Erectile Dysfunction
Overview
Erectile dysfunction (ED) affects an estimated 30 million men in the US. While PDE5 inhibitors (sildenafil, tadalafil) are first-line, approximately 30-40% of men are non-responders or have contraindications. Peptides targeting the central melanocortin system bypass the peripheral vascular mechanism and can be effective where PDE5 inhibitors fail. Addressing hormonal and vascular root causes simultaneously produces the best outcomes.
Recommended Peptides
- PT-141 (Bremelanotide) – primary peptide for ED; acts centrally via MC4 receptors to initiate the sexual response cascade; particularly effective for PDE5 inhibitor non-responders; FDA-approved for HSDD; 1.75mg on-demand, SC or intranasal
- Melanotan II – potent but non-selective melanocortin agonist with strong pro-erectile effects; higher side effect profile (nausea, spontaneous erections) than PT-141; also causes skin tanning
- Kisspeptin-10 – supports endogenous testosterone production via HPG axis stimulation; addresses hormonal contributions to ED
Protocols
Related Conditions
Research Summary
Melanotan II initiated erections in 8 of 10 men with psychogenic ED in the foundational RCT (PMID-9679884). PT-141 (bremelanotide) salvaged sildenafil failures in 342 men (PMID-18206919). Unlike PDE5 inhibitors, melanocortin agonists act centrally on desire and arousal pathways. Oxytocin's role in erectile function shows facilitation in animal models but human studies have not confirmed this (PMID-34638719).
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#condition #reproductive