That catchy “gotta go right now” jingle pokes light-hearted fun at how embarrassing we think urinary incontinence (UI) is. But UI is a medical symptom that can be caused by a wide variety of conditions, and it’s nothing to be ashamed of – yet, only half of us who have it ever mention it to our doctors.

Twice more common in women than men, it affects between 41 to 72 percent of women at midlife and older. For several decades, medical evidence has pointed to hormone therapy (estrogen, progestin) as helpful for UI, but important new research raises red flags about this long-held belief.

As Wayne State University researcher Susan L. Hendrix, DO and her colleagues recently reported in the Journal of the American Medical Association (JAMA), oral hormone therapy actually triggered UI in women who’d never had it, and worsened UI in those who had. This held true for the three most common types of UI: “stress incontinence” –triggered by coughing, sneezing, heavy lifting; “urge incontinence” – where you feel like you “gotta go” but can’t get there quickly enough, and “mixed” – a combination of those two.

In an editorial accompanying the double-blind, placebo-controlled study, which followed over 23,000 participants in the Women’s Health Initiative between the ages of 50 to 79 for one year, Catherine E. DuBueau, MD, writes, “Clinicians should no longer prescribe long-term oral … estrogens for treatment of urge, stress, or mixed UI in postmenopausal women.” More research is needed to determine whether topical estrogens have any benefit. 

So, if you have any type of urinary incontinence, or you’re on menopausal hormone therapy, talk to your family doctor or gynecologist. Don’t accept it as a normal part of aging; a number of treatments can make it better. Plus, in some cases, incontinence could be a sign of an underlying disease. Only your doctor can know for sure.

For more information about UI, and a helpful “bladder control diary,” visit the National Kidney and Urologic Diseases Information Clearinghouse at: http://kidney.niddk.nih.gov/kudiseases/pubs/bcw_ez/index.htm

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Unsafe Drinking Water on Airliners?

  Feel thirsty when you fly? Dehydration is a common side effect of airplane travel – but if you’re tempted to drink from the lavatory sink, or care to wet your whistle with coffee from the galley, be aware! The Environmental Protection Agency (EPA) has issued an alert about the safety of water on airliners.

Twice last year, the Agency collected random water samples from 327 different aircraft arriving in the U.S., and 15 percent tested positive for coliform bacteria. The numbers affected rose from 13 percent to 17 percent between the first and second tests, which were just a few months apart.

Water is piped into airplanes from public water systems. Coliforms are not themselves harmful – but they indicate that the water system may be contaminated with other disease-causing organisms (pathogens) like e. coli.

So, what’s a passenger to do? Tom Skinner, head of EPA’s Enforcement Office, says, “Passengers with suppressed immune systems or others concerned should request bottled or canned beverages while on the aircraft and refrain from drinking tea or coffee that is not made with bottled water.” Don’t be shy about asking, Skinner urges. “While boiling water for one minute will remove most pathogens from drinking water, the water used to prepare coffee and tea aboard a plane is not generally brought to a sufficiently high temperature to kill most of them.”

The good news? Most major U.S. passenger airlines have agreed to practice new water testing and disinfection procedures. And, the airline industry will be conducting studies to further identify the causes of contamination. Check the EPA Website for updates.  http://www.epa.gov/airlinewater/index.html