Episode 257 – Peptides for Sexual Wellness & Hormonal Health: PT-141, Growth Hormones, Bone Health & More!

Dr. Deb Muth0:00Welcome back to Let's Talk Wellness Now. I'm your host, Dr. Zab, and we are continuing our discussion this week on0:08peptides. And so, if you haven't heard our first conversation about peptides,0:13please go back and look at that episode. We talk all about the manufacturing, the safety, the quality of peptides, and we0:20dove into GLP1s. And today we're going to dive into peptides for sexual0:26wellness, immune function, growth hormone, and all the amazing fun things0:32we can do with peptides. So, as usual, grab your cup of coffee or tea, settle0:37in, and let's talk wellness now. And we're going to take a short pause from our sponsor. I know we've got to do0:44that, you guys. They're who keep us on the air. So, I'm going to pause for just a minute and be right back after this0:50message from our sponsor. Ladies, it's time to reignite your vitality. Primal0:56Queen supplements are clean, powerful formulas made for women like you who want balance, strength, and energy that1:03lasts. Get 25% off at primal queen.com. Serenity Health. That's primalqueen.com.1:10Serenity Health. Because every queen deserves to feel in her prime. All1:15right, everybody. We are back. And are you ready? We are talking all things peptide and I am opening the show today1:23with sexual wellness. Yes, I'm going there, you guys. I am going there. You1:29know, this has really become a big issue for people um of all ages. It's not just1:34us older people. It's younger people, too. And there's a whole variety of reasons why we have sexual dysfunction.1:42And when we're talking about sexual dysfunction, we're not just talking about it doesn't work, right? Or I can't1:48reach orgasm. A lot of it is around desire and um the thought of it and1:54wanting to connect, wanting to be kinder to one another, wanting to be touching2:00one another. A lot of it resolves or revolves around that. And so there are some peptides that can help us and I'm2:08really excited to be able to talk about those today. So the first one is called PT-141.2:14This targets the brain not the periphery. Right? So for many women I2:20will always tell you sex starts between here. It is a brain thing for us. It is2:26not necessarily a physical thing. For guys that's a little different. It's very physical. For women it's all in our2:32brain. So tip for you men that are listening. You have to prime your woman's brain first if you want her to2:38have sex with you that night. You have to be nice to her. You have to bring her flowers. Do the dishes for her. Do2:45something kind. Bring her a cup of coffee or tea or a glass of wine. Take her to dinner. You have to woo her. And2:51I don't care how long you've been married. That has to happen. And tip number two, don't say anything stupid2:57that day. I'm just being honest. When you guys say things that make us upset,3:03that lingers with us for the rest of the day. And it's it's a turnoff for us. And3:08for a lot of women, we can't get past that when it comes time to snuggle at night. And sex doesn't always have to be3:14at night either. So, you can tell I really love talking about this conversation, but we're going to get into the peptide part of it because this3:21is going to help people. So, um, PT-141 is marketed as I'm going to slaughter3:28this name, Vali, and it represents a fundamentally different approach to3:34sexual dysfunction than the PDE5s inhibitors like Slenden, Viagra,3:40Tedataphil, which is Seialis. And while the PDE5 inhibitors work specifically by3:47enhancing blood flow to the genital tissues, PT-141 works centrally in the brain by3:54modulating neural s neural circuits involved in the sexual desire and4:00arousal. Now PT-41 is a cyclic hpatipeptide. It's seven amino acid4:07peptide arranged in a cyclic structure that acts as a melanoortin receptor4:13agonist and with particularly the infinity for MC3R and MC4R subtypes.4:20It's actually a metabolite of the melanotan 2, a peptide originally4:26developed for tanning that was also found to enhance sexual desire in early4:31studies. Now the melanoortin system in the brain is involved in multiple functions including energy homeostasis4:39but it also is involved in sexual motivation and arousal behaviors. The FDA approved PT-141 in 2019 specifically4:48for the treatment of acquired generalized hypoactive sexual desire4:54HSDD in permenopausal women. So for the first time we have a medication that was5:01approved by the FDA to use for women for sexual dysfunction. We have had all of5:07these seialis tedataphil viagros for men but we had nothing for women. And so5:12this is amazing that this is available for women and approved by the FDA. It's a big deal. This represents the first5:19and only FDA approved medication specifically targeting these circuits of sexual desire rather than the peripheral5:27arousal mechanisms. And this indication is quite specific, meaning it was developed at some point, not lifelong.5:35So I if you've had sexual dysfunction your entire life, this medication was5:40not approved for you. But if it's something that you developed over time, like when you went through pmenopause or5:46menopause or some women have this experience happen after childirth, that's what we're talking about here.5:53Now, it's also not just um supposed to be used if you dislike your partner,5:59right? If your relationship is bad and you dislike your partner, this probably isn't going to fix a ton. It might help6:05a little bit, but that's not what it's meant for. So, you really have to know what you're using it for and why. And6:11the other thing that I would say is this is something that we don't go to if your hormones are not balanced properly. You6:17have to balance your hormones properly before using something like this because it still may not work. Now, the only6:24caveat to that is if you're a woman that has a risk of breast cancer and can't use hormones, then that's a different6:31story and we would have that conversation about whether or not this medication would be appropriate for you. Now, the FDA label specifies PTA1 uh6:39PT-141 as it not being indicated for HSDD in causes where low sexual desire6:46is due to coexisting medical or psychiatric conditions, problems with relationships, like we had talked about,6:53side effects to medications or other substance use. This specifically reflects the importance of differential6:59diagnosis. Low sexual desire can have many root causes and PT-41 is only7:05appropriate when those causes have been ruled out. Now, I have I used PT41 in7:10people who have sexual dysfunction issues as a result of using7:16anti-depressants. Yes, I have. I've used Flynn in that effect as well. And it7:21does work sometimes, but it doesn't work completely. But you need to know that that is not what the approval is for the7:27FDA. So that is done in something that we call off label use. So very important7:33to know. Now in these clinical trials leading to FDA approval, this was published by Kinsburg and colleagues in7:40obstetrics and gyne gynecology in 2019. PT-141 demonstrated statistically7:46significant improvements in sexual desire and decreases in distress related7:51to low desire compared to placebo. The effects manifest over 45 minutes to7:56several hours after the injection and the mechanisms involved modulation of dopamine and melanoorton pathways in the8:04hypothalamus and the brain regions that involved sexual motivation. Now cardiovascular effects of PT 141 require8:12careful attention. This drug causes transient increases in blood pressure about 3 to four points and transient8:20decreases in heart rate. And because of this, it is contraindicated in patients8:25with uncontrolled hypertension or known cardiovascular disease. And it has been studied in patients who've had recent8:32cardiovascular events or sorry hasn't been studied hasn't been studied in patients who've had recent8:39cardiovascular events. So patients need to have their blood pressures checked before starting therapy. Nausea is8:45extremely common. It is one of the biggest things I often will tell people to take an anti-nausea medicine if8:52they're going to do this because the last thing you want to do is inject this medication and think it's going to give8:57you this great time with your partner and you're so nauseated that you can't even perform, don't want to kiss, don't9:05want to do anything. It it can be pretty profound for some people. um it does affect about 40% of the patients in9:12clinical trials which is why many clinicians require or recommend an9:17anti-nausea medication like I had just said other common adverse effects include flushing injection site9:24reactions headache in about 13% of the population whic