Aim. To evaluate with validated instruments changes in quality of life and sexuality in women receiving hormonal replacement therapy (AHT). Design. Randomised, double-blind, double-dummy study with two parallel treatment arms. Patients and methods. Forty-seven healthy post-menopausal women, aged 45-64 years, were evaluated using the Female Sexual Function Index (FSFI) and the menopause-specific quality of life questionnaire (MENQOL). Of them, 40 diagnosed with sexual dysfunction were randomised (1:1) to receive daily 0.625mg of conjugated estrogens plus 1.25mg of methyl-testosterone and 100mg of micronised progesterone or placebo. After 3 months follow-up, FSFI and MENQOL questionnaires were administered for a second time. Results. Quality of life was unchanged in the placebo group whereas AHT significantly improved scores of vasomotor, psychological, physical and sexual symptoms. As expected, FSFI was not modified in the placebo group while in AHT group the FSFI score improved signifi