Shortly after I became a specialist in the care of people with epilepsy, I realized that many of my patients were not happy with their sexuality. Women and men reported to me that they had less sexual desire than they wished they had. Men complained of difficulty achieving erections and women noted painful, difficult intercourse. In going to the medical literature, I found many reports that sexual dysfunction was common in people with epilepsy, but did not find good explanations as to why this should be. I had done research into sexual function earlier in my career and decided that there was a real need for research in sexuality in people with epilepsy. Our research team is still working in this area. We have learned a lot, but there is more to know. We find that about one-third of people with epilepsy have less interest in sex than they would like and about 40% have physical sexual problems. These physical problems affect sexual arousal, making intercourse difficult and not as pleasant. Fortunately, there are effective treatments for the kind of sexual problems that arise with epilepsy – but sexual symptoms have to be identified and discussed. Physicians and patients usually do not discuss sexuality. However, even if it is a little hard to begin the discussion, sexual symptoms are important. The health-care provider will be glad the topic is brought up so that an appropriate medical evaluation can be completed and helpful treatment can begin.