Best Peptides for Menopause and Perimenopause in 2026
When a peptide is offered to women in perimenopause or after menopause, what was measured, in whom, and with what design. Each row below is one published study, with the population enrolled, the endpoint, the number reported and its PMID.
1,637
Randomised in the teriparatide fracture trial (PMID 11346808)
2,463
Enrolled in the ACTIVE trial (PMID 27533157)
10
Volunteers in the GHRH 1,44-amide study (PMID 16260425)
Read this first. Perimenopause and menopause are managed with a doctor. Nothing here is a protocol, a recommendation or a substitute for treatment.
Population is the thing to hold onto. A result in postmenopausal women with diagnosed osteoporosis describes women with diagnosed osteoporosis. A result in premenopausal women with a sexual desire disorder describes that group. A result in 10 volunteers measured against their own baseline describes those 10 volunteers. Every row carries its population, and the same figure without one means something different.
The Studies
One row per study. A compound with more than one study gets more than one row, grouped by compound rather than ordered by result.
| Compound | Population (n) | What was measured | Result | Design | PMID |
|---|---|---|---|---|---|
| Teriparatide (PTH 1-34) | Postmenopausal women with prior vertebral fracture, n = 1,637 | New vertebral fracture, median 21 months | 14 percent on placebo against 5 and 4 percent on treatment; relative risks 0.35 (95 percent CI 0.22 to 0.55) and 0.31 (0.19 to 0.50) | Randomised, placebo-controlled | 11346808 |
| Abaloparatide (PTHrP analog) | Postmenopausal osteoporosis, n = 2,463, mean age 69 | New vertebral fracture and hypercalcaemia, 18 months | Fewer new vertebral fractures than placebo; hypercalcaemia 3.4 percent against teriparatide 6.4 percent, p = 0.006 | Phase 3 randomised, placebo plus open-label teriparatide arm | 27533157 |
| Calcitonin salmon nasal spray | Postmenopausal established osteoporosis, n = 1,255 | New vertebral fracture, 5 years | 200 IU arm 51 of 287 against placebo 70 of 270, relative risk 0.67 (0.47 to 0.97), p = 0.03; the 100 and 400 IU arms not significant | Randomised, double-blind, placebo-controlled | 10996576 |
| Bremelanotide (PT-141) | Premenopausal women with hypoactive sexual desire disorder, n = 1,267 | Desire domain and desire-related distress, 24 weeks | Desire plus 0.35 and distress minus 0.33 against placebo, both p below 0.001 | Two phase 3 randomised double-blind placebo-controlled trials | 31599840 |
| Kisspeptin-10, bolus | Postmenopausal women, n = 11 | Luteinising hormone, with and without 7 days of NK3 antagonist MLE4901 | No effect on luteinising hormone in either condition | Open label, each woman against her own baseline | 28380486 |
| Kisspeptin-10, bolus | Post-menopausal women, n = 6, within a 24-woman four-group study | Gonadotrophin area under the curve over 60 minutes | Luteinising hormone plus 5.3 plus or minus 0.9 IU/l h, p = 0.002; follicle-stimulating hormone plus 2.6 plus or minus 0.8, p = 0.03 | Non-randomised comparison of hormonal states | 22956346 |
| Kisspeptin, continuous | Healthy postmenopausal women, n = 8 | Luteinising hormone across a 24-hour infusion, 10-minute sampling | Resistant to continuous kisspeptin; on estradiol replacement, pulse amplitude rose with estradiol level and infusion duration | Open label physiological study | 28368443 |
| Semaglutide | Women in menopause against premenopausal women; group sizes not reported | Weight and body composition, 4 months | Weight loss 5.8 plus or minus 4.7 percent against 5.1 plus or minus 3.2 percent, p = 0.4; lean mass minus 0.4 against minus 1.1 kg, p = 0.1 | Non-randomised clinic comparison | 39761057 |
| Intravaginal oxytocin | Postmenopausal vaginal atrophy in pooled randomised placebo-controlled trials; n = 218 for cytology, 38 for histology, 95 for endometrial thickness | Cytology, histology, endometrial thickness | Cytology standardised mean difference 35.13 (95 percent CI 32.59 to 37.67), I squared 96 percent; histology minus 0.38 and endometrial thickness 0.05, neither significant | Systematic review and meta-analysis | 32814499 |
| Recombinant human GHRH 1,44-amide | Postmenopausal volunteers, n = 10 | Overnight GH, IGF-I, visceral fat, walk and stair times, 3 months | GH up 98 plus or minus 14 percent, IGF-I up 71 plus or minus 3.5 percent, visceral fat down 16 plus or minus 7 percent, p = 0.029; 70 percent had local skin reactivity | Single arm against pre-intervention baseline, no control group | 16260425 |
| GHRH-1-29-NH2 (sermorelin) | Women with clinical and biochemical evidence of menopause, n = 5, mean age 51 | Post-stimulus GH at baseline and at 1, 3 and 6 months of transdermal estradiol | 2.74 at baseline, 4.91 at 3 months and 6.04 at 6 months, both p below 0.05; GH pulsatility unchanged | Single arm, own baseline; the peptide given as a diagnostic stimulus | 11816525 |
Dose figures are set out in the next section with their source.
Doses As Published
Regimens as the papers in the table report them:
Teriparatide 20 mcg or 40 mcg subcutaneously daily (PMID 11346808). Abaloparatide 80 mcg subcutaneously daily, against open-label teriparatide 20 mcg daily (PMID 27533157). Salmon calcitonin nasal spray 100, 200 or 400 IU daily (PMID 10996576). Bremelanotide 1.75 mg subcutaneously as needed (PMID 31599840). Semaglutide 1 mg for 4 months (PMID 39761057). Recombinant human GHRH 1,44-amide 1 mg subcutaneously twice daily for 3 months (PMID 16260425).
Disclaimer: these figures are what enrolled participants received under medical supervision in published research. Reference only. Not a recommendation, not a schedule, not advice. Every one was given by clinicians in a trial or research unit.
The Bone Trials
The teriparatide, abaloparatide and calcitonin trials enrolled postmenopausal women who already had osteoporosis. In the teriparatide trial, nonvertebral fragility fractures occurred in 6 percent on placebo against 3 percent in each active arm (PMID 11346808). ACTIVE ran abaloparatide against placebo and an open-label teriparatide arm at 28 sites in 10 countries (PMID 27533157).
PROOF is worth reading closely before treating a positive fracture result as settled. Over 5 years the reduction landed in the middle of three daily doses while the arms above and below did not separate from placebo, so it does not run in a dose-response line (PMID 10996576). A separate dosage form carries its own regulatory text. The US FDA label for calcitonin salmon injection, effective 6 March 2026, describes an injectable product rather than the nasal spray PROOF studied. It indicates the injection for postmenopausal osteoporosis when alternative treatments are not suitable, adds that fracture reduction efficacy has not been demonstrated, and asks that continued therapy be re-evaluated periodically because of a possible association with malignancy.
Kisspeptin And Flushes
A 2018 review sets out a proposed mechanism: when ovarian steroid feedback is lost, hypertrophied kisspeptin, neurokinin B and dynorphin neurons in the infundibular nucleus become overactive, driving GnRH pulses. The same review notes senktide, an NK3 receptor agonist, raised serum luteinising hormone in postmenopausal women and induced vasomotor symptoms (PMID 29902942).
A hot flush result from this literature came from the NK3 antagonist rather than from kisspeptin. In 11 postmenopausal women given MLE4901 for 7 days, flushes fell from 3.4 plus or minus 1.2 to 1.0 plus or minus 0.6 per day, p = 0.008, in the 8 women who reported them, while kisspeptin-10 given inside the same protocol did not affect luteinising hormone with or without the antagonist (PMID 28380486). An earlier study gave the same compound at the same dose by intravenous bolus to 6 post-menopausal women and recorded a rise in luteinising hormone area under the curve (PMID 22956346). Those papers read the difference differently, one as a gonadotrophin response enhanced by sex-steroid deficiency and the other as a lack of response that may reflect the hypo-oestrogenic state. See the kisspeptin profile.
Body Composition Through The Transition
Body composition is a frequent question through the transition. A 2025 study compared women in menopause with premenopausal women over 4 months of semaglutide; the postmenopausal group started heavier, 95 plus or minus 23.4 kg against 86.4 plus or minus 12.8 kg, and finished with comparable percentage weight loss (PMID 39761057). It is a clinic comparison rather than a randomised trial, and the abstract does not state either group size. Side effects are covered in the GLP-1 side effects guide, with compound detail on the semaglutide profile.
Bremelanotide And The Group It Was Trialled In
Bremelanotide, known in peptide circles as PT-141, is a melanocortin receptor agonist that appears on lists aimed at women in midlife. Two identical phase 3 trials, RECONNECT, randomised 1,267 premenopausal women with hypoactive sexual desire disorder over 24 weeks; both coprimary endpoints separated from placebo by small absolute amounts, and nausea, flushing and headache each occurred in 10 percent or more of treated women (PMID 31599840). The US FDA label for Vyleesi (bremelanotide), effective 13 November 2025, states under Limitations of Use that it is not indicated for the treatment of HSDD in postmenopausal women or in men. Background sits on the PT-141 profile, and the wider female evidence base in best peptides for women.
The Growth Hormone Axis After Menopause
The growth hormone axis has been measured directly under a hypogonadal clamp: healthy pre- and postmenopausal volunteers underwent 6 weeks of GnRH agonist-induced down-regulation, and in that state the postmenopausal women showed lower IGF-I and GH than the premenopausal women, reduced pulsatile but raised basal GH secretion, and an attenuated response to combined GHRH and GH-releasing peptide-2 (PMID 16091485). The raised basal half sits in the same result as the reduced pulsatile half. Class background sits in the HGH peptides guide and the tesamorelin profile.
Intravaginal Oxytocin
The 2021 intravaginal oxytocin review opens by calling genitourinary syndrome of menopause a major issue in menopausal health because, unlike vasomotor symptoms, it has a progressive trend. It searched Cochrane Library, MEDLINE, Web of Science, Embase, Scopus, ProQuest, Google Scholar and Persian databases without time or language limits, found five randomised placebo-controlled trials and pooled four (PMID 32814499). The 2022 hormone therapy position statement of The North American Menopause Society recommends low-dose vaginal estrogen therapy, vaginal dehydroepiandrosterone or oral ospemifene for genitourinary symptoms not relieved by over-the-counter therapies in women without indications for systemic hormone therapy (PMID 35797481).
Search Provenance
Each count below is a fact about a named query run against PubMed through E-utilities esearch.
- "kisspeptin AND menopause" in PubMed on 9 August 2026 returned 90 records; "semaglutide AND menopause" 14; "teriparatide AND postmenopausal" 985; oxytocin with "vaginal atrophy" 18.
- "BPC-157 AND menopause" returned 0 records in PubMed on 9 August 2026, as did (BPC-157 OR "BPC 157" OR "body protection compound") against the wider set (menopause OR menopausal OR perimenopause OR postmenopausal OR climacteric OR "hot flashes" OR "hot flushes") that day.
- "GHK-Cu AND menopause" returned 0 records in PubMed on 9 August 2026, as did (GHK-Cu OR "glycyl-histidyl-lysine" OR "Gly-His-Lys" OR "copper tripeptide") against that wider set.
- "epitalon AND menopause" and "ipamorelin AND menopause" each returned 0 records in PubMed on 9 August 2026, as did (ipamorelin OR "Aib-His-2Nal-Phe-Lys-NH2") against the wider set. (epitalon OR epithalon OR epithalamin OR "Ala-Glu-Asp-Gly") against that same set returned 2 records that day: PMID 7474816 and PMID 3824194.
- "sermorelin AND menopause" returned 0 records in PubMed on 9 August 2026, while "GHRH(1-29)NH2" AND menopause returned 1 record the same day: PMID 11816525. That is why entry terms are searched alongside compound names here.
Profiles for those names 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
Does perimenopause count as the same population as postmenopause in these trials?+
No, and the enrolment criteria show it. The bone trials recruited postmenopausal women who already had established osteoporosis or a prior vertebral fracture. The 2005 clamp study recruited healthy pre- and postmenopausal volunteers and then suppressed ovarian steroids for 6 weeks, modelling steroid deprivation rather than the fluctuating pattern of perimenopause (PMID 16091485). When a page says a peptide was studied in menopause, ask which group was in the room.
Why do the bone studies report fracture counts rather than bone density?+
A fracture is a discrete event counted from a radiograph, and density can move without fracture risk moving with it. PROOF makes the gap visible: lumbar spine bone mineral density rose significantly from baseline in every active treatment group, while new vertebral fractures fell in one of those groups and not in the others (PMID 10996576). A density figure alone does not tell you what happened to fractures.
What can a study measured against its own baseline establish?+
That something changed while people were taking a compound, which is weaker than showing the compound caused it. With no placebo arm, regression to the mean, seasonal change, changes in diet or activity and the effect of being measured all sit inside the result alongside any drug effect. The GHRH 1,44-amide paper states that comparisons were made with pre-intervention baseline data (PMID 16260425). A second reason to read the design before the result: in the 2001 report the peptide was the diagnostic stimulus used to probe the pituitary, and transdermal estradiol was the intervention being given (PMID 11816525).
How should a PubMed search count be read?+
As a fact about a named query run against a named index on a named date, and nothing more. It also depends on the wording of the query. PubMed indexes some papers only under a MeSH entry term rather than the compound name a reader would type, which is why each query in the search provenance section pairs a compound name with its entry terms, and why both forms are printed.
What is worth asking a doctor before starting anything described here?+
Questions that pin a proposal to a published population. Which study is being quoted, and were the participants postmenopausal, premenopausal, or neither. Has hormone therapy been discussed and either offered or ruled out with a reason. For anything aimed at bone, has bone density been measured. Is the compound a licensed prescription medicine where you live, or a research chemical used off label. Menopause and perimenopause are managed with a doctor.
References
- Neer RM, et al. N Engl J Med. 2001;344(19):1434-41. PMID 11346808
- Miller PD, et al. JAMA. 2016;316(7):722-33. ACTIVE. PMID 27533157
- Chesnut CH 3rd, et al. Am J Med. 2000;109(4):267-76. PROOF. PMID 10996576
- Kingsberg SA, et al. Obstet Gynecol. 2019;134(5):899-908. RECONNECT. PMID 31599840
- Skorupskaite K, et al. Neuroendocrinology. 2018;106(2):148-157. PMID 28380486
- George JT, Anderson RA, Millar RP. Hum Reprod. 2012;27(12):3552-9. PMID 22956346
- Lippincott MF, et al. J Clin Endocrinol Metab. 2017;102(6):2091-2099. PMID 28368443
- Szeliga A, et al. Gynecol Endocrinol. 2018;34(11):913-919. PMID 29902942
- Nicolau J, et al. Metab Syndr Relat Disord. 2025;23(1):70-76. PMID 39761057
- Ghorbani Z, Mirghafourvand M. Post Reprod Health. 2021;27(1):30-41. PMID 32814499
- Veldhuis JD, et al. Eur J Endocrinol. 2005;153(5):669-77. PMID 16260425
- Veldhuis JD, et al. J Clin Endocrinol Metab. 2005;90(11):6006-13. PMID 16091485
- Vadillo Buenfil M, et al. Ginecol Obstet Mex. 2001;69:379-85. In Spanish. PMID 11816525
- NAMS hormone therapy position statement. Menopause. 2022;29(7):767-794. PMID 35797481
- openFDA drug labelling API, labels read 9 August 2026: Vyleesi (bremelanotide), effective 13 November 2025; calcitonin salmon injection, effective 6 March 2026. open.fda.gov
- PubMed E-utilities esearch, db=pubmed. Every count above was run on 9 August 2026 with the query as printed. eutils documentation
Related Reading
This guide is educational only and is not medical advice. Menopause and perimenopause are managed with a doctor. Every figure above is reproduced from the study or label named beside it, never as a recommendation. Speak to a licensed doctor or pharmacist before any decision about hormone therapy or any compound described here.