Desire (Bremelanotide / PT-141) Reviews and Complaints 2026: A Comprehensive Analysis
Desire (Bremelanotide / PT-141) :Desire is a provider-prescribed, fast-dissolving sublingual tablet from Shed Women’s Sexual Health that combines bremelanotide (PT-141) with oxytocin. It is marketed for low sexual desire in adult women, positioned as a treatment that works on the brain’s desire system rather than the vascular system. Bremelanotide is the active ingredient in Vyleesi, an FDA-approved subcutaneous injection for hypoactive sexual desire disorder (HSDD) in premenopausal women. However, the sublingual tablet format sold as Desire is a compounded product and is not FDA-approved. This review examines the formulation, the clinical evidence, and what users are reporting about both the medication and the platform.
Review Summary Box
| Feature | Details |
|---|---|
| Overall Rating | 3.5 / 5 ⭐ |
| Best For | Premenopausal women with acquired, generalized HSDD and no uncontrolled cardiovascular risk factors |
| Not For | Postmenopausal women, men, anyone with uncontrolled hypertension or cardiovascular disease |
| Product Type | Compounded sublingual tablet (bremelanotide + oxytocin) |
| Active Ingredients | Bremelanotide (PT-141), Oxytocin |
| Format | Fast-dissolving sublingual tablet (¼ to 1 tablet) |
| FDA-Approved Version | Vyleesi (bremelanotide injection, 1.75 mg) — approved June 2019 |
| WebMD Rating (Vyleesi) | 2.8 / 5 from 37 reviews; 49% reported a positive effect |
| Drugs.com Rating (Bremelanotide) | 7.3 / 10 from 40–42 reviews; 64–65% positive |
| Common Side Effects | Nausea (40%), flushing, headache, injection site reactions, vomiting |
| Platform | Shed Women’s Sexual Health |
| Shed Trustpilot Rating | 4.5–4.6/5 from 500–875+ reviews |
| Pricing | From $56.33/month (Shed); Vyleesi brand ~$800–$1,200/month |
What Is Desire?
Desire is a compounded sublingual tablet containing bremelanotide (PT-141) and oxytocin, sold through Shed Women’s Sexual Health. The product is marketed for low sexual desire in adult women and is taken on-demand, approximately 30 minutes before intimacy. It is framed as “sexual wellness support rather than a guaranteed outcome” and is prescribed after a clinician reviews the patient’s cardiovascular history and current medications.
The Two Active Ingredients
Bremelanotide (PT-141) is a melanocortin receptor agonist. It was originally developed as a tanning agent before researchers noticed it caused increased sexual arousal as a side effect. It activates MC3R and MC4R receptors in the hypothalamus to modulate sexual desire centrally — unlike PDE5 inhibitors like Viagra, which work on blood flow. Bremelanotide was FDA-approved in June 2019 as Vyleesi, a subcutaneous injection, for acquired, generalized HSDD in premenopausal women.
Oxytocin is a hormone associated with bonding and closeness. It is included in Desire as a complementary ingredient to support the emotional and relational aspects of desire.
The Critical Distinction: Compounded vs. FDA-Approved
The FDA-approved version of bremelanotide is Vyleesi, a subcutaneous injection. Desire is a compounded sublingual tablet — a different formulation, a different route of administration, and a different product. Compounded products are not FDA-approved, and the FDA does not review them for safety, effectiveness, or quality before marketing. The clinical trial data supporting bremelanotide comes from the injectable form, not the sublingual tablet.
The Clinical Evidence for Bremelanotide
What the RECONNECT Trials Showed
The Phase 3 RECONNECT trials (N=1,267) evaluated bremelanotide 1.75 mg subcutaneous injection in premenopausal women with HSDD. The results showed:
- Modest improvements in desire and distress scores
- FSFI desire domain scores improved by 0.35 points more than placebo over 24 weeks
- FSDS-DAO distress scores improved by 0.33 points more than placebo
- Approximately 25% of women on bremelanotide reported “much improved” or “very much improved” on the Patient Global Impression of Change, compared to 17% on placebo
The Critical Analysis
A 2024 independent analysis published in the Journal of Sex Research examined the measurement properties of the RECONNECT trial outcomes and reached a sobering conclusion:
“Continuous efficacy outcomes… have questionable, at best, validity evidence for women with HSDD. We found no validity evidence for previously published categorical treatment response outcomes from the RECONNECT trials… Across RECONNECT trial data from two prior publications and the current study, bremelanotide’s benefits are statistically modest and limited to outcomes for which scant evidence of validity among women with HSDD exists”.
In plain language: the drug produces statistically measurable effects, but those effects are small, and the tools used to measure them may not be valid for this population. The benefits are real but modest, and individual response varies widely.
The 52-Week Extension
A 52-week open-label extension study demonstrated sustained improvements in sexual desire and distress with no loss of efficacy. This suggests that for women who do respond, the benefit can persist with continued use.
User Reviews and Feedback
The WebMD Rating: 2.8 out of 5
Vyleesi (bremelanotide) holds an average rating of 2.8 out of 5 from 37 reviews on WebMD, with only 49% of reviewers reporting a positive effect. The rating distribution reveals a polarized experience:
| Rating | Number of Reviews |
|---|---|
| 5 stars | 9 |
| 4 stars | 7 |
| 3 stars | 7 |
| 2 stars | 2 |
| 1 star | 15 |
The most striking feature is the 15 one-star reviews — nearly as many as all positive reviews combined. This polarization is a defining characteristic of the bremelanotide experience: for some women, it is transformative; for others, it is intolerable.
The Drugs.com Rating: 7.3 out of 10
On Drugs.com, bremelanotide holds an average rating of 7.3 out of 10 from 40–42 reviews, with 64–65% of reviewers reporting a positive effect and 19–20% reporting a negative effect. The difference between the WebMD and Drugs.com ratings highlights how dramatically the user experience can vary depending on the platform’s reviewer population.
Positive Experiences
“This stuff is real!”
“The injection is so easy you actually wonder if it went in. It works like an EpiPen. The first time I took it, I had mild nausea, almost unnoticeable. It took about 4 hours, but it works! Almost to the point where it’s uncomfortable to cross your legs. Others have more side effects, but the negative experiences are the most likely to review. I’ll bet you will be glad you tried it! Game changer!” — Drugs.com reviewer
“A true lifesaver”
“Every woman and possibly men should know about Vyleesi. Easy to use, results were more than we expected. Highly recommend.” — Drugs.com reviewer
“I’ve read so many negative comments I almost didn’t take this”
“I’ve read so many negative comments I almost didn’t take this.” — WebMD reviewer, rating 5.0
Negative Experiences
“It was like the 24-hour flu”
“I read every single review before my first dose and was, to say the least, nervous. I read about nausea, vomiting, weakness in legs, etc. It sounded awful. Why would I do this to myself? Well, I hoped for an increase in libido. Short answer, this may not exist. The first dose I took, I experienced some nausea, lack of appetite, my legs felt different, but not bad. My clitoris was very enlarged and sensitive, but almost too sensitive. I decided to try another dose. Big mistake. It was like the 24-hour flu. I napped on and off through the day, throwing up in between naps. It was awful.” — Drugs.com reviewer
“I was so sick”
“Within an hour of taking it, I was so sick. Nausea was horrible. I was throwing up and eventually dry heaving. My muscles kept tensing up. It gave me a horrible headache. Fifteen hours later, I am still having these side effects. Feels like the flu, to be honest. However, I will say it works. It does what it says. I just wish the side effects weren’t like this.” — Drugs.com reviewer
“The 20th anniversary was pretty much ruined”
“The first time I tried it, I felt some nausea and a headache with no real sexual desire. I tried it again last night and got really sick (nausea) to the point where I had to get in bed and our 20th anniversary was pretty much ruined. I did not feel turned on at all either. This morning I woke up with a headache, am nauseous, and had diarrhea. This did not work for me at all.” — Drugs.com reviewer
“Nausea, sneezing, muscle aches, and a feeling like the flu”
“First I got nauseous (15 min after shot). Then I sneezed 30x. Then I started coughing. Then my nose started running. Then my face got super hot. Then every muscle in my body started to ache. My cervix and butt hole contracted all night. And my ears hurt like I have an ear infection. Took it at 5pm. It is now noon and I feel like I have the flu. Body aches and exhausted.” — WebMD reviewer
Common Side Effects Summary
| Side Effect | Clinical Trial Incidence |
|---|---|
| Nausea | 40% — the most frequently reported adverse effect |
| Flushing | ~20% |
| Headache | ~9% |
| Injection site reactions | Common |
| Vomiting | Reported |
| Skin hyperpigmentation | ~1% (rare but documented) |
The FDA prescribing information for Vyleesi lists the most common adverse reactions (incidence > 4%) as nausea, flushing, injection site reactions, headache, and vomiting. Nausea required anti-emetic therapy in 13% of patients and led to premature discontinuation for 8%.
The Hyperpigmentation Concern
A less common but potentially permanent side effect is focal hyperpigmentation — darkening of the skin on the face, gums, or breasts. This is more likely in patients with darker skin tones and with daily use. The FDA prescribing information warns: “Focal hyperpigmentation, including on the face, gingiva and breasts, may occur when VYLEESI is used intermittently, particularly in patients with darker skin… pigmentary changes may not resolve completely after stopping VYLEESI”.
The Blood Pressure Concern
Bremelanotide can cause a transient increase in blood pressure and decrease in heart rate shortly after administration. This is why the prescribing information includes a contraindication for patients with uncontrolled hypertension or known cardiovascular disease. The Shed platform notes that a provider reviews cardiovascular history and current medications before prescribing, and that naltrexone should not be combined with bremelanotide.
Safety and Regulatory Considerations
FDA Approval Status
| Product | Status |
|---|---|
| Vyleesi (bremelanotide injection) | FDA-approved June 2019 for HSDD in premenopausal women |
| Desire (bremelanotide sublingual tablet) | Compounded product — not FDA-approved |
| Oxytocin (in Desire) | Not FDA-approved for sexual desire |
Indication Limitations
Bremelanotide is not indicated for:
- Postmenopausal women
- Men
- General sexual performance enhancement
The FDA-approved indication is narrow: acquired, generalized hypoactive sexual desire disorder in premenopausal women, characterized by low sexual desire that causes marked distress or interpersonal difficulty and is not due to a co-existing medical or psychiatric condition, relationship problems, or medication effects.
Who Should Avoid Bremelanotide
- Anyone with uncontrolled hypertension — contraindicated
- Anyone with known cardiovascular disease — contraindicated
- Anyone taking naltrexone — should not be combined
- Postmenopausal women — not indicated
- Men — not indicated (though used off-label)
- Anyone who cannot tolerate nausea — 40% incidence in trials
- Anyone with a history of hyperpigmentation disorders — risk of skin darkening
Pricing and Where to Buy
Vyleesi Brand Pricing
| Source | Cost |
|---|---|
| Retail (without insurance) | $800–$1,200 per month for the 8-dose maximum monthly supply |
| Single auto-injector | ~$290 without insurance |
| Compounded PT-141 | 40–60% less than brand Vyleesi |
Desire (Shed) Pricing
Pricing for Desire is available through the Shed platform. The product page lists a starting price of $56.33/month. The platform is FSA and HSA eligible, and Shed offers “no surprises, upfront pricing” once the intake is complete. The product includes free discreet shipping and unlimited provider follow-ups, including dose adjustments.
Where to Buy
Desire is available exclusively through Shed Women’s Sexual Health (tryshed.com). The platform uses U.S.-licensed providers and a licensed U.S. pharmacy. It is not available in retail pharmacies.
Shed Platform Reputation
Shed has a mixed reputation as a telehealth platform. On Trustpilot, Shed holds a 4.5–4.6/5 rating from approximately 500–875+ reviews. However, the Better Business Bureau shows 250 total complaints in the last three years, with 87 complaints closed in the last 12 months. The German Trustpilot page shows a lower rating of 2.3/5 with complaints about customer service being “non-existent/incompetent” and issues with billing and prescription fulfillment.
The platform’s Trustpilot rating discrepancy (4.5/5 on the main page vs. 2.3/5 on the German page) suggests that user experiences vary significantly depending on the specific service line and region.
Conclusion and Final Verdict
Strengths
- ✅ Bremelanotide is FDA-approved (as Vyleesi) for HSDD in premenopausal women — a legitimate, evidence-based treatment for a real condition
- ✅ The only treatment that addresses low desire through the central nervous system rather than the vascular system
- ✅ On-demand dosing — no daily pill to remember
- ✅ Clinician-reviewed intake — cardiovascular history and medications are screened before prescribing
- ✅ FSA/HSA eligible at Shed
- ✅ Affordable through Shed — from $56.33/month vs. $800–$1,200 for brand Vyleesi
- ✅ Some users report transformative results — restored desire and improved intimacy
- ✅ 52-week extension data shows sustained efficacy for responders
Weaknesses
- ⚠️ Desire is a compounded product — not FDA-approved in its sublingual form
- ⚠️ 40% of clinical trial participants reported nausea — the most common reason for discontinuation
- ⚠️ WebMD rating of 2.8/5 with only 49% reporting a positive effect
- ⚠️ 15 one-star reviews out of 37 — the experience is highly polarized
- ⚠️ Modest effect sizes in clinical trials — 0.35-point improvement on FSI desire domain vs. placebo
- ⚠️ Validity of outcome measures questioned by independent analysis
- ⚠️ Blood pressure and heart rate changes — contraindicated in uncontrolled hypertension
- ⚠️ Risk of skin hyperpigmentation — may be permanent
- ⚠️ Not indicated for postmenopausal women or men — off-label use is common but unstudied
- ⚠️ Shed has 250 BBB complaints in three years, with customer service complaints
- ⚠️ No independent reviews of the specific Desire sublingual formulation were found
Who May Benefit
Premenopausal women with acquired, generalized HSDD — low desire that causes marked distress and is not explained by relationship problems, medications, or other conditions — may find bremelanotide worth discussing with their healthcare provider. Those who can tolerate the nausea and who respond to the medication often describe it as life-changing. The on-demand dosing is convenient for those who want support for specific occasions rather than daily medication.
Who Should Avoid
- Anyone with uncontrolled hypertension or cardiovascular disease
- Postmenopausal women and men — not indicated
- Anyone who cannot tolerate significant nausea
- Anyone taking naltrexone
- Anyone with a history of hyperpigmentation disorders
- Anyone who wants an FDA-approved product — the Desire sublingual tablet is compounded
Overall Recommendation
Rating: 3.5 out of 5 Stars
Desire offers a compounded sublingual version of bremelanotide, a legitimate FDA-approved medication for HSDD in premenopausal women. The active ingredient has real clinical evidence behind it, and for the women who respond, it can be transformative. However, the experience is highly polarized: 40% of trial participants experienced nausea, the WebMD rating is only 2.8/5, and nearly half of reviewers gave it one star. The sublingual tablet is not FDA-approved, and no independent reviews of this specific formulation were found. For women with HSDD who have discussed the risks with their provider and can tolerate the side effects, bremelanotide may be worth trying. For everyone else, the side effect profile and modest effect sizes make this a medication to approach with realistic expectations.
Frequently Asked Questions
What is Desire (bremelanotide)?
Desire is a compounded sublingual tablet from Shed Women’s Sexual Health containing bremelanotide (PT-141) and oxytocin, prescribed for low sexual desire in adult women.
Is Desire FDA-approved?
No. The FDA-approved version of bremelanotide is Vyleesi, a subcutaneous injection approved in June 2019 for HSDD in premenopausal women. The Desire sublingual tablet is a compounded product and is not FDA-approved.
Does bremelanotide work?
Clinical trials show modest but real effects. The RECONNECT trials found improvements in desire and distress scores compared to placebo, but effect sizes were small (0.35-point difference on the FSI desire domain). An independent analysis questioned the validity of the outcome measures used.
What are the side effects?
The most common side effect is nausea, reported by 40% of clinical trial participants. Other side effects include flushing, headache, injection site reactions, vomiting, and rare but potentially permanent skin hyperpigmentation.
Is Desire safe?
Bremelanotide carries a contraindication for uncontrolled hypertension and cardiovascular disease because it can cause transient increases in blood pressure and decreases in heart rate. A clinician should review your cardiovascular history and medications before prescribing.
How much does Desire cost?
Shed lists Desire starting at $56.33/month**. The FDA-approved Vyleesi brand costs approximately **$800–$1,200 per month without insurance. Compounded versions typically cost 40–60% less.
Who should avoid bremelanotide?
Postmenopausal women, men, anyone with uncontrolled hypertension or cardiovascular disease, anyone taking naltrexone, and anyone who cannot tolerate significant nausea should avoid or use with extreme caution.
Is bremelanotide the same as Addyi?
No. Addyi (flibanserin) is a daily pill approved for HSDD in 2015. Vyleesi (bremelanotide) is an on-demand injection approved in 2019. They work through different mechanisms — flibanserin on serotonin receptors, bremelanotide on melanocortin receptors.
Can men use bremelanotide?
Bremelanotide is not FDA-approved for men, though it is used off-label in some clinics. Phase 2 research showed effects on erectile function and desire, but no Phase 3 program in male populations has been published.
Where can I buy Desire?
Desire is available through Shed Women’s Sexual Health (tryshed.com). It requires a clinician-reviewed intake before prescribing.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Bremelanotide is a prescription medication with significant side effects and contraindications. Always consult a qualified healthcare professional before starting any new medication, especially if you have existing health conditions, take medications, or are pregnant or nursing. Individual results may vary.
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