This session equips clinicians to identify, evaluate, and manage female sexual dysfunction in postmenopausal women and women with osteoporosis, a population in which these problems are common yet rarely raised or addressed. It opens with an overview of female sexual function and the prevalence of desire, arousal, orgasm, and pain problems, the frequent overlap among them, and the medical conditions, medications, and life circumstances that contribute, framed within a biopsychosocial model. Because fewer than six percent of postmenopausal women raise sexual concerns on their own, the session models how to initiate the conversation, how to interpret the answer to a screening question, and how to respond when a patient does or does not report a concern. It then works through the four categories of dysfunction in turn. For hypoactive sexual desire disorder it reviews the inhibitory and excitatory balance of neurotransmitters and hormones and the full range of strategies, from eliminating sexual and nonsexual pain, managing insomnia and vasomotor symptoms, and modifying medications, through sex therapy and the pharmacologic options of flibanserin, bremelanotide, menopausal hormone therapy, and off label testosterone, with their efficacy and adverse effects. For dyspareunia it presents the DSM-V genito-pelvic pain and penetration disorder criteria, a structured differential that extends well beyond genitourinary syndrome of menopause, and the management ladder of lubricants, moisturizers, and estrogen based and non estrogen based prescription products, with attention to osmolality and product selection. For orgasmic dysfunction it traces the pathway to orgasm, the requirements for orgasm, the biologic and psychosocial etiologies, and the approved and off label options for increasing clitoral sensation and blood flow. The session closes on osteoporosis specifically, establishing that sexual problems in these women arise from comorbidities, medications, postmenopausal status, body image, and fear of fracture rather than from osteoporosis itself, and it offers ergonomic and positioning strategies to reduce pain and fear for both patient and partner.