Recently, the British Medical Journal published an article about the management of ‘overactive bladder syndrome’. Symptoms of this can include the sensation of needing to pass urine urgently, frequent urination and the need to get up at night to pass water. Men with these symptoms are often investigated for an enlarged prostate. Women don’t have prostates, so the emphasis will be on their bladders. However, it is entirely possible for men to have symptoms that actually come from their bladders, and for this to be missed because of we doctors’ preoccupation with the prostate.

Anyway, the BMJ article contained a lot of information about the management of this syndrome, including injecting botox into the bladder muscle to paralyse it. What the article did not do is mention the one approach which I find almost always reaps dividends in practice: magnesium supplementation.

The bladder is essentially a muscular bag. Magnesium is a nutrient that is important for proper muscle function. If magnesium levels are on the low side, this tends to make muscles prone to ‘tension’ and cramping. Low magnesium may there cause muscular cramps, as well as conditions such as ‘tension’ headaches, oesophageal spasm (spasm in the food pipe or gullet) and painful periods (the womb is made of muscle). It can also, in theory at least, cause ‘irritable bladder’.

As magnesium levels rise, the muscle is more likely to remain in an appropriately ‘relaxed’ state, and this can help relieve symptoms of ‘irritable bladder’. I’ve seen it work time and again in practice. There’s even some evidence for it. In one placebo-controlled study, magnesium supplementation was found to be quite effective for relieving the symptoms of irritable bladder [2]. This positive result was despite the fact that the form of magnesium used in this study was magnesium oxide – probably the least useful and absorbable form of magnesium.

In practice, I prefer to use other forms of magnesium such as magnesium citrate, taurinate, glycinate or succinate. A dose of around 400 mg of magnesium is usually what’s required to get good symptomatic relief.

References:

1. Marinkovic SP, et al. The management of overactive bladder syndrome. BMJ. 2012 Apr 17

2. Gordon D, et al. Double-blind, placebo-controlled study of magnesium hydroxide for treatment of sensory urgency and detrusor instability: preliminary results. Br J Obstet Gynaecol. 1998;105(6):667-9