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Primary research: Sexual dysfunction, melanocortin receptor activation Mechanism: Activates melanocortin-4 receptors (MC4R) in the central nervous system, distinct from PDE5 inhibitors like sildenafil Regulatory status: FDA-approved as Vyleesi (2019) for HSDD in premenopausal women Key distinction: Works through CNS melanocortin pathways rather than vascular mechanisms SS-31 / Elamipretide (Mitochondrial Peptide) SS-31 (Elamipretide) is a synthetic tetrapeptide that selectively targets the inner mitochondrial membrane by binding cardiolipin