Understand the source comparison
Peptides for Perimenopause Protocol Evidence Guide: Comparison by Mechanism
GH Secretagogues (MK-677, Hexarelin, CJC-1295/Ipamorelin) Stimulate pituitary GH release via ghrelin receptor or GHRH analog pathways Restore pulsatile GH secretion suppressed by estrogen withdrawal; improve lean mass, bone density, sleep quality MK-677: 12.5–
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- GH Secretagogues (MK-677, Hexarelin, CJC-1295/Ipamorelin)
- Stimulate pituitary GH release via ghrelin receptor or GHRH analog pathways
- Restore pulsatile GH secretion suppressed by estrogen withdrawal; improve lean mass, bone density, sleep quality
- MK-677: 12.5–25mg daily; Hexarelin: 100–200mcg 2x/day cycled; CJC/Ipa: 200/200mcg nightly
- Strong. Multiple RCTs in postmenopausal women show sustained IGF-1 elevation and body composition benefits
- Best-supported class for neuroendocrine restoration during perimenopause. MK-677 offers simplest dosing but monitor glucose
- Thymic Peptides (Thymalin, Epithalon)
- Upregulate thymulin secretion; reactivate thymic epithelial cells; lengthen telomeres (Epithalon)
- Counter accelerated immune senescence and T-cell production decline during estrogen withdrawal
- Thymalin: 10mg SC every 3–5 days for 10 doses; Epithalon: 10mg daily for 10 days, repeated quarterly
- Moderate. Strong Eastern European institutional data; limited Western replication
- Addresses immune aging component most protocols ignore. Sourcing quality matters due to peptide synthesis complexity
- Metabolic Regulators (Tesofensine, AOD-9604)
- Tesofensine: triple monoamine reuptake inhibition; AOD-9604: stimulates lipolysis without GH receptor binding
- Reverse visceral fat accumulation and metabolic rate decline from insulin resistance and reduced sympathetic tone
- Tesofensine: 0.25–0.5mg daily; AOD-9604: 300mcg SC daily fasted
- Moderate. Tesofensine Phase II strong, Phase III halted; AOD-9604 pre-clinical only
- Use when GH secretagogues alone don't reverse metabolic dysfunction. Tesofensine most potent but requires cardiovascular monitoring
- Neuroprotective (Cerebrolysin, Dihexa, P21)
- Neurotrophic factor delivery; BDNF upregulation; cognitive enhancement via multiple pathways
- Address brain fog, memory lapses, and cognitive decline linked to estrogen's neuroprotective loss
- Cerebrolysin: 5–10mL IV 2–3x/week; Dihexa: 5mg oral daily; P21: 10mg nasal spray daily
- Weak to moderate. Cerebrolysin has stroke/dementia trials; Dihexa and P21 remain pre-clinical
- Cognitive symptoms are real but peptide evidence is weakest here. Prioritize GH/metabolic correction first