Objectives: The aim of the study was to document sexual function in Kelantanese postmenopausal women. Method: A semi-structured questionnaire in Malay language was administered to 326 women (mean age of 57.1 +/- 6.58 (S.D.) years) residing in Kelantan. The subjects comprised of naturally menopaused, healthy women. Results: Of the total respondents, 70% (n = 227) were with a spouse at the time of the study. Of these, more than two-thirds reported a decrease in sexual activity following menopause. Varying degree of dyspareunia was reported by 44% of the women. A small fraction (8.8%) reported inability of the vagina to stretch sufficiently to enable the complete penetration of an erect penis. Of the total married respondents, vaginal secretion during sexual intercourse was decreased in 52.4%, did not change in 31% but increased in 1.3% of the women following menopause. Sexual desire was reportedly decreased or absent in two-thirds of the total respondents (n = 326). Conclusion: It appears that sexual function significantly decreases during menopause. This may be due to dyspareunia, poor lubrication, loss of sexual desire, and the spouse's health status and ageing itself. Although declining sexual function was recognised by nearly two-thirds of the women, more than half did not take any action to improve their sexual function. Of those who did, they used hormonal therapy, traditional, alternative medicine or practiced healthy lifestyle or a varied combination of above self-help actions. (c) 2005 Elsevier Ireland Ltd. All rights reserved.