Kisspeptin Boosted Sexual Brain Responses and 'Feeling Sexy' in Women With Low Desire

Thirty-two premenopausal women with diagnosed HSDD participated in a randomized, double-blind, placebo-controlled crossover trial. Each participant received both kisspeptin and placebo infusions on separate visits. Brain activity was measured using functional MRI while participants viewed sexual stimuli. Self-reported behavioral measures including feelings of sexiness and sexual aversion were collected.

HSDD is the most common sexual dysfunction in women, yet there are very few approved treatments. This is the first RCT showing that kisspeptin — a peptide already known to influence sexual processing in men — can modulate the sexual brain circuits in women with clinically diagnosed low desire. The finding that kisspeptin reduced brain activity in inhibition-related areas while boosting self-reported sexual feelings suggests it works by releasing the 'brakes' on sexual desire rather than just pressing the 'accelerator.'

The only FDA-approved drugs for HSDD — flibanserin (Addyi) and bremelanotide (Vyleesi) — have modest efficacy and notable side effects. Kisspeptin represents a fundamentally different approach: rather than targeting serotonin or melanocortin pathways, it works through the brain's reproductive hormone control system. Published in JAMA Network Open, this study establishes kisspeptin as a legitimate new therapeutic avenue for female sexual dysfunction and sets the stage for longer-term clinical trials.

Limited to premenopausal women — effects in postmenopausal women with HSDD are unknown. The single-session crossover design assessed acute effects only; whether repeated kisspeptin administration produces lasting changes in sexual desire is untested. Brain imaging changes during fMRI may not translate directly to improved sexual behavior in real-world settings. The study measured brain responses to stimuli in a scanner, not actual sexual experiences.