When it comes to vasoactive intestinal polypeptide (VIP), it is a 28-amino-acid neuropeptide widely distributed in the nervous system and gastrointestinal tract.
In penile erection, VIP acts as a supportive pro-erectile neurotransmitter/neuromodulator, primarily at the peripheral level.
Its production follows the classic pathway for neuropeptides: gene expression → pre-pro-protein synthesis → proteolytic processing → mature peptide.
Here’s the 101:
1. Gene and transcription
Encoded by the VIP gene on human chromosome 6q25.
The gene also encodes peptide histidine isoleucine (PHI) or peptide histidine methionine (PHM) in humans (a related 27-amino-acid peptide co-produced with VIP).
Transcription occurs primarily in neurons (cholinergic/parasympathetic, sensory) and some immune cells such as mast cells and lymphocytes.
Regulated by neuronal activity, growth factors such as NGF and cytokines.
2. Translation and initial processing
Translated as a pre-pro-VIP precursor (~170 amino acids).
Pre-sequence (signal peptide) is cleaved in the endoplasmic reticulum → pro-VIP (~150 amino acids).
Pro-VIP contains:
N-terminal signal
PHM/PHI sequence
Connecting peptide
VIP sequence
C-terminal extension
3. Post-Translational ProcessingIn secretory vesicles:
Prohormone convertases (PC1/3 and PC2, common in neurons) cleave at dibasic sites (Lys-Arg or Arg-Arg).
VIP and PHM are excised as separate peptides.
C-terminal glycine on pre-VIP is used by peptidylglycine α-amidating monooxygenase (PAM) → amidation of VIP’s C-terminus (essential for bioactivity).
Final mature VIP sequence: His-Ser-Asp-Ala-Val-Phe-Thr-Asp-Asn-Tyr-Thr-Arg-Leu-Arg-Lys-Gln-Met-Ala-Val-Lys-Lys-Tyr-Leu-Asn-Ser-Ile-Leu-Asn-NH₂.
4. Storage and release
Packaged into large dense-core vesicles (co-stored with acetylcholine and nNOS in parasympathetic nerves).
Released by high-frequency neuronal stimulation (Ca²⁺-dependent exocytosi
In penile tissue: Released from cavernous nerve terminals upon parasympathetic activation.
Ao VIP binds VPAC1 and VPAC2 receptors (Gs-coupled GPCRs) on cavernosal smooth muscle → adenylate cyclase activation → cAMP ↑ → PKA → hyperpolarization (K⁺ channels), reduced Ca²⁺ sensitivity, myosin dephosphorylation → relaxation.
Primary effect: Enhances veno-occlusion (traps blood) more than arterial inflow.
Synergizes with NO (cGMP pathway); some independence (not blocked by NOS inhibitors).
In hypogonadal models (low testosterone), VIP effects stronger due to VPAC2 upregulation.
Nov 1: Androgens (testosterone) upregulate VIP expression/content in penile nerves.
Note 2: Diabetes decreases VIP nerve density/content.
Note 3: When it comes to using VIP, you have to test your inflamattory markers first since it can lead to T-cell exhaustion and also, there’s no evidence that it’s quite effective when it comes to ED. So most likely, lowering inflammation and relaxing will do more for you.
Now two peptides that can help you are PT-141 and BPC-157.
We have discussed these in the peptide series but here’s the 101 for both.
PT-141, also known as bremelanotide, is a cyclic heptapeptide and an active metabolite of Melanotan II.
Its chemical structure is: Ac-Nle-cyclo[Asp-His-D-Phe-Arg-Trp-Lys]-OH.
It acts as a non-selective agonist of melanocortin receptors (primarily MC3R and MC4R, with some activity at MC1R, MC3R, MC4R, and MC5R.
Originally developed from research on α-melanocyte-stimulating hormone (α-MSH) analogs for sunless tanning, it was found to induce sexual arousal as a side effect.
Primary approved use:
FDA-approved (since June 2019) under the brand name Vyleesi for the treatment of generalized acquired hypoactive sexual desire disorder (HSDD) in premenopausal women, where the low desire is not due to medical, psychiatric, relationship, or substance-related issues.
Administered as a subcutaneous autoinjector (1.75 mg dose) at least 45 minutes before anticipated sexual activity.
Off-label and investigational uses:
Broad off-label use in men for erectile dysfunction (ED), particularly in PDE5 inhibitor (Viagra, Cialis) non-responders and for low libido.
Potential benefits in both sexes for psychogenic or mixed-origin sexual dysfunction, where vascular treatments fall short.
Mechanisms of action.
Unlike PDE5 inhibitors that enhance penile blood flow via peripheral nitric oxide pathways, PT-141 acts centrally in the brain:
Primarily agonizes MC4R (and MC3R) in hypothalamic regions, triggering neural circuits for sexual motivation and arousal.
Enhances dopamine release in key areas (e.g., medial preoptic area), boosting desire, mood, and sexual confidence.
Indirectly increases genital blood flow through CNS effects, without direct vascular action.
May improve subjective arousal, orgasm intensity, and overall sexual satisfaction by modulating pleasure/reward pathways.
This central mechanism makes it effective for desire-driven issues, even when vascular health is intact.
Core benefits:
Significantly increases sexual desire and arousal in approved (women) and off-label (men/women) populations.
Restores erectile function in difficult cases, including PDE5 non-responders (synergistic when combined).
Elevates mood, reduces performance anxiety and intensifies pleasurable sensations/orgasms via dopaminergic effects.
Works regardless of underlying vascular limitations; valuable for psychological, hormonal, or stress-related low libido.
Administration:
FDA-approved: Vyleesi subcutaneous autoinjector (thigh or abdomen).
Research/off-label: Often supplied as lyophilized powder (10 mg vials) reconstituted with bacteriostatic water for subcutaneous injection; some compounding pharmacies offer nasal sprays (though intranasal was discontinued early due to BP variability).
Potential risks:
Most common: Nausea (40%, often worst on first dose; may require anti-nausea meds like ondansetron), flushing (20%), headache (11%), injection site reactions (13%), transient blood pressure increase (systolic ~6 mmHg, diastolic ~3 mmHg), fatigue, dizziness.
Hyperpigmentation: Focal skin darkening (face, gums, breasts) – rare at recommended dosing (<8/month), but occurs in >1/3 with daily/high-frequency use; may be permanent in some cases, higher risk in darker skin tones.
Cardiovascular: Contraindicated in uncontrolled hypertension or significant heart disease.
Other: Vomiting, nasal congestion (if nasal form), no alcohol interaction (unlike flibanserin).
Long-term data limited: No fertility issues in animal studies, modest weight loss noted in some trials (via MC4R appetite effects).
Drug interactions: Slows gastric emptying, reducing oral absorption of some meds (naltrexone, indomethacin).
Now BPC-157, is derived from a protein found in human gastric juice and has the following 15 amino acid sequence: Gly-Glu-Pro-Pro-Pro-Gly-Lys-Pro-Ala-Asp-Asp-Ala-Gly-Leu-Val
Primary uses (based on preclinical and limited human data)
Accelerated healing of common gym/overuse injuries, such as elbow tendinitis, tendon/ligament tears, muscle strains, and post-surgical recovery.
Gastrointestinal tract protection and repair (ulcers, inflammatory bowel conditions, leaky gut).
Neuroprotection and potential nerve regeneration.
Support for chronic joint/connective tissue disorders (osteoarthritis-like models).
Cardiovascular benefits (improved blood flow, endothelial protection).
Liver protection in toxin-induced damage models.
Ongoing research areas: Spinal cord injury regeneration, corneal healing, and interstitial cystitis/bladder pain.
Other areas such as spinal cord regeneration, are under ongoing research.
The main mechanisms of action include:
Upregulates vascular endothelial growth factor (VEGF) expression (a protein that promotes new blood vessel formation) by activating the VEGF receptor 2 (VEGFR2) pathway that triggers the Akt-eNOS pathway, which increases production of nitric oxide (NO) in the blood vessel walls, resulting in enhanced tissue perfusion, aiding repair of muscles, tendons, ligaments and even bones since without adequate blood supply, injured tissues cannot heal properly.
Stimulates fibroblast proliferation and collagen deposition (which is also crucial for healing the gut lining).
Protects and repairs gastrointestinal mucosa by modulating tight junction proteins.
Downregulates Nos2 and Nfkb and thus reduces inflammatory responses.
Downregulates pro-inflammatory cytokines such as TNF-α, IL-6 and upregulates anti-inflammatory pathways.
Influences serotonin and dopamine systems in the gut-brain axis and it may promote nerve regeneration via growth factor pathways (JAK2 signaling).
Activates focal adhesion kinase (FAK)-paxillin complexes that move cells into the damaged areas to begin rebuilding tissue and early growth response gene 1 (Egr-1) is also activated (involved in cell growth, survival and blood vessel formation).
Administration Forms:
Oral: Highly stable in human gastric juice (>24 hours intact), making it effective for gut-focused issues (IBD models, ulcers).
Injectable (subcutaneous, intramuscular, or intra-articular): Preferred for localized tissue repair (near injury site) due to direct delivery and potentially higher local concentrations.
Potential risks:
Angiogenesis promotion could potentially exacerbate undiagnosed tumors.
Modulating tissue growth and repair mechanisms can ALWAYS, no matter the COMPOUND, negatively affect some autoimmune cases.
It’s also banned by WADA.