The present chapter outlines the sexual aftermath of cancer treatment and strategies for improvement. Sexual dysfunction is underdiagnosed and undertreated after surgery, chemotherapy, radiation, and hormone-modulating therapies. The treatment of genitourinary syndrome of menopause (GSM) is multimodal and includes behavioral modifications, local therapy, and physical therapy. Vaginal estrogen should be first-line treatment for GSM in women with hormone non-responsive cancer. For those with ovarian, endometrial, and breast cancer, vaginal estrogen may be considered with persistent symptoms after regular use of non-hormonal moisturizers. As an alternative, vaginal androgens may be of utility in improving libido and vaginal health. The authors do not endorse the use of compounded formulas due to a lack of formula standardization and a dearth of safety and efficacy data. Vaginal lasers, including CO2 lasers, are discouraged after two sham-controlled randomized trials found they were not effective, and adverse events have been reported in women with cancer. Dyspareunia is common, especially if encountered in the setting of radiation-induced vaginal stenosis. Treatment may involve addressing GSM, serial vaginal dilation, pelvic floor therapy, and/or psychological therapy. In those with low sexual desire, filbanserin and bremelanotide are novel FDA-approved therapies with central mechanisms that may change the landscape for treating female sexual desire disorders.