Introduction: Female Sexual Disorders (FSD) hinder race-propagation and deteriorate life-quality. Middle-aged/elderly women are more likely to suffer because of low serum estrogen; causing vaginal smooth muscle shrivel, mucosal thinning and decreased secretions; resulting into dyspareunia, distress and disturbed family relations. Topical estrogen improves symptoms, but its systemic absorption produces side-effects. Oral Nigella sativa seed (Black-Seed, BS) has been shown to control menopausal symptoms because of estrogen like effects. Present study aimed to evaluate efficacy of BS powder and oil in middleaged/elderly women with FSD. Methods: Forty women, aged 45-65 years, visiting Gynecology Department of Teaching Hospital of Rawalpindi Medical University, with FSD symptoms were recruited. Participants were randomly divided into four groups (10 each), A, B, C & D, receiving BS-powder (oral) & BS-oil (topical), BS-oil (topical), BSpowder (oral) & Olive-oil (topical), and Olive-oil (topical), respectively. Patients consumed grounded BS, mixed with equal amount of honey, one teaspoon twice daily and applied BS-/Olive-oil on external genitalia and outer-1/3 of vagina every night for one month; and allowed to mate with spouses twice weekly during this period. Female Sex Function Index (FSFI), pre- and post-intervention was assessed with FSFI-questionnaire and results compared statistically. Results: Study revealed highly significant improvement in FSD symptoms (Desire, arousal, lubrication, orgasm, satisfaction and pain) in group A (BS oral & BS-oil topical) as compared to B, C & D. Conclusion: Oral BS with topical BS-oil effectively improved FSD symptoms in middle-aged/elderly women, because of systemic and topical estrogenic, anti-inflammatory and analgesic potential, besides lubrication.