A growing body of evidence is available to guide care for women with sexual concerns. This article considers the case of a 60-year-old woman who with menopause developed decreased libido, rapidity of sexual arousal, and intensity of orgasm. She requests information about strategies to optimize sexual function. Effects of aging and menopause on female sexual response are reviewed and an evaluation approach presented to help clinicians respond productively to women who request intervention. The effectiveness and safety of different treatment options are discussed, including education, lifestyle changes, counseling, medications, mechanical devices, and pelvic floor exercises; recommendations are made to help postmenopausal women maximize sexual pleasure and satisfaction.