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Female sexual dysfunction is a common disorder and is classified into four major categories. To successfully diagnose and treat these disorders, physicians must have a working knowledge of the anatomy and physiology of the female sexual response. In addition, the physician must identify the cause of the dysfunction and tailor the treatment to the specific cause. The present review defines and classifies female sexual dysfunction, discusses the pertinent anatomical and physiological features, identifies the four causes of female sexual dysfunction and presents a diagnostic approach for the practicing physician.