Research consistently reports that older people tend not to seek medical help for sexual concerns or difficulties. This article reviews the literature to examine help-seeking for, and doctor-patient interactions about, sexual problems in the middle and later life age groups. Twenty-five articles from 1999 to 2010 were identified and analyzed. Significant barriers to seeking medical help included psychosocial factors relating to the patient, such as thinking that sexual changes were "normal with ageing," and also to the doctor-for example, assuming that sex was less important to older patients than it was to their younger patients. Inadequate training at medical school for health care professionals (HCPs) was also identified as a barrier. People were more likely to seek help if their doctor had asked about sexual function during a routine visit sometime during the previous three years. However, doctors tended not to take a proactive approach to sexual health management, and indeed often had limited knowledge of later-life sexuality issues. There are clear implications for sexual well-being if the doctor does not ask and the patient does not tell. Providing education about later-life sexuality for HCPs is crucial if we are to meet the needs of older patients in useful and effective ways.