Uquora – Hope, Hype and Maybe a Case of Diarrhea

Before you go out and spend $25 for 10 packets of Uquora, the new after-sex UTI prevention drink that launched today, you should consider if it actually works.

What’s in Uqora?

Uqora’s main active ingredient is D-Mannose (2 gm), combined with Vitamin C (600 mg), Vitamin B6, Calcium and Magnesium. (The company website does not list amounts for the last three ingredients.) The ingredients are made into a powder that you mix with water and drink.

The manufacturer claims that Uqora will reduce the chance of getting a UTI if you drink it after having sex, after exercise or during travel, all activities linked to recurrent UTI’s in women.

There is absolutely no data that taking Uqora (or D-mannose) in a single dose after intercourse will prevent a UTI. 

Does Uqora Prevent UTI’s?

Actually, no one knows if Uquora prevents UTI’s.

Uqora’s manufacturers base their claims on a single randomized study of D-mannose powder 2 mg, taken daily for 6 months. The study was published as a brief comment in BJU International. There’s so little data that I can actually post the entire study here –

After initial antibiotic treatment of the acute UTI (ciprofloxacin 500 mg twice daily for 1 week), patients were randomly allocated to three equal groups. The first group received prophylaxis with 2 g of D-mannose powder daily for 6 months, the second received prophylaxis with 50 mg of nitrofurantoin once a day, and the third did not receive prophylaxis. During the 6-month study period 98 of our patients (32%) had a recurrent UTI. The rate of recurrent UTI was significantly higher in the group that did not receive prophylaxis (60%) compared with the groups receiving D-mannose (15%) and nitrofurantoin (20%) which did not differ significantly. The risk of recurrent UTI episodes was significantly higher in the no-prophylaxis group compared with the groups that received active prophylaxis (relative risk 0.24 and 0.34). Also, we found that patients in the D-mannose group had a significantly lower risk of side effects compared with patients in the nitrofurantoin group, although nitrofurantoin was generally well tolerated. In patients who were taking D-mannose, episodes of diarrhoea were the only side effect and were noted in 8% of patients, but they did not require discontinuation of the prophylaxis. Patient compliance (assessed by recording the intake of prophylaxis on a self-report sheet) was very high and there was no difference between patients taking nitrofurantoin or D-mannose.

Note we have no information about the three study populations – were they similar to start with? Did they have similar baseline frequencies of UTI’s? What bacteria caused their infections (not all bacteria have the structure that would make them susceptible to D-mannose)? There is no data on comparative compliance between placebo and study groups, and no controlling for frequency of intercourse during treatment, the factor most important in predicting UTI recurrence in this type of patient.

That’s it folks. A single study, poorly reported, whose authors actually state that “more studies will certainly be needed to confirm the results of our study.”

To make matters worse, Uqora is not taken daily, the way D-mannose was given in this study. It is taken only after intercourse. There is absolutely no data that taking D-mannose or Uqora in a single dose after intercourse will prevent a UTI. And the manufacturers have not done a single study of their product in humans.

What About the Other Ingredients ?

I’m not going to belabor the point, except to say that the data on Vitamin C comes from yet another single study of daily use, this time in pregnant women. There are no data that taking a single dose of Vitamin C after sex will do anything other than turn your urine yellow.

Vitamin B6 is given to “Increase urination and urinary flow”, based on what data I don’t know.

Calcium and magnesium are there “to prevent the loss of these ions through urination”. Which means what, exactly? And how does this help prevent UTI’s?

Uqora Sidesteps the FDA

Uqora’s manufacturers call it a “dietary supplement” so they think they can sidestep FDA oversight. Their site has the usual disclaimer “This product is not intended to diagnose, treat, cure, or prevent any disease”. Yet the same website claims that ‘The Uqora product is an efficacious combination of ingredients that should be taken soon after sexual activity to reduce the risk of developing a UTI.”

This is standard supplement industry behavior.

I have no idea where Uqora is made, but somehow I suspect it’s not in the states or they’d have said it on the website. Being a so-called “supplement”, there is no oversight of the manufacturing process and no one has to verify what’s in it to anyone.

They do have a pretty website and a cute video, which seems to be all you need these days to get your product covered by TechCrunch.com.

You Might Get Diarrhea (and a UTI) from taking Uqora

I wouldn’t believe the website when it says that “There are no known side effects for the active ingredients at any of the suggested doses.”

You can see in the study up there that 8% of women taking D-mannose had diarrhea. Magnesium also can cause diarrhea. So can high doses of Vitamin C. Put them all together in one drink and who knows what may happen.

And of course, diarrhea not uncommonly can lead to …. you guessed it. A UTI.

Bottom Line

$25 is an awful lot of money to spend on an unproven UTI remedy.  Then again, if you happen to be constipated, you may get your money’s worth…

Strategies for UTI Prevention

• Drink enough water to keep from being dehydrated.
• Empty your bladder after sex.
• Wipe from front to back.
• If you have recurrent UTI’s and are using the diaphragm, consider if another birth control might be worth trying.
• Cranberry juice may or may not be effective, but as long as you take an unsweetened variety, it is unlikely to harm you.
• If you want to take Vitamin C, which may be effective if taken daily, you can get it cheaply from the drugstore – take 100 mg daily, and stop if you get diarrhea
• If these strategies are ineffective in preventing recurrent UTI’s associated with intercourse there are prescriptions that your doctor may prescribe. These include post-coital antibiotics such as macrodantin, and daily suppressive doses of Methenamine hippurate (Hyprex). In post menopausal women, vaginal estrogen has been shown to be effective in reducing UTI frequency.