Jardiance works by forcing your kidneys to dump excess sugar into your urine, and that sugar-rich urine creates a breeding ground for infections in the perineal area (the skin between your genitals and rectum). The drug belongs to a class called SGLT2 inhibitors, which block a protein in the kidneys that normally reabsorbs glucose back into the bloodstream. The result: your body excretes dramatically more sugar through urine, sometimes increasing urinary glucose excretion from about 3% to 30% of filtered glucose.
That glucose has to pass through the genital and perineal region every time you urinate. The warm, moist environment of the perineum, now regularly bathed in sugar-laden urine, becomes an ideal home for yeast and bacteria to multiply.
How Sugar in Urine Fuels Perineal Infections
Yeast and bacteria thrive on glucose. Under normal conditions, urine contains very little sugar because the kidneys reclaim almost all of it. Jardiance deliberately short-circuits that process, so urine leaving the body carries a much higher sugar concentration. Every trip to the bathroom deposits traces of that sugary urine on the skin folds of the perineum and genitals.
The perineum is particularly vulnerable because it stays warm and doesn’t get much airflow. Skin folds trap moisture. For people with diabetes, who may already have slightly impaired immune responses, this combination of excess glucose, warmth, and moisture tips the balance in favor of microbial overgrowth. Yeast infections (caused by Candida species) are the most common outcome, but bacterial infections can also take hold, especially if there’s any small cut or break in the skin.
How Common Are Genital Infections on Jardiance?
Clinical trial data from the FDA shows a clear difference between Jardiance users and people taking a placebo. Among women, genital yeast infections occurred in 5.4% to 6.4% of those on Jardiance, compared to just 1.5% on placebo. Among men, rates were 1.6% to 3.1% on Jardiance versus 0.4% on placebo. So while the absolute numbers are still relatively small, Jardiance roughly triples to quadruples the risk of genital fungal infections compared to no treatment.
Women are affected more often than men, which tracks with the fact that the female anatomy has more skin folds and a shorter urethra, giving yeast and bacteria easier access to warm, moist tissue. But men are not exempt, particularly uncircumcised men, where the foreskin creates a similar environment for sugar residue to collect.
Fournier’s Gangrene: The Rare but Serious Risk
Beyond yeast infections, there is a much rarer but far more dangerous complication: Fournier’s gangrene. This is a rapidly spreading, life-threatening infection of the skin and tissue in the genital and perineal area. The U.S. FDA issued a safety warning linking SGLT2 inhibitors, including Jardiance, to this condition. Bacteria typically enter through a small cut or break in the skin, and the sugar-rich environment helps the infection take hold and spread quickly.
Fournier’s gangrene can begin as what seems like a minor perineal infection or abscess and then escalate within hours. It requires emergency treatment, including surgery to remove the infected tissue. Cases have been reported in both men and women. The UK’s medicines regulator advises that a urogenital infection or perineal abscess may precede the gangrene, which is why catching early signs matters.
Warning Signs That Need Immediate Attention
Standard genital yeast infections on Jardiance typically show up as redness, itching, swelling, or unusual discharge. These are uncomfortable but manageable and usually respond to antifungal treatment.
The symptoms that signal something more dangerous are different in character. Seek urgent medical care if you notice:
- Severe pain or tenderness in the genital or perineal area, especially if it seems out of proportion to what you can see on the skin
- Swelling or redness that spreads beyond a small area
- Fever or general malaise alongside any genital or perineal symptoms
- Skin that feels warm, hard, or discolored in the area between your genitals and rectum
Reducing Your Risk While Taking Jardiance
You can’t eliminate the extra urinary glucose (that’s how the drug works), but you can reduce how long that glucose sits on your skin. The Cleveland Clinic Journal of Medicine recommends washing the genital and perineal area thoroughly after urination. This is the single most practical thing you can do: physically remove the sugar residue before yeast or bacteria can feed on it.
Staying well hydrated also helps. More fluid means more dilute urine, which lowers the glucose concentration hitting your skin with each bathroom trip. It also encourages more frequent urination, which reduces the time bacteria spend in the urinary tract. Keeping your blood sugar well controlled matters too, since higher overall blood glucose means even more sugar ends up in the urine.
Wearing breathable, moisture-wicking underwear and changing out of damp clothing promptly can reduce the warm, moist conditions that fungi prefer. Preventive antibiotics or antifungal medications are not routinely recommended, even for people at higher risk. The focus is on hygiene and early recognition.
Who Faces Higher Risk
Women are more prone to genital infections on SGLT2 inhibitors than men, based on clinical trial data. People with poorly controlled diabetes face compounded risk because their immune defenses are already strained and their baseline urinary glucose levels are higher to begin with. A history of recurrent yeast infections before starting Jardiance also raises the likelihood of experiencing them on the medication.
For people who are scheduled for surgery or need a urinary catheter, some clinicians recommend temporarily pausing the SGLT2 inhibitor a few days beforehand. A catheter introduces a foreign object into the urinary tract, and the combination of sugar-rich urine and a device that can carry bacteria inward increases infection risk. This is a conversation to have with your prescribing doctor before any planned procedure.
The perineal effects of Jardiance are a direct, predictable consequence of how the drug works. It trades a manageable increase in infection risk for significant benefits in blood sugar control and, in many patients, heart and kidney protection. For most people, basic hygiene adjustments are enough to stay ahead of the problem. The key is knowing what to watch for so a minor yeast infection doesn’t get mistaken for something routine if it starts behaving like something worse.