Abstract: This monograph describes the physiology of women's sexual response, particularly the interplay of psycho-logic and biologic factors: the mind modulates physiology; disease affects the psyche. The current understanding of women's sexual response cycles, including the concepts of sexual motivation and sexual arousability, are presented to clarify the etiology and evolution of common types of sexual dysfunction and to provide management guidelines. Changes in sexuality through the life cycle are addressed. Principles and methods to assess sexual concerns and diagnose sexual problems, including disorders of sexual interest, arousal, and orgasm, are outlined, as are risk factors for sexual dysfunction. This update also includes discussions of the management of pain from estrogen deficiency and provoked vestibulodynia and nonconsummation of relationship from fear of vaginal penetration. The uncertainty regarding androgen supplementation also is discussed.