Jardiance (empagliflozin) works by flushing excess sugar out through your urine, and that sugar-rich environment is exactly what yeast feeds on. In clinical trials, about 5 to 6% of women and up to 3% of men on Jardiance developed genital yeast infections, compared to just 1.5% and 0.4% on placebo. The good news: simple daily habits can significantly cut your risk, and most people who do get an infection can treat it without stopping the medication.
Why Jardiance Causes Yeast Infections
Jardiance belongs to a class of drugs called SGLT2 inhibitors. These medications block the kidneys from reabsorbing glucose, so more sugar ends up in your urine. That glucose-rich urine passes through the genital area every time you use the bathroom, creating a warm, moist, sugar-coated environment where Candida yeast thrives.
Candida albicans, the most common culprit, has a specific adaptation that makes this worse. In glucose-rich environments, it produces a protein that helps it stick to tissue more aggressively while also evading your immune cells. So the problem isn’t just more sugar on the skin. The yeast actually becomes harder for your body to fight off when that sugar is present.
Who Is at Highest Risk
Not everyone on Jardiance will develop yeast infections, and your personal risk depends heavily on a few factors. A large study published in BMJ Open Diabetes Research & Care found that the strongest predictors were being female (about 3.6 times the risk compared to men) and having a history of genital infections. If you had a yeast infection within the past year before starting Jardiance, your risk of another one roughly quadrupled. Even infections from one to five years earlier tripled the risk.
The one-year infection rate was 23.7% for women with a history of prior infections and 12.1% for men in the same category. Without that history, rates dropped to 10.8% for women and just 2.7% for men. Higher BMI also independently increased risk. Interestingly, higher blood sugar levels (measured by A1c) did not predict infection risk on SGLT2 inhibitors, which means even people with well-controlled diabetes can still develop them.
Rinse After Every Bathroom Visit
The single most targeted prevention strategy is simple: rinse your genital area with plain water after every time you urinate, and again before bed. This advice comes from a protocol presented at the American Diabetes Association, where patients starting SGLT2 inhibitors (including Jardiance) were given this specific instruction. The logic is straightforward. Since the drug puts sugar in your urine, rinsing removes that sugar from the skin before yeast can use it as fuel.
You don’t need special soaps or washes. In fact, fragranced soaps, douches, and intimate hygiene products can disrupt the natural balance of bacteria and yeast in the genital area, potentially making things worse. Plain water is enough. If you’re away from home, carrying a small squeeze bottle of water can make this practical throughout the day.
Choose the Right Clothing
Yeast thrives in warm, moist conditions, so what you wear matters more than you might think. Cotton underwear is the best choice because it wicks away moisture and allows airflow to the skin. Synthetic fabrics trap heat and sweat, creating the exact conditions Candida loves. Even underwear marketed as having a “cotton crotch panel” doesn’t offer the same protection as fully cotton fabric, since the surrounding synthetic material still limits breathability.
Loose-fitting pants and skirts help too. Tight jeans, leggings, and shapewear press fabric against the skin and reduce ventilation. If you’re prone to infections, going without underwear at night or wearing loose pajamas or boxers increases airflow and can promote healing. Avoid wearing panty liners daily, as they reduce breathability and can cause irritation even though they seem like they’d help with moisture.
Stay Hydrated and Manage Blood Sugar
Drinking plenty of water serves a dual purpose on Jardiance. First, the medication is a mild diuretic, so your body needs more fluid than usual. Second, staying well-hydrated means you urinate more frequently, which reduces the time sugar-laden urine sits in contact with genital tissue. Think of it as a natural rinsing cycle.
Keeping your blood sugar well controlled also matters, though perhaps not in the way you’d expect. While A1c levels don’t predict infection risk from the medication itself, chronically high blood sugar independently impairs immune function and makes your body less effective at fighting Candida. Good glucose management supports your body’s natural defenses against yeast overgrowth from all causes.
What Probiotics Can and Cannot Do
Probiotics containing Lactobacillus strains are often recommended for vaginal health, and there is some supporting evidence, though with important caveats. A systematic review and meta-analysis found that probiotics alone were no better than placebo at clearing an active yeast infection. However, when used alongside standard antifungal treatment, probiotics significantly improved cure rates and reduced positive cultures.
The most promising finding was for preventing recurrence. In one trial, only 7.2% of women taking probiotics had a repeat infection, compared to 35.5% of those on placebo. The strains with the best evidence include Lactobacillus rhamnosus, Lactobacillus reuteri, and Lactobacillus acidophilus. These bacteria produce lactic acid and antifungal compounds that compete with Candida for space on vaginal tissue. While no trials have been done specifically in Jardiance users, the mechanism is relevant since the underlying infection is the same organism. Probiotics are reasonable as a preventive strategy but shouldn’t be relied on as a standalone treatment for active symptoms.
Recognizing Symptoms Early
Catching a yeast infection early makes treatment faster and reduces the chance of it becoming severe enough to require pausing Jardiance. The symptoms differ somewhat between men and women.
In women, the hallmarks are white, cottage cheese-like vaginal discharge that typically doesn’t have a strong odor, itching and irritation around the vulva and vagina, and soreness or stinging during sex or urination.
In men, look for redness, irritation, and burning around the head of the penis and under the foreskin. There may be a white discharge with an unpleasant smell, and difficulty pulling back the foreskin.
If you notice any of these signs, early treatment with an over-the-counter antifungal cream or suppository (the same ones available at any pharmacy) is typically effective. Jardiance’s manufacturer specifically notes that your doctor may recommend over-the-counter antifungal treatment as a first step. If symptoms don’t improve within a few days of using one, contact your healthcare provider.
Do You Need to Stop Jardiance?
Most people do not need to stop taking Jardiance because of a yeast infection. Current clinical guidance is clear: treat the infection with antifungal medication and continue the SGLT2 inhibitor, given its significant cardiovascular and kidney benefits. Only in cases of severe genital infection is it reasonable to temporarily pause the medication, and it should be restarted as soon as the infection resolves.
Even for people who get recurrent infections, Jardiance is not considered off-limits. The decision to permanently stop should involve weighing the burden of repeated infections against the life-saving benefits of the drug, which include reduced risk of heart failure, kidney disease progression, and cardiovascular death. For many people, the prevention strategies above are enough to keep infections manageable without giving up those benefits.
A Daily Prevention Routine
Putting it all together, a practical daily checklist for Jardiance users looks like this:
- Rinse with water after every trip to the bathroom and before bed
- Wear cotton underwear during the day and consider going without at night
- Choose loose-fitting clothing when possible, especially in warm weather
- Drink enough water to keep urine pale and frequent
- Skip fragranced products in the genital area, including soaps, sprays, and wipes
- Consider a Lactobacillus probiotic if you have a history of yeast infections
- Keep antifungal cream on hand so you can treat symptoms at the first sign
These steps won’t eliminate the risk entirely, but they directly counteract the mechanism that causes the problem: sugar on the skin in a warm, moist environment. The people who do best on Jardiance are typically the ones who build these habits into their routine from day one, rather than waiting for a first infection to motivate change.