The menopause is an important transition point for women in terms of their experience of sex. Higher expectations of a longer, healthier lifespan means that access to health professionals with the skills to address sexual issues is more important than ever. This review of the literature considered four broad areas: the influence of patient and practitioner characteristics on consultations about sexual issues for peri- and postmenopausal women; perceived barriers to discussion of sexual issues; the role and effectiveness of communication training; and examples of good practice in the field. This is an under-researched area with few papers focusing on the specific needs of this group of patients or practitioners. In order to improve the quality of life of mid-life and older women, more high-quality research is needed that can inform both education and training for gynaecologists, and the development of high-quality services.