This is a study of 185 women attending a menopause clinic in London, England. Individual interviews carried out by a gynecologist trained in sex therapy found a variety of psychosexual problems affected the lives of a large majority of the women. Sex problems existing prior to menopause were exacerbated. For most of the women, however, problems developed during the years immediately preceding and following menopause. Problems included disorders of sexual desire, sexual response and sexual behavior. Menopause clinic staff should be alert to the presence of sex problems and should play a role in diagnosis, treatment and/or referral.