Sexual Health Protocol — Male

Restore erectile function, libido, and sexual confidence through central melanocortin activation and gonadal support

Patient profile: Males 35–65 with erectile dysfunction (mild–moderate), low libido, or hypogonadism; including psychogenic ED where PDE5 inhibitors are insufficient

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⚠️

This protocol is an educational example only. It does not apply to your specific health situation. Medical supervision is required. Peptide therapy is not approved by regulatory bodies for many of the described indications.

Protocol Stack

PT-141 (Bremelanotide)

Primary

Dose

1.0–1.75 mg

Frequency

As-needed SC, maximum 2x/week

Timing

45–90 min before sexual activity

Duration

Ongoing as-needed

HCG (Human Chorionic Gonadotropin)

Supporting

Dose

500 IU

Frequency

2x/week SC

Timing

Any time, consistent days

Duration

Ongoing; reassess testosterone every 3 months

Oxytocin

Optional

Dose

20–40 IU

Frequency

As-needed intranasal

Timing

15 min before intimacy

Duration

Optional — as-needed

Monitoring Parameters

✓Total and free testosterone — baseline, 3 months, 6 months
✓LH, FSH — baseline (rules out primary hypogonadism)
✓Estradiol (E2) — baseline and with each testosterone check
✓Hematocrit — every 6 months (HCG can stimulate erythropoiesis)
✓Blood pressure (PT-141 causes transient elevation) — check after first dose
✓IIEF-5 score — baseline, monthly
✓Prolactin — baseline (elevated prolactin is a reversible cause of ED)

Expected Outcomes

PT-141 onset: effects within 45–90 min, duration 6–12 hours

Week 4 (HCG): Testicular fullness and minor testosterone uplift

Month 3: Testosterone increase 15–30% from HCG; libido improvement sustained

Month 6: Comprehensive reassessment; option to add CJC-1295/Ipamorelin for synergistic anabolic support

Contraindications

✗Cardiovascular disease with unstable angina or recent MI (PT-141 raises BP transiently)
✗Primary hypogonadism — HCG will not be effective, TRT required
✗Prostate cancer or PSA > 4 ng/mL without urological clearance
✗PT-141 in patients with history of severe nausea with emetics
✗HCG in men desiring fertility preservation (suppresses spermatogenesis at high doses)

Clinical Notes

PT-141 works centrally via MC3R/MC4R activation — unlike PDE5 inhibitors it does not require sexual stimulation and addresses both physiological and psychogenic ED. Common side effect is flushing and mild nausea (usually resolves in 1h). Starting dose of 1.0 mg is recommended; titrate to 1.75 mg only if response is insufficient. HCG maintains testicular volume and endogenous testosterone during any concurrent TRT.

Case Study

Clinical Practice Example

Male, 51, with 2-year history of moderate ED (IIEF-5 score 12/25), low libido, morning testosterone 8.9 nmol/L. Started PT-141 + HCG. First PT-141 dose produced noticeable erection quality improvement — patient described it as 'like being 30 again'. After 3 months of HCG: testosterone 13.2 nmol/L, IIEF-5 19/25. Continued on long-term protocol.

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