Excerpt: 'Ask Dr. Marie,' by Marie Savard


Not long after I took the medication for cystitis, I read a research study published in the prominent New England Journal of Medicine that reported on how women with symptoms of a urinary tract infection could be accurately diagnosed and successfully, safely, and efficiently treated just on the basis of their response to a three-day course of antibiotics. I learned about a simple method of culturing the urine called the dipslide method, which seemed like a terrific and inexpensive tool that women could use themselves to diagnose their own urinary tract infections (UTIs) at home. They could thus avoid the cost of a doctor's visit and pay only for a short course of antibiotics while minimizing the side effects of medication. Empowering women with information and control was part of my DNA from the beginning, so this study really got me excited! I knew I had found the research area I wanted to devote myself to during my time in Colorado. The results of my study were eventually published in the prestigious American Journal of Medicine. The study also launched my career in women's health, patient empowerment, and the use of evidenced-based medicine to inform patients and doctors alike about the best and most cost-effective treatments.

By the mid-1990s I was the director of the Center for Women's Health at the Medical College of Pennsylvania and a regular columnist for Woman's Day magazine as a women's health expert. As it happened, I was on the leading edge of this specialty precisely when the recognition in medical circles that women are not just "small men" came at last. I felt somewhat vindicated. I had long been a proponent of treating women with regard to the fact that we metabolize differently from men, that our livers work differently, and that our powerful hormones are sometimes protective and sometimes a challenge to our overall brain and body well-being. Soon I became an advisor to the spanking-new Subcommittee on Clinical Competency in Women's Health of the American Board of Internal Medicine.

Because I'm not a gynecologist but rather an internist with a specialty in women's health, my expertise about the strictly female concerns of the area "below the belt" is informed by my in-depth knowledge of the body as a whole and my awareness of the potent mind/body connection. As you may know, the phrase "below the belt" comes from a boxing rule that prohibits hitting a man's groin. What's interesting is that in the 1970s when women's boxing became a professional sport, the "below the belt rule" was applied to women as well, in order to protect the womb. Male and female boxers alike now wear external protectors so that there's less chance of damage to the organs we need in order to conceive. I like the idea that we should also learn to protect our precious area internally with good health knowledge and habits rather taking a chance on harming it with life choices that "hit below the belt."

There is also a general lack of understanding about what really goes on "down there" and a good measure of mortification about the often smelly, sticky, itchy, leaky symptoms of what we still refer to among ourselves as "female troubles." That's the reason I chose to make our internal female organs and our "plumbing" the main focus of this book. I do make some references to our breasts, but only when issues concerning them are intrinsically tied to the functions and problems of our mysterious inner gynecological landscape.

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