Top 10 Questions for the OB/GYN

What's on a woman's mind when she visits her Ob/Gyn? Below are answers to some typical questions Dr. Bost gets everyday.

Q: Can birth control pills lower my sex drive?

A: They certainly can and do for about 10 to 15 percent of my patients. Most authorities think that birth control pills tend to lower the amount of testosterone in your bloodstream, which can in turn lower libido or sex drive. Pills that have a relatively lower dose of progesterone will be less likely to cause this effect.

Q: Does it actually hurt my husband not to have sex regularly?

A: Every man in America wants me to answer "yes" to this question! But the answer to the question of physical harm from lack of sex is really "no." Most experts agree that men have a more basic physical need for sex than women do, but proof that physical harm occurs from avoiding intercourse is lacking. A man who has been aroused for a prolonged period of time may experience some pelvic and even scrotal discomfort if he does not ejaculate afterward, but his is not quite the same thing.

Q: Is there a medication or herb I can take to make me want to have sex?

A: No. Although many chemicals, herbs, and foods have been touted off and on again as sex stimulants, nothing has yet passed double-blinded tests against a placebo. Besides, if a true aphrodisiac existed, you can bet those dirty old men in Washington, D.C., would pass legislation to have it added to the food we eat. The words fortified and enriched might take on a whole new meaning.

Q: Is 'natural estrogen' that comes from soybeans or yams, safer than the synthetic pills or patches?

A: This has been a hot topic for the past several years. I approach it with patients by asking a couple of key questions. Do you think estrogens are safe? If your answer is "no," you should refuse to take any estrogen, including the estrogen-like substances found in plants. Which estrogen is better? If you think "natural is better," then which estrogen is more "natural," the one produced by your body the day before your ovaries stopped working (estradiol, branded as Estrace, Estraderm patches, and generic) or one produced by a sweet potato? You decide.

Q: My husband says he needs to have sex to feel 'loved', but I don't feel that way at all. How do we handle this?

A: Your mate's primary "love language" is often different from yours and may be difficult for you to "speak" naturally. But, if you don't learn how to express your love in a way that you can each understand, your attempts to communicate love to each other will be much like an American and Chinese businessman attempting to negotiate a contract without an interpreter-utter chaos and frustration.

Q: Have your recommendations for improving one's sex life worked for you?

A: You may not know this, but male gynecologists don't have sex. Well, they do allow us to have sex twice a year, but only to have children. Seriously, my wife and I struggle with many of the same problems you do. In The Hurried Woman, I've shared some of our experiences in the hope that you may benefit from our successes as well as failures. We haven't achieved perfection yet and probably never will, but we've come a long way together and look forward to steadily improving our relationship with God, each other, and those we love. Our sincere hope is that you can, too.

Q: Do you think estrogens are safe?

A: It is clear that the large amount of available scientific evidence strongly supports the use of estrogen to prevent osteoporosis and heart disease in women. Using estrogen increases the risk of developing only one cancer-cancer of the uterus-and this risk can be eliminated if progesterone is given at the same time. Based on the overwhelming majority of currently available scientific data, estrogen does not cause breast cancer. I believe the benefits of estrogen far outweigh the risks.

Q: Will I grow a beard if I take testosterone?

A: No, not if you have your blood levels tested to be sure they are within the normal range.

Q: Do you ever recommend divorce for your patients?

A: Since I am not a marriage counselor, I don't make recommendations like that. If a patient tells me that her husband is physically abusive or that she and her children are in immediate danger at home, I do recommend that she leave and seek safe shelter, immediately. Personally, I think divorce is all too common in America today. My wife and I have four children, and we agreed a long time ago on a way to prevent divorce in our marriage-the one who files gets all the kids!

Q: If a man says something in the forest and there's no woman there to hear him, is he still wrong?

A: Probably so, but at lest he won't be told he's wrong more than once, if at all.