Sexual activity was evaluated in 51 women with hirsutism associated with increased levels of circulating androgens before and while on combined treatment with the antiandrogen cyproterone acetate (CA) and ethinyl estradiol (EE2) and compared to a reference group of 52 subjects. The percentage of unbound testosterone (T) was higher (p less than 0.001), the coital frequency lower (p less than 0.05), and the masturbation frequency higher (p less than 0.04) in hirsute women. Mean frequency of total activity (coitus plus masturbation) was similar in the two groups. Treatment with combination of CA and EE2 resulted in a decline of unbound T (p less than 0.001). There was no change of total sexual activity, but coital frequency increased (p less than 0.05) and masturbation frequency declined (p less than 0.04). It is concluded that raised levels of circulating androgens, as judged by free T concentration, are not of crucial importance in the expression of sexual behavior in hirsute women.