Peptides for Perimenopause and Menopause: What the Evidence Shows

Perimenopause is the demand, and the evidence sits elsewhere

Perimenopause is a distinct, staged clinical state, not a synonym for menopause. The STRAW plus 10 consensus set criteria for the early and late menopausal transition and for early postmenopause, to be applied regardless of a woman's age, ethnicity, body size or lifestyle, with the stated purpose of improving comparability across studies of midlife women.¹ That is the standard against which the compounds below should be read, because the population a trial enrolled is the population its result describes.

Read against it, the gap is stark. A single query on 13 September 2026 combining the peptides marketed for this transition, BPC-157, ipamorelin, CJC-1295, epitalon, GHK-Cu, sermorelin, tesamorelin, MOTS-c and thymosin alpha, against perimenopause or perimenopausal, returned zero records.⁵⁰ Widening the term set to every menopause word does not change it: ipamorelin, CJC-1295, sermorelin, tesamorelin, epitalon, BPC-157 and GHK-Cu each return zero.⁵¹ A raw count for peptide AND perimenopause does return 919, and that number means almost nothing, because PubMed expands the word peptide across a MeSH tree that covers every peptide in biology, including endogenous hormones.⁵⁰

The human trials that do exist enrolled a different group. Of the studies gathered here, the enrolments were postmenopausal, or premenopausal for bremelanotide, or pre- and postmenopausal with no perimenopausal arm. Not one enrolled perimenopausal women. The wider female evidence base is set out in best peptides for women, and kisspeptin's full profile sits on the kisspeptin page.

Regulators have not filled the gap either. No prescription medicine carries a US FDA-approved indication for treating perimenopausal symptoms. A sweep of the entire FDA label index on 13 September 2026 found eleven records naming perimenopause or perimenopausal in their indications text. Seven are over-the-counter or homeopathic products, and the only prescription product among them is goserelin, whose perimenopause wording is an oncology indication, the palliative treatment of advanced breast cancer in pre- and perimenopausal women. Not one of the eleven is a peptide.⁴³

The studies, one row each

One row per study, grouped by compound, with the design stated in its own column so the evidence level is visible before the result. A compound with more than one study gets more than one row. The figures here are trial outcomes, each tied to the PMID in the same row. Dose figures appear in the sections below, in a fixed format that marks each one as not a recommendation.

Two rows here are pooled syntheses rather than single trials, the 2021 and 2023 intravaginal oxytocin reviews, and they are labelled as such. A systematic review enrols nobody; the trials inside it do.

Bone: the strongest evidence, and it is postmenopausal

This is the best evidence on the page, several large randomised trials with fracture endpoints, and none of it is about perimenopause. The teriparatide trial randomly assigned 1,637 postmenopausal women with prior vertebral fractures to parathyroid hormone (1-34), the molecule marketed as teriparatide, or placebo, and over a median 21 months new vertebral fractures occurred in 14 percent on placebo against 5 and 4 percent on treatment, relative risks 0.35 (0.22 to 0.55) and 0.31 (0.19 to 0.50), with nonvertebral fragility fractures at 6 percent against 3 percent in each active arm.² The trial gave parathyroid hormone (1-34) at 20 mcg or 40 mcg subcutaneously daily (trial dose, not a recommendation, PMID 11346808).² The abstract reports only minor side effects, occasional nausea and headache, and does not state a mean age or blinding.²

ACTIVE was a phase 3, double-blind trial at 28 sites in 10 countries, 2,463 women with a mean age of 69, comparing abaloparatide against placebo and an open-label teriparatide arm over 18 months. New morphometric vertebral fractures occurred less frequently in the active groups than placebo, though the abstract prints the per-arm percentages as a table rather than in the text, and hypercalcaemia was lower with abaloparatide at 3.4 percent against teriparatide 6.4 percent, p = 0.006.³ ACTIVE gave abaloparatide 80 mcg subcutaneously daily against open-label teriparatide 20 mcg daily (trial dose, not a recommendation, PMID 27533157).³ If you want an actual fracture number for abaloparatide, it comes from the European regulator, not the abstract: the Eladynos EMA overview states that after 18 months 0.5 percent of those treated had a new spinal fracture against 4.2 percent on placebo, in a main study it describes as involving 2,070 patients, a figure that should not be reconciled with the 2,463 randomised across three arms in the publication.⁴⁵³ The Tymlos label calls abaloparatide a human parathyroid hormone related peptide, PTHrP(1-34), analog.³⁸

PROOF is worth reading closely before treating a positive fracture result as settled. In 1,255 postmenopausal women with established osteoporosis, over 5 years only the middle of three daily doses of salmon calcitonin nasal spray separated from placebo, 200 IU at 51 of 287 against 70 of 270, RR 0.67 (0.47 to 0.97), p = 0.03, while the 100 IU and 400 IU arms did not, so it does not run in a dose-response line, and retention was poor, with 783 of 1,255 completing 3 years and 511 completing 5 years.⁴ PROOF used salmon calcitonin nasal spray at 100, 200 or 400 IU daily (trial dose, not a recommendation, PMID 10996576).⁴ Lumbar spine bone mineral density rose significantly from baseline in every active arm even where fractures did not fall, which is the density-against-fracture gap worth carrying into any bone claim.⁴

The current labels are blunter than the trials. The nasal spray PROOF studied still has a US FDA label, and it indicates the product for postmenopausal osteoporosis in women more than 5 years postmenopause when alternative treatments are not suitable, adding that fracture reduction efficacy has not been demonstrated and that it has not been shown to increase bone mineral density in early postmenopausal women.³⁶ The injectable form carries the same fracture-efficacy caveat plus a periodic re-evaluation note tied to a possible association with malignancy.³⁵ The two PTH-family peptides are restricted the same way: Forteo is indicated for postmenopausal women with osteoporosis at high fracture risk,³⁷ Tymlos likewise,³⁸ and in the EU Forsteo and Eladynos carry the same postmenopausal indication, Eladynos with an 18-month maximum.⁴⁶⁴⁵ Not one of these is indicated for perimenopause or for prevention in women without osteoporosis, and the calcitonin nasal label narrows further to more than 5 years postmenopause.³⁶

Collagen peptides: randomised evidence, positive for bone density, null for skin

Collagen peptides are the one oral peptide with randomised, placebo-controlled evidence in postmenopausal women, and the honest reading runs both ways. On bone, a 12-month randomised, double-blind, placebo-controlled trial in 131 postmenopausal women with age-related low bone density reported that the collagen group raised bone mineral density at the spine and femoral neck against controls, ANCOVA p = 0.030 and p = 0.003, an effect on density, not on fractures.⁵ It used 5 g of specific collagen peptides orally daily for 12 months (trial dose, not a recommendation, PMID 29337906).⁵ A second randomised study pointed the same way in 51 postmenopausal women with osteopenia, where collagen added to calcium and vitamin D raised trabecular tibia volumetric BMD by 2.54 plus or minus 3.43 percent against the comparator, p = 0.02, with higher spine areal BMD, p = 0.01, again density and geometry rather than fracture.⁷ That arm took 5 g collagen peptides daily with 500 mg calcium and 400 IU vitamin D for 12 months (trial dose, not a recommendation, PMID 34980546).⁷

Two things keep this in proportion. The independence of the evidence is worth stating as a record: one author of the bone trial is affiliated to the Collagen Research Institute GmbH while the paper declares no conflict of interest, and the same group's later follow-up discloses lectures part-supported by a collagen manufacturer and patent co-inventorship on collagen peptides.⁵⁶ That 4-year follow-up is itself open label with no control group, reports its result only in words as a clinically relevant increase in spine BMD, and gives no figure and no p value.⁶ And every collagen trial here measured density, geometry or turnover markers; none measured fractures, which is the same density-against-fracture gap that limits the calcitonin result.⁵⁷

On skin the randomised result is null. A 6-month randomised, double-blind, factorial trial in 56 menopausal women with stage I dermatoporosis, aged 60 to 93, tested oral hydrolysed collagen and a topical serum against placebo and found no significant difference on any measure, clinical scores, dermal elasticity, thickness, echogenicity or histology, p greater than 0.1, concluding that collagen peptides do not benefit forearm skin and should not be used routinely in this population.⁸ It gave oral hydrolysed collagen 5 g daily and a topical 2.5 percent serum daily for 6 months (trial dose, not a recommendation, PMID 36547800).⁸ More on the class sits in the collagen guide.

Hot flushes: the kisspeptin story, and what actually got approved

The mechanism here is real, and it is not the same thing as a treatment. Vasomotor symptoms affect roughly 70 percent of people going through menopause, and a 2018 review estimates that 65 to 75 percent of postmenopausal symptoms are vasomotor.¹⁰⁹ The proposed mechanism is that when ovarian steroid feedback is lost, hypertrophied kisspeptin, neurokinin B and dynorphin neurons in the infundibular nucleus become overactive and drive the GnRH pulses behind hot flushes; the same review notes that giving senktide, an NK3 receptor agonist, to postmenopausal women raised luteinising hormone and induced vasomotor symptoms, so the agonist caused flushes.⁹ A 2026 Nature Reviews Endocrinology review states the point that matters for this page: the kisspeptin discovery revolutionised the understanding of hot flushes, and what it produced was NK3 receptor antagonists as the first non-hormonal therapy targeting that biology.¹⁰ The kisspeptin neuron is the explanation; the drug is an antagonist of a different receptor.

That distinction corrects a common claim. No study collected here administered kisspeptin to treat hot flushes. In the one paper that measured flushes, the compound given for 7 days was MLE4901, an NK3 receptor antagonist at 40 mg twice daily orally (trial dose, not a recommendation, PMID 28380486), and the flush reduction, from 3.4 plus or minus 1.2 to 1.0 plus or minus 0.6 per day, p = 0.008 in the 8 of 11 women who reported flushes, belongs to that antagonist; kisspeptin-10, given as a 0.3 microg/kg intravenous bolus probe inside the same protocol (diagnostic stimulus, not a treatment, PMID 28380486), did not affect luteinising hormone with or without the antagonist.¹¹ What kisspeptin administration actually did in postmenopausal women, across all three administration studies, was move gonadotrophins and only gonadotrophins. A 0.3 microg/kg intravenous bolus in 6 post-menopausal women raised LH area under the curve by 5.3 plus or minus 0.9 IU/l h, p = 0.002, and FSH by 2.6 plus or minus 0.8, p = 0.03 (trial dose, not a recommendation, PMID 22956346).¹² A continuous infusion at 12.5 microg/kg/h for 24 hours in 8 healthy postmenopausal women found them resistant to continuous kisspeptin; on estradiol replacement they were also resistant initially, and then LH pulse amplitude rose with the estradiol level and the infusion duration, with no subgroup size, estradiol dose or effect size given (trial dose, not a recommendation, PMID 28368443).¹³ Neither of those studies reported any flush, sleep, mood or bone endpoint. Tellingly, the two bolus papers read similar data in opposite directions, one calling the response enhanced by sex-steroid deficiency, the other calling the lack of response a reflection of the hypo-oestrogenic state.¹²¹¹ The full compound picture is on the kisspeptin page.

What actually carries a US indication for vasomotor symptoms due to menopause is not a peptide. Two drugs do: fezolinetant, whose label describes it as a small-molecule NK3 receptor antagonist taken as a 45 mg oral tablet (approved-label figure, not a recommendation, FDA label),³⁹ and elinzanetant, described on its label as an NK1 and NK3 receptor antagonist taken as a 60 mg oral capsule (approved-label figure, not a recommendation, FDA label),⁴⁰ and both are also authorised in the EU, Veoza from December 2023 and Lynkuet from November 2025.⁴⁷⁴⁸ One caution belongs with the approved option, at its own evidence level: a 2026 review flags a possible increased risk of neoplasms with fezolinetant, drawn from pooled and meta-analyses rather than a regulatory finding, while the current FDA label carries no such warning in its indication.¹⁴³⁹ A separate 2026 review pairs kisspeptin with perimenopause explicitly but contains no trial, no population, no dose and no outcome, and its language of clinical translation potential is a statement of hope, not evidence.¹⁵

Weight and body composition through the transition

Body composition is a frequent question, and the one menopause-specific study is a comparison with no stated design. A 2025 report compared women in menopause with premenopausal women over 4 months of semaglutide; its entire methods section is a single sentence of aim, with no control group and no group sizes reported.¹⁶ The postmenopausal group started heavier, 95 plus or minus 23.4 kg against 86.4 plus or minus 12.8 kg, and finished with a comparable proportion of weight lost, 5.8 plus or minus 4.7 percent against 5.1 plus or minus 3.2 percent, p = 0.4, and comparable lean mass change, minus 0.4 against minus 1.1 kg, p = 0.1, on semaglutide 1 mg for 4 months (trial dose, not a recommendation, PMID 39761057).¹⁶ The honest reading is that the postmenopausal group started heavier and lost a similar proportion, not that semaglutide works better or worse after menopause.

The best current synthesis says the same thing about the whole field. A 2026 Spanish Menopause Society position statement, searching the literature through 30 April 2026 for studies in peri- or postmenopausal women, concludes that semaglutide provides the largest amount of direct menopause-specific evidence among incretin therapies, although that evidence remains limited and largely observational, and that tirzepatide and other dual incretins are clinically promising but require menopause-specific evaluation.¹⁷ The same statement adds a caution worth carrying, that any association between hormone therapy and greater semaglutide-related weight loss remains hypothesis-generating and should not justify starting hormone therapy to augment weight loss.¹⁷ No GLP-1 label mentions menopause: Wegovy is indicated for cardiovascular risk reduction and for weight reduction in obesity or overweight, with no menopause or perimenopause wording.⁴² Side effects are covered in the GLP-1 side effects guide, with compound detail on the semaglutide profile.

The growth hormone peptides: measured directly, and mostly marketed on hope

This is where the marketing is loudest and the menopause evidence is thinnest. The compounds actually sold to midlife women, ipamorelin, CJC-1295, sermorelin and tesamorelin, each return zero PubMed records against any menopause term on 13 September 2026, so there is no trial in this population and therefore no dose to report for them.⁵¹ The one FDA-approved GHRH analog among them, tesamorelin, is approved only for HIV-associated lipodystrophy and its label states it is not indicated for weight loss because it is weight neutral, nothing about menopause.⁴¹

What has been measured is narrower and older. A single-arm study gave 10 postmenopausal volunteers 1 mg of recombinant human GHRH 1,44-amide subcutaneously twice daily for 3 months (trial dose, not a recommendation, PMID 16260425) and reported overnight GH up 98 plus or minus 14 percent, IGF-I up 71 plus or minus 3.5 percent, abdominal visceral fat down 16 plus or minus 7 percent, p = 0.029, and faster walking and stair times, with 70 percent of subjects reporting local skin reactivity; its own methods state that comparisons were made with pre-intervention baseline data, so there is no control group.¹⁸ The only randomised, placebo-controlled trial of an orally active growth hormone secretagogue in postmenopausal women is largely negative: in 292 women aged 64 to 85 with low femoral neck bone density, MK-677 with or without alendronate raised femoral neck BMD to 4.2 percent against 2.5 percent for alendronate alone, p below 0.05, but produced no gain at the spine, total hip or total body, and the authors conclude the secretagogue did not translate into BMD increases at sites other than the femoral neck.²¹ It used MK-677, ibutamoren, 25 mg orally daily for 12 months, with or without alendronate 10 mg daily (trial dose, not a recommendation, PMID 11238495), and its first author was affiliated to the manufacturer.²¹ More on that compound sits in the MK-677 guide.

The mechanism points against easy optimism. A growth hormone releasing peptide works less well after menopause, and giving oestrogen back does not fix it: hexarelin at 2 micrograms/kg as a single intravenous bolus (trial dose, not a recommendation, PMID 9186268) produced a GH response of 453.6 against 1630.4 mcg.min/l in young women, p below 0.002, and 3 months of transdermal estradiol did not modify it.²² Measured directly under a 6-week hypogonadal clamp with no perimenopausal arm, postmenopausal women showed lower IGF-I and GH, reduced pulsatile but raised basal GH secretion, and an attenuated response to combined GHRH and GH-releasing peptide-2; that design models steroid deprivation rather than the fluctuating pattern of perimenopause, which is a reading this page draws rather than a claim the paper makes.¹⁹ And the 2001 Spanish-language report often cited here is not a peptide trial at all: GHRH-1-29-NH2 was given as a single 50 microgram intravenous diagnostic bolus (diagnostic stimulus, not a treatment, PMID 11816525) while transdermal estradiol was the actual intervention, post-stimulus GH rising over 6 months of estradiol with pulsatility unchanged; the sequence is the one marketed as sermorelin, but the paper is not indexed under that name.²⁰ The class background is in the HGH peptides guide and the tesamorelin profile.

Bremelanotide and the group it was trialled in

Bremelanotide, a melanocortin receptor agonist sold in research circles as PT-141, has real phase 3 evidence, and the population is the point. Two identical phase 3 randomised double-blind placebo-controlled trials, RECONNECT, randomised 1,267 premenopausal women with hypoactive sexual desire disorder over 24 weeks; both coprimary endpoints separated from placebo, desire by 0.35 and distress by minus 0.33 in the integrated studies, both p below 0.001, with the abstract giving no scale range, and adverse events described as more nausea, flushing and headache, 10 percent or more in both studies.²³ It used bremelanotide 1.75 mg subcutaneously as needed over 24 weeks (trial dose, not a recommendation, PMID 31599840).²³ The label draws the line the trial did: Vyleesi is indicated for premenopausal women with acquired, generalised HSDD, and its Limitations of Use state it is not indicated for HSDD in postmenopausal women or in men.³⁴ There is no trial of bremelanotide in postmenopausal women in this research; a query for bremelanotide and postmenopausal returned 7 records on 13 September 2026, and every one is a review or overview of female sexual dysfunction pharmacotherapy, not a trial in that group.⁵⁰ Background sits on the PT-141 profile, and the wider female evidence base in best peptides for women.

Intravaginal oxytocin: the picture has moved against it

Since the earlier version of this page, the best synthesis of intravaginal oxytocin has flipped. The 2021 review it used to headline did report a large pooled cytology effect, a standardised mean difference of 35.13, 95 percent CI 32.59 to 37.67, though with very high heterogeneity, I squared 96 percent, and with histology and endometrial thickness not significant; it found five trials and pooled four, and endometrial thickness there functions as a safety endpoint, not an efficacy one.²⁴ A larger and newer 2023 meta-analysis, seven studies and 631 patients, found the vaginal maturation index did not separate from placebo, MD 12.34, 95 percent CI minus 12.52 to 37.19, p = 0.33, with dyspareunia, vaginal pH and histology all non-significant, and concluded that although oxytocin has been proposed as an alternative to estrogen, its findings show the opposite.²⁵

Three further things weigh against the older headline. An independent 2024 systematic review funded by a US federal agency, which screened 11,993 citations and included 46 randomised trials, lists vaginal oxytocin among treatments that may provide no benefit, at low or very low certainty of evidence.²⁶ One trial in this literature, a 140-woman randomised study from 2018, was retracted in 2024, its record now opening with the words retracted article; the retraction postdates both reviews, so neither could have accounted for it, and this page makes no claim about whether either review included it.²⁹³⁰ And against an active comparator rather than an inert placebo, oxytocin was no better: in a double-blind study, 79 women on daily intravaginal oxytocin gel and 78 on an aqueous hypromellose gel both improved from baseline over 12 weeks, but the difference between groups was not significant at either time point, with one breast cancer reported in the oxytocin group and assessed as unlikely related, and a study author disclosing personal fees from a peptide company.²⁸ The dose the trials used was intravaginal oxytocin gel 400 IU, one applicator per night, for 8 weeks in a 96-woman randomised trial of postmenopausal women aged 40 to 60 (trial dose, not a recommendation, PMID 32429977),²⁷ and 400 IU daily for 12 weeks against that active comparator gel (trial dose, not a recommendation, PMID 33116956); the 2021 review states no dose at all.²⁸²⁴

What the guidelines recommend instead is documented. The 2022 North American Menopause Society statement holds that hormone therapy remains the most effective treatment for vasomotor symptoms and the genitourinary syndrome of menopause, and that for genitourinary symptoms not relieved by over-the-counter therapies in women without indications for systemic hormone therapy, low-dose vaginal estrogen therapy or other therapies, for example vaginal dehydroepiandrosterone or oral ospemifene, are recommended.³¹ No intravaginal oxytocin product appears as an approved product in this research, which is not the same as saying none exists.

What is actually sold as a peptide for menopause

Set the evidence above beside what the market sells, recorded as what each page says on the day it was read, with no endorsement and no accusation. One page titled 9 Best Peptides for Perimenopause in 2026 promises exactly what the search asks for and ranks the field by symptom, naming BPC-157, GHK-Cu, CJC-1295, ipamorelin and sermorelin most often; its own disclaimer then contradicts its headline, stating that the peptides discussed are research chemicals not approved for human consumption, therapeutic use or self-administration.⁵² A Florida clinic page draws the perimenopause line explicitly, calling CJC-1295 with ipamorelin the common entry point as the GH axis declines, and stating an expectation that after menopause deep sleep is the first thing the combination tends to restore, while also listing compounds it will not prescribe, among them sermorelin, PT-141, kisspeptin and thymosin alpha-1.⁵³ A third page in the same category states the gap plainly: no peptide has strong human evidence for menopause, and the growth hormone secretagogues marketed for it act on growth hormone, not sex hormones, and do not restart ovarian function.⁵⁴

Stated as a finding, the gap is complete. Every compound marketed across those pages returns zero PubMed records against any menopause term on 13 September 2026,⁵¹ and zero as an FDA label substance,⁴⁴ and no approved label anywhere in this research supports a menopause or perimenopause indication for any of them.⁴³ The one exception worth naming precisely is tesamorelin, which is a real approved drug, but only for HIV lipodystrophy.⁴¹ The epitalon family is a useful test of how thin some of this is: its entire PubMed yield against every menopause term is two Russian-language records, one from 1995 that carries no abstract at all,³² and one from 1986 in which epithalamin is used as a diagnostic probe, neither able to support any claim of effect.³³ Neither vendor page publishes a price, so there is no figure to quote.⁵²⁵³

On the Vietnam question specifically, this research could not establish a registration fact. The Drug Administration of Vietnam public services portal is reachable, but its registration and price search returns no results to an automated request, a limitation confirmed against a control drug that must be registered, so this page makes no claim, either way, about which of these compounds are registered or sold in Vietnam.⁵⁵ Licensed medicines available locally are covered separately in therapeutic peptides in Vietnam.

Search provenance

Each count below is a fact about a named query run against PubMed through E-utilities esearch on 13 September 2026, and nothing more. The counts the earlier version of this page reported have been re-run and re-dated to that day.⁴⁹

Profiles for the names that come up empty sit on the BPC-157 and GHK-Cu pages. Product identity is a separate problem, covered in the certificate of analysis guide and the blood testing guide.

Questions

Sources and references

Every figure on this page traces to one of these sources, fetched on 13 September 2026. Numbers match the citation markers in the text.

1. 1.Harlow SD, Gass M, Hall JE, et al; STRAW + 10 Collaborative Group. Executive summary of the Stages of Reproductive Aging Workshop + 10. Menopause. 2012;19(4):387-95. pubmed.ncbi.nlm.nih.gov/22343510
2. 2.Neer RM, Arnaud CD, Zanchetta JR, et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med. 2001;344(19):1434-41. pubmed.ncbi.nlm.nih.gov/11346808
3. 3.Miller PD, Hattersley G, Riis BJ, et al. Effect of abaloparatide vs placebo on new vertebral fractures in postmenopausal women with osteoporosis. JAMA. 2016;316(7):722-33. ACTIVE. pubmed.ncbi.nlm.nih.gov/27533157
4. 4.Chesnut CH 3rd, Silverman S, Andriano K, et al. A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis. Am J Med. 2000;109(4):267-76. PROOF. pubmed.ncbi.nlm.nih.gov/10996576
5. 5.Konig D, Oesser S, Scharla S, Zdzieblik D, Gollhofer A. Specific collagen peptides improve bone mineral density and bone markers in postmenopausal women, a randomized controlled study. Nutrients. 2018;10(1):97. pubmed.ncbi.nlm.nih.gov/29337906
6. 6.Zdzieblik D, Oesser S, Konig D. Specific bioactive collagen peptides in osteopenia and osteoporosis: long-term observation in postmenopausal women. J Bone Metab. 2021;28(3):207-213. pubmed.ncbi.nlm.nih.gov/34520654
7. 7.Lampropoulou-Adamidou K, Karlafti E, Argyrou C, et al. Calcium and vitamin D with and without collagen peptides on bone mineral density in postmenopausal women with osteopenia. J Clin Densitom. 2022;25(3):357-372. pubmed.ncbi.nlm.nih.gov/34980546
8. 8.Guadanhim LRS, Miot HA, Soares JLM, et al. Efficacy and safety of topical or oral hydrolyzed collagen in women with dermatoporosis: a randomized, double-blind, factorial study. Dermatol Ther (Heidelb). 2023;13(2):523-534. pubmed.ncbi.nlm.nih.gov/36547800
9. 9.Szeliga A, Czyzyk A, Podfigurna A, et al. The role of kisspeptin/neurokinin B/dynorphin neurons in vasomotor symptoms in postmenopausal women. Gynecol Endocrinol. 2018;34(11):913-919. pubmed.ncbi.nlm.nih.gov/29902942
10. 10.Torres E, Wall EG, Navarro VM. Neurokinin receptor antagonists for vasomotor symptoms: from KNDy neurons to clinical translation. Nat Rev Endocrinol. 2026;22(7):387-403. pubmed.ncbi.nlm.nih.gov/41981275
11. 11.Skorupskaite K, George JT, Veldhuis JD, Millar RP, Anderson RA. Neurokinin 3 receptor antagonism reveals roles for neurokinin B in gonadotropin secretion and hot flashes in postmenopausal women. Neuroendocrinology. 2018;106(2):148-157. pubmed.ncbi.nlm.nih.gov/28380486
12. 12.George JT, Anderson RA, Millar RP. Kisspeptin-10 stimulation of gonadotrophin secretion in women is modulated by sex steroid feedback. Hum Reprod. 2012;27(12):3552-9. pubmed.ncbi.nlm.nih.gov/22956346
13. 13.Lippincott MF, Chan YM, Rivera Morales D, Seminara SB. Continuous kisspeptin administration in postmenopausal women: impact of estradiol on luteinizing hormone secretion. J Clin Endocrinol Metab. 2017;102(6):2091-2099. pubmed.ncbi.nlm.nih.gov/28368443
14. 14.Boretti E, Dogne JM, Douxfils J. Potential risk of neoplasms with fezolinetant: clinical evidence, mechanisms, and post-marketing implications. J Endocr Soc. 2026;10(6):bvag082. pubmed.ncbi.nlm.nih.gov/42137787
15. 15.Xu Y, Wu H, Mu R, et al. Kisspeptin neurons as integrative hub: cross-talk of HPO-HPT-HPA axes in perimenopausal reproductive health. Compr Physiol. 2026;16(1):e70115. Narrative review, no trial data. pubmed.ncbi.nlm.nih.gov/41721211
16. 16.Nicolau J, Blanco-Anesto J, Bonet A, Felix-Jaume JJ, Gil-Palmer A. Effectiveness of low doses of semaglutide on weight loss and body composition among women in their menopause. Metab Syndr Relat Disord. 2025;23(1):70-76. pubmed.ncbi.nlm.nih.gov/39761057
17. 17.Sanchez-Prieto M, Romero-Dominguez M, Orozco R, et al; MenoYoung Spain. Incretin-based therapies in peri- and postmenopausal women with obesity: an expert position statement from the Spanish Menopause Society. Maturitas. 2026;213:109101. pubmed.ncbi.nlm.nih.gov/42664617
18. 18.Veldhuis JD, Patrie JM, Frick K, Weltman JY, Weltman AL. Administration of recombinant human GHRH-1,44-amide for 3 months reduces abdominal visceral fat and increases physical performance in postmenopausal women. Eur J Endocrinol. 2005;153(5):669-77. pubmed.ncbi.nlm.nih.gov/16260425
19. 19.Veldhuis JD, Erickson D, Mielke K, et al. Distinctive inhibitory mechanisms of age and relative visceral adiposity on growth hormone secretion in pre- and postmenopausal women studied under a hypogonadal clamp. J Clin Endocrinol Metab. 2005;90(11):6006-13. pubmed.ncbi.nlm.nih.gov/16091485
20. 20.Vadillo Buenfil M, Garcia De Leon LE, Caracas Portilla N, Gonzalez Barcena D. Effect of transdermal 17-beta estradiol on GH release by GHRH (1-29) in climacteric women. Ginecol Obstet Mex. 2001;69:379-85. In Spanish. pubmed.ncbi.nlm.nih.gov/11816525
21. 21.Murphy MG, Weiss S, McClung M, et al; MK-677/Alendronate Study Group. Alendronate and MK-677, individually and in combination, on bone turnover and BMD in postmenopausal osteoporotic women. J Clin Endocrinol Metab. 2001;86(3):1116-25. pubmed.ncbi.nlm.nih.gov/11238495
22. 22.Arvat E, Gianotti L, Broglio F, et al. Oestrogen replacement does not restore the reduced GH-releasing activity of hexarelin in post-menopausal women. Eur J Endocrinol. 1997;136(5):483-7. pubmed.ncbi.nlm.nih.gov/9186268
23. 23.Kingsberg SA, Clayton AH, Portman D, et al. Bremelanotide for the treatment of hypoactive sexual desire disorder: two randomized phase 3 trials. Obstet Gynecol. 2019;134(5):899-908. RECONNECT. pubmed.ncbi.nlm.nih.gov/31599840
24. 24.Ghorbani Z, Mirghafourvand M. The efficacy and safety of intravaginal oxytocin on vaginal atrophy: a systematic review. Post Reprod Health. 2021;27(1):30-41. pubmed.ncbi.nlm.nih.gov/32814499
25. 25.Farahat RA, Salamah HM, Mahmoud A, et al. The efficacy of oxytocin gel in postmenopausal women with vaginal atrophy: an updated systematic review and meta-analysis. BMC Womens Health. 2023;23(1):494. pubmed.ncbi.nlm.nih.gov/37716966
26. 26.Danan ER, Sowerby C, Ullman KE, et al. Hormonal treatments and vaginal moisturizers for genitourinary syndrome of menopause: a systematic review. Ann Intern Med. 2024;177(10):1400-1414. Funded by AHRQ and PCORI. pubmed.ncbi.nlm.nih.gov/39250810
27. 27.Zohrabi I, Abedi P, Ansari S, et al. The effect of oxytocin vaginal gel on vaginal atrophy in postmenopausal women: a randomized controlled trial. BMC Womens Health. 2020;20(1):108. pubmed.ncbi.nlm.nih.gov/32429977
28. 28.Fianu Jonasson A, Bixo M, Sundstrom Poromaa I, Astrom M. Safety and efficacy of an oxytocin gel and an equivalent gel without hormonal ingredients (Vagivital) in postmenopausal women with vulvovaginal atrophy. Med Devices (Auckl). 2020;13:339-347. pubmed.ncbi.nlm.nih.gov/33116956
29. 29.Torky HA, Taha A, Marie H, et al. Role of topical oxytocin in improving vaginal atrophy in postmenopausal women: a randomized, controlled trial. Climacteric. 2018;21(2):174-178. RETRACTED. pubmed.ncbi.nlm.nih.gov/29347848
30. 30.Statement of retraction: role of topical oxytocin in improving vaginal atrophy in postmenopausal women. Climacteric. 2024;27(5):507. pubmed.ncbi.nlm.nih.gov/39254427
31. 31.The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022;29(7):767-794. pubmed.ncbi.nlm.nih.gov/35797481
32. 32.Komarov FI, Khavinson VKh, et al. Use of epithalamin in climacteric myocardiopathy. Klin Med (Mosk). 1995;73(4):40-2. In Russian; the PubMed record carries no abstract. pubmed.ncbi.nlm.nih.gov/7474816
33. 33.Karpov RS, Slepushkin VD, Mordovin VF, et al. Pathogenesis and diagnosis of dysovarian cardiomyopathy. Ter Arkh. 1986;58(11):70-3. In Russian; epithalamin used as a diagnostic probe. pubmed.ncbi.nlm.nih.gov/3824194
34. 34.Vyleesi (bremelanotide), US FDA label read via the openFDA drug label API. NDA210557, effective 13 November 2025. Premenopausal HSDD; not indicated in postmenopausal women or men. open.fda.gov drug label API
35. 35.Calcitonin salmon injection, US FDA label read via openFDA. ANDA215864, effective 6 March 2026. Postmenopausal osteoporosis when alternatives unsuitable; fracture reduction efficacy not demonstrated. open.fda.gov drug label API
36. 36.Calcitonin salmon nasal solution, US FDA label read via openFDA. ANDA076979, effective 29 June 2026. Postmenopausal osteoporosis in women more than 5 years postmenopause; fracture reduction efficacy not demonstrated. open.fda.gov drug label API
37. 37.Forteo (teriparatide), US FDA label read via openFDA. NDA021318, effective 3 August 2026. Postmenopausal osteoporosis at high fracture risk. open.fda.gov drug label API
38. 38.Tymlos (abaloparatide), US FDA label read via openFDA. NDA208743, effective 11 August 2026. A human parathyroid hormone related peptide, PTHrP(1-34), analog; postmenopausal osteoporosis at high fracture risk. open.fda.gov drug label API
39. 39.Veozah (fezolinetant), US FDA label read via openFDA. NDA216578, effective 26 February 2026. Moderate to severe VMS due to menopause; described as a small-molecule NK3 receptor antagonist, 45 mg oral tablet. open.fda.gov drug label API
40. 40.Lynkuet (elinzanetant), US FDA label read via openFDA. NDA219469, effective 16 June 2026. Moderate to severe VMS due to menopause; described as an NK1 and NK3 receptor antagonist, 60 mg oral capsule. open.fda.gov drug label API
41. 41.Egrifta SV and Egrifta WR (tesamorelin), US FDA label read via openFDA. BLA022505, effective 29 July 2026. HIV lipodystrophy only; not indicated for weight loss. open.fda.gov drug label API
42. 42.Wegovy (semaglutide), US FDA label read via openFDA. NDA215256, effective 23 April 2024. Obesity and cardiovascular risk; no menopause wording in the indication. open.fda.gov drug label API
43. 43.US FDA drug label index sweep for perimenopause and perimenopausal in indications, via openFDA, 13 September 2026. Eleven records: seven over-the-counter or homeopathic, and goserelin (Zoladex) for advanced breast cancer; none a peptide. open.fda.gov drug label API
44. 44.US FDA drug label index sweep for kisspeptin, BPC-157, ipamorelin, epitalon, CJC-1295, sermorelin and MOTS-c as label substances, via openFDA, 13 September 2026. Zero records for each. open.fda.gov drug label API
45. 45.Eladynos (abaloparatide), European Medicines Agency EPAR. Authorised 12 December 2022; postmenopausal osteoporosis; after 18 months 0.5 percent had a new spinal fracture against 4.2 percent on placebo in a main study of 2,070 patients. ema.europa.eu Eladynos
46. 46.Forsteo (teriparatide), European Medicines Agency EPAR. Osteoporosis in postmenopausal women and in men at increased fracture risk. ema.europa.eu Forsteo
47. 47.Veoza (fezolinetant), European Medicines Agency EPAR. Authorised 7 December 2023; moderate to severe VMS associated with menopause. ema.europa.eu Veoza
48. 48.Lynkuet (elinzanetant), European Medicines Agency EPAR. Authorised 17 November 2025; moderate to severe VMS associated with menopause or caused by adjuvant endocrine therapy for breast cancer. ema.europa.eu Lynkuet
49. 49.PubMed E-utilities esearch, db=pubmed, counts re-run 13 September 2026: kisspeptin AND menopause 91; semaglutide AND menopause 16; teriparatide AND postmenopausal 986; oxytocin AND vaginal atrophy 18; the BPC-157, GHK-Cu, epitalon, ipamorelin and sermorelin queries returning 0 as printed. ncbi.nlm.nih.gov E-utilities
50. 50.PubMed E-utilities esearch, db=pubmed, perimenopause-specific queries run 13 September 2026, including the combined marketed-peptide query returning 0 records against perimenopause and the raw peptide AND perimenopause query returning 919. ncbi.nlm.nih.gov E-utilities
51. 51.PubMed E-utilities esearch, db=pubmed, per-compound counts against the menopause term set, run 13 September 2026: ipamorelin, CJC-1295, sermorelin, tesamorelin, epitalon, BPC-157 and GHK-Cu each 0; MOTS-c 2; MK-677 1; GHRP-2 17; hexarelin 1; kisspeptin 106; bremelanotide 20. ncbi.nlm.nih.gov E-utilities
52. 52.Peptide Mind, "9 Best Peptides for Perimenopause in 2026 (Ranked by Symptom Relief)", fetched 13 September 2026. Recorded as what the page says; no endorsement. peptidemind.com
53. 53.Perfect B, a clinic in Doral, Florida, "Best Peptides for Women Over 50: A Post-Menopausal Guide", fetched 13 September 2026. Recorded as what the page says; no endorsement. perfectb.com
54. 54.Form Blends, "Best Peptides for Menopause", fetched 13 September 2026. Recorded as a same-category page that states the evidence gap plainly. formblends.com
55. 55.Drug Administration of Vietnam public services portal, fetched 13 September 2026. Reachable (HTTP 200), but the registration and price search returns no results to an automated request, confirmed against a control drug that must be registered. dichvucong.dav.gov.vn