Sexual Wellness · Vyleesi (Bremelanotide)
Vyleesi for women.FDA-approved for premenopausal HSDD.
Bremelanotide (brand name Vyleesi) is FDA-approved for hypoactive sexual desire disorder (HSDD) in premenopausal women. It works through the central nervous system. It is not a hormone, an SSRI, or a vascular drug, and it is not used continuously. Dosing is per event, by patient self-injection.
FDA status, on label
Vyleesi (bremelanotide) is FDA-approved for the treatment of acquired, generalized HSDD in premenopausal women. Use outside that indication is off label and disclosed at consultation.
A note on care
Discreet, dignified, evidence-graded.
HSDD is the most common female sexual concern, and it is distinct from arousal disorder, orgasmic disorder, or pain disorders. Vyleesi was approved on the basis of the RECONNECT phase-3 trials, which demonstrated improvements in desire and distress scores compared with placebo in premenopausal women.
Vyleesi does not require continuous dosing. It is taken on-demand, approximately 45 minutes before anticipated sexual activity, by single-use auto-injector. Dosing is limited to one dose per 24 hours and no more than 8 doses per month per the label.
How it works
Central nervous system, not hormones.
Bremelanotide is a melanocortin-receptor agonist, with preferential activity at MC4R. The mechanism is upstream of vascular response and is associated with central modulation of sexual desire pathways.
Because it is not hormonal, it does not produce the perimenopause and menopause-related effects that some patients hope estrogen or testosterone therapy will address. Patients presenting with HSDD in the setting of menopause may benefit from hormone therapy first, with Vyleesi considered if desire concerns persist.
In context
Where this fits among other options.
Vyleesi vs Addyi (flibanserin)
Both are FDA-approved for premenopausal HSDD. Addyi is daily oral; Vyleesi is per event subcutaneous. Side-effect profiles differ. Your provider reviews fit at consultation.
Vyleesi vs HRT
HRT addresses hormonal contributors to desire (often the case in perimenopause and menopause). Vyleesi acts centrally and does not address hormonal deficits. They can be combined when clinically indicated.
Candidacy
Who this is appropriate for.
- Premenopausal women with acquired, generalized HSDD
- Patients seeking on-demand, non-hormonal therapy
- Patients who have not responded sufficiently to lifestyle, relational, or hormonal interventions
Safety considerations
What we screen for.
- Uncontrolled hypertension or known cardiovascular disease
- Pregnancy or breastfeeding
- Concurrent naltrexone use (significant interaction)
- Hyperpigmentation history (focal pigmentation can occur with repeated dosing)
Frequently asked
Frequently asked questions.
HSDD (hypoactive sexual desire disorder) is persistent or recurrent low sexual desire that causes distress and is not better explained by another medical or psychiatric condition, medication, or relationship factor. Diagnosis is clinical, made by your provider at consultation.
Subcutaneous self-injection by single-use auto-injector approximately 45 minutes before anticipated sexual activity. Maximum one dose per 24 hours; no more than 8 doses per month per the FDA label.
Nausea (especially first dose), flushing, injection-site reaction, headache, and a transient blood-pressure increase. Focal hyperpigmentation can occur with repeated use. Your provider reviews the full safety profile at the Good Faith Exam.
Yes, in many cases. Vyleesi acts centrally; HRT addresses hormonal contributors. They can be combined when clinically appropriate. Your provider determines fit based on your history and clinical picture.
Coverage varies. Genesis Longevity is a cash-pay clinic and does not bill insurance directly. Many patients confirm coverage independently and submit itemized receipts for reimbursement.
Next step
Schedule a private consultation.
Your conversation is confidential. Provider-led, evidence-graded, no pressure.