This study examined the clinical workload, outcome and direct costs of managing women with sexual dysfunction in an NHS clinic in the UK. A retrospective analysis of a 3-month period showed that of 47 referrals to the clinic, 38 undertook treatment. The therapists' assessments suggested that over 80% of patients improved on treatment. The average cost per patient was£ 472 (compared to£ 335 per annum for erectile dysfunction, which included physician's and drug costs). The average cost by type of practitioner was£ 278 (psychologist),£ 322 (physician),£ 532 (physician and psychologist) and£ 597 (sex therapist). Patients required between 1 and 51 treatment sessions, which were mainly restricted to psychological therapy. Female sexual dysfunction (FSD) represents a significant economic burden to the NHS. Further research on the potential role and cost effectiveness of pharmacological agents for FSD is warranted.