(023) Duty Sex in Menopause: The Role of Relationship Satisfaction When Sexual Function Declines

Abstract Introduction Menopause is often accompanied by declines in sexual function, which may increase engagement in sex out of obligation or “Duty Sex,” rather than intimacy or pleasure. Such experiences may be especially common among partnered menopausal women, as the onset of sexual dysfunction can create tension between reduced desire and perceived expectations to maintain sexual frequency (Avis et al., 2009). Duty Sex can diminish both partners’ sexual and relationship satisfaction, further exacerbate sexual dysfunction, and reduce overall well-being (Muise et al., 2013; Watson et al., 2017). Objective Although Duty Sex tends to increase across the lifespan, few studies have directly examined its relationship to menopause (Wyverkens et al., 2018). This study investigated hypothesized risk factors (sexual dysfunction, menopausal symptoms) and protective factors (relationship satisfaction) associated with Duty Sex among menopausal women. Methods Women (97 postmenopausal, 4 perimenopausal) aged 45-69 (M = 54.87; SD = 4.78) completed measures of sexual function (FSFI; Rosen et al., 2000), menopausal symptoms (MENQOL; Hilditch et al., 1996), and relationship satisfaction (GMREL; Lawrence SD = 39.22; range = 0-100%) was determined by asking how many sexual encounters in the past month occurred because of an initial sense of obligation or duty. Eligibility criteria included being sexually active, in a romantic relationship (≥ 3 months), and no sexual violence history, as such experiences tend to increase Duty Sex (Metcalfe et al., 2024). Correlations were computed between Duty Sex and all predictors, followed by multiple linear regressions examining the influence of sexual function, menopausal symptoms, and relationship satisfaction. Results Length of menopause was significantly and negatively correlated with Duty Sex (r = -0.24), whereas participants’ age was not. A multiple regression revealed that severity of sexual dysfunction (b = -3.48, p .01) but not vasomotor, physical, or psychosocial symptoms, predicted Duty Sex and accounted for 33% of the variance (R2 = 0.33). Desire, arousal, lubrication, orgasm, satisfaction, and pain each individually correlated with Duty Sex, with more dysfunction associated with more frequent Duty Sex (rs = -0.38 to -0.60). However, a multiple regression indicated that only arousal significantly predicted Duty Sex (b = -10.50; p = .02), accounting for 35% of the variance (R2 = 0.35). A significant interaction emerged between overall sexual function and relationship satisfaction (b = 3.17, p .01), such that lower sexual function predicted more Duty Sex, particularly among women with low relationship satisfaction (R2 = 0.37). Conclusions Impaired sexual function, especially diminished arousal, appears to drive Duty Sex, whereas other menopausal symptoms are less relevant. Sexual arousal involves feelings of excitement and being turned on during sex; when absent, sexual encounters may become less desirable, thereby increasing Duty Sex. However, relationship satisfaction appears to buffer this effect. Women with satisfying relationships and adequate sexual function may engage in sex more for pleasure or closeness, while those with dysfunction may find such motives diminished. Conversely, women with low function but high relationship satisfaction may feel more empowered to decline unwanted sex or collaborate with their partner to adopt strategies to manage dysfunction (eg, lubricants for vaginal dryness). Clinically, enhancing relationship satisfaction may help reduce Duty Sex, even among women experiencing sexual dysfunction. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Stripes Beauty.