Female sexual function, as well as sexual dysfunction often seen during menopause, is assumed to be closedly related to the hormonal milieu of the body, particularly that of the target organs of the sex steroids. Estrogen as the hormone associated with female reproductive functioning is given first consideration in treating complaints of dysfunction, especially dyspareunia. However, simply restoring some, or all, of the estrogenization of the premenopausal years does not always lead to improvement in overall sexual functioning. Decreased libido is often still present in situations that appear to be anatomically satisfactory. Thus, exogenous testosterone, in a number of dosage forms, is often used adjunctively. Although the results are often gratifying, side effects may be a problem for some women. Treated women should be monitored for increased facial oiliness, acne, hirsutism, and alopecia.