Objective: Why do we care whether the menopausal woman engages in – let alone enjoys – sexual pleasure or not? It is surely a very individual area and should be addressed on an individual basis. Today, the majority of menopausal women are busy with work, looking after children and grandchildren and lead fulfilling, busy lives. Why not a great sexual life too? Design and Method: Retrospective analysis of peri and post-menopausal women, experiencing problems related to sexual dysfunction. Detailed sexual health history was obtained, detailing specifics around gynaecological and sexual health screenings and interventions. This gave rise to key factors that displayed sexual dysfunction elements, but once addressed, diminished or resolved the dysfunction. Results: It was found that the majority of women were guarded in discussing sexual problems from a psychosexual framework, however, it remained less challenging to subscribe to the perceived problem being a medical/gynaecological problem. Awareness of age-related health issues and discussion around this influenced appropriate management. Conclusions: Adequate baseline screening is a key concept to address practical impediments and discuss these from a normal aging process. A direct approach, practical information, engagement with the partner and awareness of options around sexual positions and exploration drive these consultations positively. Support and education via linking with a Clinical Psychologist during this process was found to be a key aspect to outcome.