

The exploration of Bremelanotide for men is particularly promising for those dealing with acquired or situational forms of MHSDD. While traditional erectile dysfunction medications focus on performance, Bremelanotide directly addresses the psychological and neurochemical aspects of sexual desire. This distinction makes it a valuable addition to the range of treatment options available for men seeking to enhance their sexual functioning and overall sexual health. By increasing sexual desire and addressing desire disorders, Bremelanotide could significantly improve the quality of life for men experiencing low libido and related sexual problems.

Goldstein, who in 1997 famously warned that “men should never ride bicycles” due to the perineal arterial compression caused by traditional seats, has since observed that the cycling industry adapted.

Modern bifurcated, cloven bicycle seats are designed to avoid pressure on the perineum, helping protect blood flow to the penis. This aligns with his broader vascular model of erectile dysfunction, which underscores the importance of healthy circulation to maintain sexual function and enhance sexual performance.

The significance of Dr. Goldstein’s work lies in its potential to revolutionize treatment options for men experiencing hypoactive sexual desire disorder (MHSDD). By focusing on the neurochemical aspects of sexual desire, Bremelanotide offers a novel approach that complements traditional vascular treatments like PDE-5 inhibitors, which primarily address erectile dysfunction. This dual approach could benefit men who face personal distress due to decreased sexual desire and lack of interest in sex, ultimately enhancing their sex life and overall well-being. Additionally, understanding the psychological conditions and lifestyle changes needed to support healthy sexual function is crucial. This comprehensive perspective on sexual health not only addresses the physical aspects but also considers mental health and relationship factors that contribute to a fulfilling sex life.

MHSDD, now classified in the DSM-5-TR, affects up to 15% of men and is categorized into several subtypes:

Lifelong/generalized: The individual has never experienced sexual desire.
Acquired/generalized: Sexual desire was previously present but has since diminished.
Acquired/situational: Sexual desire has decreased for a specific partner but may still exist for others or for self-stimulation.

While Bremelanotide directly targets sexual desire, rather than performance (like erectile dysfunction drugs), it could be especially beneficial for men experiencing the acquired or situational forms of MHSDD.

Off-Label Use of Bremelanotide for Men

Despite Bremelanotide not being FDA approved for men, Dr. Irwin Goldstein’s research has shown promising results in its use for men with sexual dysfunction. In a study published in the Journal of Urology, titled “Use of the CNS Agent Bremelanotide in Men with Sexual Dysfunction: Results from a Sexual Medicine Clinic”, Goldstein and co-author Sue W. Goldstein found that the nausea rate among male participants was about 30%—lower than the 40% nausea rate reported in women during previous studies. This reduced incidence of nausea makes Bremelanotide a more appealing option for men, especially those dealing with hypoactive sexual desire disorder (MHSDD).

Bremelanotide works by targeting the neurochemical pathways associated with sexual desire, offering a novel treatment approach for men with low sexual desire. By focusing on the psychological and neurochemical aspects of sexual functioning, it provides an alternative to traditional erectile dysfunction medications, which primarily address performance issues. This dual approach can significantly enhance sexual health and improve the quality of life for men facing sexual problems, low libido, and decreased sexual desire. As more clinics, like Regeneris Elite Men’s Health Clinic, consider offering Bremelanotide, it could become a valuable addition to the treatment options for male sexual dysfunction.

At Regeneris Elite Men’s Health Clinic, we aim to be one of the providers offering Bremelanotide as a treatment option for men. Given its FDA approval for women and the minimal physiological differences between men and women generally — outside of sexual organs, and some mild overlap regarding sexual desire mechanisms — we are extrapolating its use for men. While causes of MHSDD may differ, Bremelanotide’s neurochemical action presents a potentially valuable, complementary approach to vascular-oriented treatments like PDE-5 inhibitors (Viagra, Cialis).

Side Effects and Accessibility

While Bremelanotide has shown a reasonable safety profile, nausea remains a significant side effect. Many women have reported needing anti-nausea medications to handle this discomfort. For men considering Bremelanotide, it’s essential to be aware of this potential side effect. The cost of Bremelanotide is notably high, priced at $250 per injection. However, there may be opportunities for men to obtain it at a reduced cost through compounding pharmacies. Since Bremelanotide’s patent covers its specific use rather than the peptide itself, these pharmacies might provide more affordable alternatives.

Additionally, exploring the option of compounding pharmacies could make Bremelanotide more accessible for men experiencing low sexual desire or hypoactive sexual desire disorder. By offering a cost-effective solution, men can potentially enhance their sexual function and improve their overall quality of life. This accessibility is crucial in ensuring that more individuals can benefit from the potential advantages of Bremelanotide in treating sexual dysfunction.

The Bigger Picture of Male Sexual Health

While Bremelanotide offers a promising new approach to addressing male sexual desire issues, it is crucial to consider sexual health from a holistic perspective. Sexual desire is influenced by more than just physiological factors; emotional connection, intimacy, and engagement with family, friends, and community are significant contributors. Addressing these underlying emotional and relational causes of hypoactive sexual desire disorder (MHSDD) is as important as finding pharmacological solutions.

At Regeneris Elite Men’s Health Clinic, we advocate for a comprehensive treatment plan for male sexual health that incorporates both physical and emotional aspects. Bremelanotide is an exciting new tool in this broader approach, potentially helping men restore sexual desire while also focusing on vascular health and emotional well-being. By integrating treatments that address both the neurochemical and psychological aspects of sexual functioning, men can achieve a more satisfying and fulfilling sex life.

Additionally, lifestyle changes such as regular aerobic exercise, maintaining a healthy diet, and reducing stress can also play a vital role in improving sexual function and boosting sexual desire. These changes, perhaps someday combined with medical treatments like Bremelanotide, may enhance overall sexual health and well-being. By considering all these factors, men can tackle low libido and sexual dysfunction more effectively, leading to a better quality of life.

Peak Masculinity
Starts Here

By Dr. Ryan Welter

August 15, 2025