Best Peptides for Sexual Health & Libido

Sexual desire is not just plumbing. That distinction matters, because most people's first association with sexual dysfunction treatment is a little blue pill — Viagra, Cialis, or their generics. These drugs work by relaxing blood vessels and increasing blood flow. They fix the hydraulics. But if the problem is that your brain isn't sending the signal in the first place, improved blood flow alone won't help.

That's where peptides have opened a genuinely different door. Some act directly on brain circuits that govern desire. Others regulate the hormones that drive it. One is already FDA-approved. Several more are in clinical trials. And the science behind them is not hypothetical — we're talking about randomized, double-blind, placebo-controlled studies in JAMA Network Open, not Reddit anecdotes.

This guide covers every peptide with meaningful research behind it for sexual health. For each, you'll get the mechanism, the evidence, the limitations, and the regulatory status. No hype. No sales pitch. Just what the data actually says.

How Sexual Desire Works — The Biology
The Top Peptides for Sexual Health & Libido
Comparing Sexual Health Peptides
Peptides vs. Traditional ED Medications
Safety and Side Effects
For Women vs. For Men
Frequently Asked Questions
The Bottom Line
References

How Sexual Desire Works — The Biology

Before diving into specific peptides, it helps to understand the system they're trying to influence. Sexual desire isn't a single switch. It's a network of brain regions, hormones, and neurotransmitters that all have to cooperate.

The brain. Sexual desire starts in the hypothalamus, where neurons process cues — visual, olfactory, emotional — and translate them into arousal signals. The melanocortin system (MC3R and MC4R receptors) plays a central role here. So does the limbic system, which processes emotional and reward-driven motivation. Dopamine is the main neurotransmitter pushing desire forward; serotonin often acts as the brake.

Hormones. Testosterone drives libido in both men and women — not just men. Estrogen matters for vaginal health and arousal in women. Gonadotropin-releasing hormone (GnRH) from the hypothalamus triggers LH and FSH release from the pituitary, which in turn drives testosterone and estrogen production. Anything that disrupts this cascade — age, stress, medications, illness — can reduce desire.

The vascular component. Erection in men and clitoral engorgement in women require blood flow mediated by nitric oxide and cyclic GMP. This is where PDE5 inhibitors like Viagra work. But this is the downstream plumbing, not the upstream desire.

The peptides in this guide target different parts of this system. Some act on the brain directly. Others influence the hormonal cascade. A few do both.

The Top Peptides for Sexual Health & Libido

1. PT-141 (Bremelanotide)

What it is: PT-141 (bremelanotide, brand name Vyleesi) is a synthetic cyclic heptapeptide and melanocortin receptor agonist. It was FDA-approved in June 2019 for hypoactive sexual desire disorder (HSDD) in premenopausal women. It is the only peptide approved specifically for treating low sexual desire.

How it works: PT-141 bypasses the vascular system entirely. It activates MC3R and MC4R receptors in the hypothalamus — the same brain region that regulates hunger, temperature, and sexual behavior. By stimulating these receptors, PT-141 increases dopaminergic activity in brain circuits that govern desire and arousal [1]. This is a fundamentally different mechanism from Viagra or Cialis, which is why PT-141 can work when PDE5 inhibitors don't.

Clinical evidence in women: The phase 3 RECONNECT trials enrolled over 1,200 premenopausal women with HSDD across two identical randomized, double-blind, placebo-controlled studies. Women self-administered 1.75 mg subcutaneous injections as needed. Both trials met their primary endpoints: statistically significant increases in sexual desire (effect size 0.49-0.61) and decreases in distress related to low desire (effect size 0.60-0.62) compared to placebo [2].

A 52-week open-label extension with 684 women showed that efficacy was sustained over long-term use. The safety profile was consistent with the core studies, with nausea (40.4%), flushing (20.6%), and headache (12%) as the most common side effects [3].

Clinical evidence in men: PT-141 is not FDA-approved for men, but clinical trials exist. In a study of 342 men with erectile dysfunction who had failed sildenafil (Viagra), intranasal PT-141 (10 mg) produced a "positive clinical response" in 33.5% of subjects vs. 8.5% on placebo [4]. Earlier phase 2 studies showed dose-dependent increases in erectile response and significantly increased penile rigidity — from 3 minutes above 80% rigidity on placebo to 38 minutes with PT-141 [5].

The key finding: PT-141 can produce erections even in men who don't respond to PDE5 inhibitors, because it works through a completely different pathway.

Administration: Subcutaneous injection, typically 1.75 mg, at least 45 minutes before anticipated sexual activity. Effects can last up to 72 hours. Maximum: one dose per 24 hours, no more than 8 doses per month.

Side effects: Nausea is the most common (about 40% in clinical trials) and is usually mild and transient. Flushing, headache, and injection site reactions also occur. PT-141 can transiently raise blood pressure (about 6 mmHg systolic, 3 mmHg diastolic) and is contraindicated in people with uncontrolled hypertension or cardiovascular disease [2].

2. Kisspeptin

What it is: Kisspeptin is a naturally occurring neuropeptide encoded by the KISS1 gene that acts as the master regulator of the reproductive hormone axis. It sits at the very top of the hormonal cascade — it's the signal that tells GnRH neurons to fire, which triggers LH and FSH release, which drives testosterone and estrogen production.

How it works for sexual health: Kisspeptin does two things that matter for desire. First, it stimulates the HPG axis, potentially increasing sex hormone levels. Second — and this is the newer, more exciting finding — it appears to directly modulate brain regions involved in sexual attraction and arousal, independent of its hormonal effects [6]. Kisspeptin interacts with dopamine, serotonin, GABA, and nitric oxide pathways in the brain.

Clinical evidence in men: A randomized, double-blind, placebo-controlled trial at Imperial College London gave kisspeptin infusions to 32 men with HSDD. The results, published in JAMA Network Open (2023), were striking. Kisspeptin significantly modulated brain activity in sexual-processing networks (Cohen d = 0.81, p = 0.003), increased penile tumescence by up to 56% compared to placebo (p = 0.02), and improved behavioral measures of sexual desire — particularly happiness about sex (p = 0.02) [6].

The researchers noted this was "the first evidence showing that kisspeptin administration substantially modulates sexual brain processing in men with HSDD." This matters because there are currently zero approved pharmacological treatments for low sexual desire in men.

Clinical evidence in women: A parallel trial in 32 premenopausal women with HSDD found that kisspeptin reduced activity in brain regions associated with negative self-talk and body image concerns during sexual stimuli, while increasing activity in areas linked to emotional processing [7]. Women reported feeling "more sexy" during kisspeptin infusion compared to placebo. The effects were most pronounced in women with the highest baseline distress about their sexual function.

Limitations: All published kisspeptin trials to date used intravenous infusions in hospital settings — not practical for real-world use. The studies were small (30-35 participants each). Kisspeptin has a very short half-life, though subcutaneous and intranasal delivery routes are being evaluated. It's still in Phase 2 clinical development, so FDA approval, if it comes, is years away.

Why it's exciting anyway: Kisspeptin represents a genuinely novel approach. It works through the body's own reproductive signaling system, it affects both the hormonal and brain-based components of desire, and early data suggests it may be effective in both men and women. If the delivery challenges are solved, it could fill a significant gap in treatment options.

See also: Kisspeptin Research Profile

3. Melanotan II

What it is: Melanotan II is a synthetic analog of alpha-melanocyte stimulating hormone (α-MSH). It was originally developed to induce skin tanning without UV exposure. The sexual arousal effects were discovered as an unexpected side effect during early clinical testing. PT-141 is actually a metabolite of Melanotan II — structurally nearly identical but with a different C-terminal group.

How it works: Like PT-141, Melanotan II activates melanocortin receptors (MC1R through MC5R). But it's non-selective — it hits all of them. MC1R activation causes skin darkening. MC3R and MC4R activation produces the sexual desire and arousal effects. This lack of selectivity is both its appeal (multiple effects) and its problem (more side effects) [8].

Clinical evidence: Two small but rigorous double-blind, placebo-controlled crossover studies tested subcutaneous Melanotan II (0.025 mg/kg) in men with erectile dysfunction.

In the psychogenic ED study (10 men), 8 of 10 developed clinically apparent erections after Melanotan II. Mean duration of penile rigidity above 80% was 38 minutes with treatment vs. 3 minutes with placebo (p = 0.0045) [9].

In the organic ED study (10 men with vascular or mixed ED), Melanotan II initiated erections in 12 of 19 injections vs. 1 of 21 placebo doses. Mean tip rigidity above 80% lasted 45.3 minutes vs. 1.9 minutes (p = 0.047). Notably, 68% of Melanotan II doses were followed by reports of increased sexual desire, compared to 19% of placebo (p < 0.01) [10].

Why it was superseded: Melanotan II was never developed into an approved drug for sexual dysfunction. Instead, its more selective metabolite (PT-141/bremelanotide) was pursued through clinical trials and ultimately gained FDA approval. The main reasons: Melanotan II's non-selectivity causes skin darkening, mole changes, nausea, and potential long-term melanocytic effects that PT-141 largely avoids.

Current status: Melanotan II is not FDA-approved for any indication. It's widely available online as a research chemical, but quality control is inconsistent and safety data from unregulated products is limited. The risk of mole changes and melanocytic stimulation is a real concern for long-term use.

4. Oxytocin

What it is: Oxytocin is a nine-amino-acid neuropeptide produced in the hypothalamus and released by the posterior pituitary. It's best known as the "bonding hormone" — involved in childbirth, breastfeeding, and social attachment. But its role in sexual function is more nuanced than the popular press suggests.

What the research shows — endogenous oxytocin: The link between oxytocin and orgasm is well-established. Multiple studies have measured plasma oxytocin levels during sexual activity and consistently found that levels rise during arousal and peak sharply at orgasm in both men and women [11]. A 2021 systematic review in Sexual Medicine analyzed 13 eligible studies and concluded that oxytocin levels are highest during orgasm/ejaculation and may modulate sexual fantasies and thoughts that help trigger arousal [12].

What the research shows — exogenous oxytocin: Here's where it gets complicated. Giving people oxytocin (usually as a nasal spray) has produced mixed results.

One case report documented "dramatic improvement" in a man's libido, erection quality, and orgasm with chronic intranasal oxytocin use [13]. A study in couples found that men reported higher sexual satiety after intercourse with oxytocin, while women felt more relaxed and better able to share sexual desires [14].

But a controlled laboratory study in 27 healthy women using intranasal oxytocin (24 IU) found no effects on sexual drive, arousal, or orgasm [15]. A broader review concluded that the facilitatory role of oxytocin found in animal sexual behavior studies hasn't been consistently confirmed in humans [16].

The disconnect: Endogenous oxytocin clearly rises during sexual activity and likely plays a role in orgasm, bonding, and sexual satisfaction. But administering exogenous oxytocin doesn't reliably reproduce those effects. The timing, dose, route of administration, and individual variation all appear to matter enormously.

Best use case: Oxytocin may have its strongest role in the relational and emotional aspects of sexuality — bonding, emotional closeness, post-orgasmic satisfaction — rather than as a direct libido booster. Some clinics prescribe it alongside other sexual health treatments (like PT-141 or testosterone) as a complementary agent.

See also: Oxytocin Science Guide

5. CJC-1295 and Ipamorelin

What they are: CJC-1295 is a synthetic GHRH analog, and Ipamorelin is a selective growth hormone releasing peptide. Together, they're the most commonly prescribed peptide stack in anti-aging clinics, primarily for body composition and recovery. Their connection to sexual health is indirect — but real.

How they relate to libido: CJC-1295 and ipamorelin don't act on sexual desire pathways directly. Instead, they stimulate growth hormone (GH) release from the pituitary, which increases circulating IGF-1. The sexual health connection runs through several pathways:

Testosterone support. Higher GH and IGF-1 levels can help maintain Leydig cell function in the testes, supporting testosterone production [17]. Since testosterone is the primary hormonal driver of libido in both sexes, this matters — especially in aging men where GH, IGF-1, and testosterone all decline together.
Body composition. GH promotes fat loss and lean mass preservation. Improved body composition often correlates with better self-image, energy, and sexual confidence.
Sleep quality. GH secretagogues often improve sleep depth, and sleep is one of the most overlooked factors in sexual desire. Chronic sleep deprivation suppresses testosterone and disrupts dopamine signaling.
Vascular health. GH and IGF-1 support endothelial function and blood flow — relevant for both erectile function and female arousal.

Evidence: The strongest human pharmacokinetic data comes from a 2006 study showing that a single CJC-1295 injection produced 2- to 10-fold increases in GH for 6+ days and 1.5- to 3-fold increases in IGF-1 for 9-11 days [17]. However, no published clinical trials have directly measured sexual function outcomes from CJC-1295/ipamorelin treatment. The libido benefits reported by patients and clinics are anecdotal, not proven.

Limitations: The connection between GH peptides and libido is plausible but unproven in controlled studies. These peptides face regulatory restrictions following the FDA's 2023 compounding guidance. They're not a direct treatment for sexual dysfunction — they're part of a broader hormonal optimization strategy.

6. Gonadorelin

What it is: Gonadorelin is a synthetic version of gonadotropin-releasing hormone (GnRH), the 10-amino acid peptide that the hypothalamus produces to trigger LH and FSH release from the pituitary gland.

How it relates to sexual health: Gonadorelin is primarily used to support endogenous testosterone production, particularly in men on testosterone replacement therapy (TRT) who want to maintain testicular function and fertility. By pulsatile stimulation of the pituitary, it keeps the HPG axis active — which matters because exogenous testosterone shuts down GnRH, LH, and FSH, causing testicular atrophy and infertility.

Why it appears on this list: Low LH drives low testosterone, and low testosterone is one of the most common causes of reduced libido in men over 40. Gonadorelin addresses the upstream cause rather than replacing the downstream hormone. Some clinics use it as an alternative or complement to hCG for maintaining fertility and testicular size during TRT.

Evidence: Gonadorelin's effects on LH and FSH release are well-documented and form the basis of the GnRH stimulation test used diagnostically. However, dedicated studies measuring libido or sexual function outcomes from gonadorelin treatment are limited. Its sexual health benefits are inferred from its ability to support testosterone production.

Limitations: Gonadorelin requires pulsatile dosing to mimic the body's natural GnRH release pattern. Continuous exposure actually suppresses the HPG axis (this is how GnRH agonists like leuprolide work to lower testosterone in prostate cancer). Timing and dosing protocol are critical.

Comparing Sexual Health Peptides

Peptide	Primary Mechanism	Works For	Evidence Level	FDA Status
PT-141	MC3R/MC4R brain activation	Men and women (desire + arousal)	Strong (Phase 3 RCTs)	FDA-approved (women HSDD)
Kisspeptin	GnRH stimulation + direct brain effects	Men and women (desire)	Moderate (Phase 2 RCTs)	Investigational
Melanotan II	Non-selective melanocortin agonism	Men (erection + desire)	Moderate (small RCTs)	Not approved
Oxytocin	Bonding/emotional pathways	Both (orgasm, satisfaction)	Mixed (conflicting results)	Approved for other uses
CJC-1295/Ipamorelin	GH → IGF-1 → testosterone support	Men primarily (indirect)	Low (anecdotal)	Not approved
Gonadorelin	GnRH → LH/FSH → testosterone	Men (HPG axis support)	Low-moderate (inferred)	Approved for diagnostics

Peptides vs. Traditional ED Medications

This is not an either/or situation. Peptides and traditional medications work through different mechanisms and can address different problems.

Feature	PDE5 Inhibitors (Viagra, Cialis)	PT-141 (Bremelanotide)	Kisspeptin
Target	Blood vessels (penile)	Brain (hypothalamus)	Brain + HPG axis
What it fixes	Blood flow / erection mechanics	Sexual desire and arousal	Desire, arousal, hormonal drive
Works without desire?	Yes (physical only)	No — requires some context	Modulates desire circuits
Works for desire problems?	No	Yes	Yes (early evidence)
For women?	Limited evidence	FDA-approved for women	Promising in trials
Speed of onset	30-60 minutes	45-60 minutes	Minutes (IV infusion)
Duration	4-36 hours (varies by drug)	Up to 72 hours	Short (hours)
Main side effects	Headache, flushing, visual changes	Nausea, flushing, mild BP increase	Still being evaluated

For men whose only issue is achieving/maintaining erections, PDE5 inhibitors remain first-line. For men who don't respond to PDE5 inhibitors, or whose primary problem is desire rather than function, PT-141 is a legitimate alternative. For women with HSDD, PT-141 is currently the only FDA-approved peptide option.

Safety and Side Effects

PT-141: The most studied, with the best-characterized safety profile. Nausea is the main issue (40% in trials, usually mild). Transient blood pressure elevation makes it contraindicated in uncontrolled hypertension. No serious cardiovascular events were reported in clinical trials [2, 3].

Kisspeptin: Early safety data is favorable. No serious adverse events reported in clinical trials. But long-term safety data doesn't exist yet, and all studies used intravenous infusions under medical supervision [6, 7].

Melanotan II: Side effects include nausea, facial flushing, mole darkening, and fatigue. The melanocytic stimulation (darkening of moles) is the most concerning long-term risk, as it could theoretically mask or promote melanocytic changes. It is unregulated, so product quality varies wildly [8].

Oxytocin: Intranasal oxytocin is generally well tolerated in studies. Rare side effects include nasal irritation and headache. At high doses, it can cause water retention. Long-term effects of chronic use are not well studied [15].

CJC-1295/Ipamorelin: Common side effects include injection site reactions, headache, and flushing. Ipamorelin's selectivity means it doesn't significantly raise cortisol or prolactin. Water retention and joint pain can occur with sustained GH elevation [17].

For Women vs. For Men

Sexual health peptides aren't one-size-fits-all. The biology of desire differs between men and women, and so does the evidence.

For women:

PT-141 has the strongest evidence. The RECONNECT Phase 3 trials were conducted in women, and the FDA approval is specifically for premenopausal women with HSDD [2].
Kisspeptin showed promising results in the JAMA Network Open trial — reducing brain activity in regions associated with negative self-perception and increasing feelings of sexiness [7].
Oxytocin may help with emotional closeness and communication around sex, though controlled studies in women have not shown consistent effects on desire or arousal [15].

For men:

PT-141 has solid Phase 2 evidence for both desire and erectile function, including in men who fail PDE5 inhibitors. It is not FDA-approved for men but is prescribed off-label [4, 5].
Kisspeptin produced significant improvements in sexual brain processing and penile tumescence in men with HSDD — the first peptide to show this [6].
Melanotan II has the earliest clinical data in men with ED, but has been superseded by PT-141 [9, 10].
CJC-1295/Ipamorelin and gonadorelin support the hormonal environment (testosterone, GH, IGF-1) that underpins male sexual function, but are adjunctive rather than direct treatments.

For both sexes, stress management, sleep optimization, exercise, and relationship quality remain foundational. No peptide overcomes chronic sleep deprivation, untreated depression, or relational conflict.

Frequently Asked Questions

What's the most effective peptide for low libido? PT-141 (bremelanotide) has the strongest clinical evidence. It's the only peptide FDA-approved for low sexual desire (HSDD in premenopausal women), and clinical trials show meaningful improvements in desire and reductions in related distress. For men, it also works — particularly for those who don't respond to Viagra or Cialis — though it's prescribed off-label.

Can peptides help with erectile dysfunction? Yes, but through a different mechanism than traditional ED drugs. PT-141 acts on the brain rather than blood vessels, which is why it can help men who've failed PDE5 inhibitors. Melanotan II showed similar effects in early trials. However, if your ED is purely a blood flow issue, PDE5 inhibitors remain the first choice.

Are sexual health peptides safe? PT-141 has been through Phase 3 clinical trials and FDA review, with a well-characterized safety profile. The main side effect is nausea. Kisspeptin's early safety data is reassuring but limited. Melanotan II carries risks from unregulated sourcing and melanocytic stimulation. As with any medication, the risk-benefit calculation depends on your specific health situation.

How fast does PT-141 work? Most people feel effects within 45-60 minutes of injection. The effects can last up to 72 hours, though intensity varies. It's meant to be taken as-needed, not daily.

Can women use peptides for sexual health? Absolutely. PT-141 is specifically approved for women with HSDD. Kisspeptin showed promising results in women in clinical trials. This is an area where the peptide approach may have an advantage over traditional options — there are very few effective treatments for low desire in women, and PT-141 directly addresses the neurological component.

What about combining peptides for sexual health? Some clinics combine PT-141 with oxytocin (for bonding/emotional aspects) or with GH peptides (for broader hormonal support). The rationale is reasonable, but combination studies haven't been published. If you're considering combinations, work with a physician who can monitor your response.

Does kisspeptin increase testosterone? Yes, kisspeptin stimulates the GnRH-LH cascade that drives testosterone production. In clinical studies, kisspeptin infusions increased LH and testosterone levels in both men and women. But the effects are transient with current administration methods, and it's not yet available as a treatment.

Is Melanotan II the same as PT-141? Almost, but not quite. PT-141 is a metabolite of Melanotan II. They share the same core mechanism (melanocortin receptor activation), but PT-141 was refined to be more selective for the sexual desire effects and less likely to cause skin darkening. PT-141 made it through clinical trials; Melanotan II didn't.

The Bottom Line

The science of peptides for sexual health is more advanced than most people realize. PT-141 is not a fringe research compound — it's an FDA-approved medication with Phase 3 clinical trial data showing it works for low sexual desire in women, with strong off-label evidence in men. For anyone dealing with desire-based sexual dysfunction, especially those who haven't responded to PDE5 inhibitors, it represents a genuinely different therapeutic approach.

Kisspeptin is the most exciting compound on the horizon. The clinical trial data — published in JAMA Network Open, not promotional materials — shows that it modulates the brain's sexual processing networks in both men and women with low desire. If researchers solve the delivery problem (short half-life, currently requires IV infusion), kisspeptin could become the first treatment specifically designed around the neurobiology of desire.

The indirect players — CJC-1295/ipamorelin, gonadorelin, oxytocin — aren't sexual health treatments per se. They support the hormonal and emotional infrastructure that healthy sexual function depends on. They're supporting cast, not leading roles.

What hasn't changed: the basics still matter most. Sleep, stress management, exercise, relational health, and hormonal balance are the foundation. Peptides work best when that foundation is solid. They're a tool, not a magic fix — but for the right person with the right problem, the evidence says they're a tool that actually works.

References

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