A relationship guide puts satisfaction before sexual frequency, with context on shared communication, midlife changes and when professional support matters.
On 2026-10-26, Rise and Grow Therapy published a clinical relationship guide about living in a sexless relationship. Mark Ryan’s practitioner guidance shifts attention from the calendar to the conversation: how each partner feels about their sexual relationship and whether they can say so freely.
That distinction matters for couples who feel distressed about differing desire. The guide focuses on people who are unhappy with their sexual relationship, not on making all couples have more sex. It states that a low-sex or sexless relationship is not inherently a problem when both partners are content.
Ryan’s guide combines practitioner recommendations with research it cites. It is not a new experiment testing whether a particular conversation or closeness exercise changes a couple’s sexual relationship.
The relationship evidence includes a study of 72 heterosexual dating couples. That study examined desire differences and relationship adjustment, including the role of sexual satisfaction in the relationship-satisfaction link.
A separate mixed-methods study involved 229 people in long-term relationships and identified 17 strategies for navigating desire differences. Its focus was how people managed those differences and how their strategies related to sexual and relationship satisfaction.
The guide also draws on a 2013 meta-analysis of 20 randomized studies of psychological interventions for sexual dysfunction. That research compared interventions with waiting lists and assessed sexual-dysfunction symptoms and sexual satisfaction. Its scope was treatment for sexual difficulties rather than a general assessment of couples having little or no sex.
These distinct sources provide the background for Ryan’s recommendations. Understanding their different purposes helps separate research findings from the guide’s practical advice.
Across the relationship studies summarized in the guide, sexual satisfaction mattered alongside desire differences. In the dating-couple study, desire differences were associated with relationship adjustment. Sexual satisfaction statistically mediated the association with relationship satisfaction for both women and men. In plain language, satisfaction was part of the link researchers observed between differing desire and how the relationship was going.
In the long-term relationship study, strategies involving both partners were associated with higher sexual and relationship satisfaction than strategies carried out alone. Communication and shared activities were among the joint approaches described. The finding draws attention to how couples respond to desire differences rather than treating the difference itself as the only issue.
The guide’s summary of the intervention review reports moderate average effects on sexual-dysfunction symptom severity and sexual satisfaction compared with waiting lists. This adds evidence about psychological support to the relationship research.
Ryan’s practical emphasis is on understanding each person’s experience of silence or distance before negotiating frequency. That is a different starting point from assuming that the couple’s first task is to agree on how often sex should happen.
The long-term relationship study was a survey, so it cannot establish that communicating or sharing activities caused higher satisfaction. The direction of the link remains uncertain. For example, greater satisfaction might make joint approaches easier rather than being their result. That is a possible explanation, not a finding established by the study.
The small dating-couple study also has limits of reach. Its heterosexual dating sample should not be generalized confidently to long-term or same-sex couples. Neither relationship study establishes how a particular midlife couple will respond.
The randomized intervention evidence concerns people with sexual dysfunction, not sexlessness as a relationship category. The guide says results varied by problem and were strongest for women with clinically defined low desire and women with orgasm difficulties.
Finally, Ryan’s conversation sequence is practitioner guidance rather than a proven protocol for every couple. Keeping these distinctions clear allows the research to inform a discussion without turning it into a promise.
Read alongside other midlife guidance, the update supports a wider view of sexual changes. Utah State University Extension describes how perimenopause and menopause may involve dryness, irritation or pain. It also notes that sleep and mood can affect interest in intimacy, alongside stress and overall wellbeing.
This matters because a discussion framed only as a disagreement about frequency may leave relevant discomfort or health changes out of view. The Extension resource considers physical and psychological dimensions together with relationship factors. Its emphasis on communicating and adapting as needs change sits alongside Ryan’s focus on understanding before negotiation.
The earlier relationship studies give the guide a basis for considering shared responses to differing desire. The Extension guidance adds reasons to pay attention to comfort and changing needs. These perspectives are complementary rather than competing explanations for a couple’s experience.
Keeping midlife desire in its wider context also avoids making one possible contributor stand in for the whole picture. A bodily change and a relationship concern do not have to be treated as mutually exclusive. The useful question is which influences may be relevant, not which single explanation should win.
The practical value of the guide lies in changing the purpose of the first conversation. Ryan recommends understanding how both partners feel before deciding whether anything should change. The guide sets no universal threshold for sexless or normal; satisfaction and the freedom to express it are the more useful reference points.
His suggested sequence keeps those aims in view:
That approach treats differing levels of desire as a shared relationship concern, rather than assigning blame to the person who wants more or less sex. Mutual participation does not mean that either partner owes the other sexual contact.
Ryan recommends medical advice when pain or illness may be involved. Medication effects, bodily changes and low mood are also reasons to seek qualified assessment rather than treating every change as a communication issue. The guide specifically says persistent pain during sex warrants medical advice. Utah State University Extension similarly recommends discussing persistent or concerning symptoms with a healthcare provider.
These conversations serve different purposes. A couple may discuss what feels comfortable and what each person needs, while a qualified healthcare professional considers symptoms and individual care decisions. General relationship guidance does not replace that assessment.
Fear and coercion belong outside ordinary communication exercises. Ryan cautions that feeling obliged to have sex, fearing consequences for refusing or being controlled elsewhere in the relationship requires attention beyond these exercises. In those circumstances, a conversation exercise is not an adequate substitute for appropriate support.
The guide begins by moving attention away from the calendar. Its more useful question is not how a couple’s frequency compares with someone else’s, but whether each person feels satisfied and free to speak. That leaves room for mutually wanted change and for a low-sex relationship that both partners genuinely value.
Partners face the everyday task of making sense of different levels of desire; Sexential brings an educational perspective to that task. Its coverage for adults aged 35 to 65 connects physical and hormonal changes with psychological and relationship context, helping readers separate possible influences and discuss changing needs while keeping individual care decisions outside its educational role.
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