This chapter discusses some of the sexual symptoms experienced by some people with epilepsy and reviews appropriate diagnostic tests and treatments. To help understand why sexual life might be impacted by epilepsy, it discusses the biology of sexuality. Sexual dysfunction may arise in as many as one-third to one-half of men and women with epilepsy. The dysfunction appears to occur because of disruption to the brain regions controlling sexual behavior, disturbance of the hormones supporting sexual behavior, and the effects of antiepileptic drugs (AEDs). Specific therapies can be directed toward specific sexual problems. Treatment will focus on seizure control, including alternative medications and the provision of directed therapies, which may include biofeedback, behavioral medicine techniques, newer medications to improve physiological sexual arousal, and more traditional couple or individual counseling. In sexual therapy, couples practice sexual exercises according to a schedule established by the therapist.