Menopause is a complex transition that affects various aspects of a woman’s life, including biological, psychological, relational, and sociocultural factors. This chapter looks at how hormonal changes, especially decreases in estrogen and androgens, relate to sexual health. It highlights how common and often overlooked female sexual dysfunction (FSD) is. The genitourinary syndrome of menopause (GSM), which includes symptoms like vaginal dryness, pain during intercourse, and urinary issues, significantly contributes to sexual discomfort. Psychological factors such as anxiety, depression, and concerns about body image, along with relationship dynamics and cultural stigma, also make sexual challenges worse. The chapter recommends a biopsychosocial approach to diagnosis and treatment, using tools like the FSFI and DSDS, hormonal assessments, and pelvic exams. Treatment options include local and systemic hormone therapies, psychosexual counseling, pelvic floor physiotherapy, and new methods such as PRP and laser therapy. It stresses the importance of communication models like the PLISSIT framework to encourage open discussions and partner involvement. By using a multidisciplinary, patient-focused approach, healthcare providers can help menopausal women regain their sexual health, dignity, and quality of life. The chapter emphasizes that addressing sexuality is essential for effective menopausal care.