question from a user
I've been on TRT for 1.5 years and have not been able to figure out why it has caused ED. Estrogen is where it should be. I'm not on excess T. Not on finasteride. The only new clue you've given is the sympathetic nervous system, but my T levels aren't abnormal. Unless there is something about synthetic T that activates the sympathetic nervous system more than my previous endogenous T? What is the melanocortin receptor pathway?
AlphaMD's Answer
The melanocortin receptor pathway is a relatively newly discovered mechanism for both erectile function and libido. It is entirely separate from traditional hormonal pathways previously thought to be the exclusive cause for libido.
Bremelanotide and PT-141 are peptide hormones currently used for this purpose. They activate this pathway.
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