Given the rapid aging of the population globally and in Iran, the sexual health of older women an essential yet neglected need within the health system faces significant cultural, social, and executive barriers. This challenge profoundly impacts the quality of life, marital relationships, and mental health of older adults. To achieve operational solutions, this policy brief was developed based on qualitative research findings. Four primary challenges were identified from the study: the impact of youthful hardships on present life, transitions through critical life stages, learned helplessness, and biological limitations. Based on these findings and expert opinions, three policy options were designed: A) Public education and culture-building to shift attitudes toward sexual health in aging; B) Establishing and strengthening specialized sexual health counseling services for the elderly; C) Developing online counseling platforms and dedicated helplines for elderly sexual health. Analysis of the benefits, drawbacks, and barriers of these options revealed that online services (Option C) are the top priority due to their ability to ensure privacy, reduce shame, provide wider coverage, and incur lower costs. This is followed by public education and subsequently, specialized clinical counseling. Furthermore, it is necessary to establish a strategic council involving the Ministry of Health, national media (IRIB), the Islamic Propagation Organization, and medical universities to design cultural content, invest in online platforms, and train specialized personnel. These measures can effectively address cultural taboos while bringing the sexual health of older women to the forefront of the health agenda.