What is Bremelanotide?

PT-141 (Bremelanotide) is a melanocortin receptor agonist that is under study and development for the treatment of female sexual complaints. It is also used in the treatment of male sexual complaints. Originally, this medication was developed and tested as a sunless tanning agent but did not induce the desired effects; however, it was noticed that some subjects reported increased sexual arousal and spontaneous erections. Some serious concerns regarding the benefit and risk ratio of Bremelanotide caused delay in the stage 3 clinical trial regarding some severe changes in blood pressure. The melanocortins are thought to play an important role in female sexual health and functioning. The medication, which is under study and in advanced clinical trials, is a centrally acting drug that can affect the brain. It is a colorless, odorless chemical that is placed within a nasal inhaler and has been used by many women with sexual complaints. Some women who have taken the medication have reported increased warmth or throbbing in the genitals as well as an associated increased desire to engage in intercourse after use of the drug in pilot studies. A phase 2A pilot clinical study looked at this medication in premenopausal women diagnosed with female sexual dysfunction (FSD) and it has not shown encouraging results.

On May 13, 2008, Palatin Technologies, the maker of Bremelanotide, announced it has discontinued further development of Bremelanotide for the treatment of both male and female sexual dysfunction. However, the company released a statement identifying that it is also advancing a new compound, PL-6983, which in animal models causes significantly lower increases in blood pressure than those seen with Bremelanotide, into phase 1 clinical studies for treatment of male and female sexual dysfunction. There is hope in the future, and we should await further studies and publications.

What are vaginal moisturizers?

The liberal use of local nonmedicated, nonhormonal vaginal moisturizers such as Replens or vitamin E suppositories can provide relief for the symptoms of vaginal atrophy. These agents are recommended for use two or three times weekly. Women should wear a light pad when using vitamin E suppositories because they may stain undergarments. They help improve the vaginal lining or mucosa and help maintain the ridges and folds within the vaginal tissues. They should be used independently of sexual intercourse. Other types of moisturizers claim to be all natural. Another option is Moist Again. KY Vaginal liquid beads (Johnson and Johnson) are also another excellent vaginal moisturizer. KY Silk E (Johnson and Johnson) is also a popular vaginal moisturizer as is Vagisil.

As the number one recommended product, Replens (Lil' Drugstore Products) has been leading the way to increase the visibility of vaginal moisturizers among women seeking alternatives to hormone therapy. In past years, the New England Journal of Medicine reported that Replens was just as effective at relieving vaginal dryness as prescription hormones. Over-the-counter, Replens Vaginal Moisturizer provides soothing, immediate, and long-lasting relief from feminine dryness for 72 hours. Replens is available over-the-counter in many local pharmacies. In a published randomized trial, a polycarbophil-based vaginal moisturizer that is available over the counter (Replens) provided relief of vaginal (dryness) symptoms.

The liberal use of local nonmedicated, nonhormonal vaginal moisturizers such as Replens or vitamin E suppositories can provide relief for the symptoms of vaginal atrophy.

What are vaginal lubricants?

Vaginal lubricants are products that you can purchase over-the-counter that can be placed in the vagina before sexual activity to help create a sense of moisture or lubrication. Some women have decreased natural ability to create lubrication on their own, so store-bought or commercially available lubricants can be used to maintain a moist environment so that intercourse is not painful. The use of water-based vaginal lubricants with intercourse is also encouraged when vaginal dryness and atrophy are diagnosed.

Not all lubricants are created equal. Vaginal lubricants that contain spermicides, bactericides, perfumes, coloration, and flavors may also irritate a sensitive vaginal lining. Warming additives and fruit flavors may contain chemical irritants as well. These additives can be problematic especially in menopausal women. Read the labels because you can develop sensitivities to some of the chemicals in lubricants. Some of the common offenders include glycerin and parabens.

Lubricants can be purchased online discreetly, and many are available in your local pharmacy. Lubricate all surfaces as part of foreplay and be sure to keep lubricant handy in case more is needed. Lubricants may be water- or silicone-based. The lubricants come in a variety of different textures and viscosities; experiment with different types to find the type that is best for you. There are many different brands with different qualities. Some are warming, some are not. Some formulations do not contain glycerin or parabens. Some types are both fragrance-free and latex-compatible and can be used to increase your and your partner's sensual sensitivity and for total-body massage.

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