How to Prevent SGLT2 Inhibitor Genital Infections: Hygiene, Hydration, and Timing

If you're taking an SGLT2 inhibitor like Farxiga, Jardiance, or Invokana for type 2 diabetes, you’ve probably heard about the risk of genital infections. It’s not a scare tactic-it’s real. About 1 in 10 women and 1 in 20 men on these drugs will get a yeast infection. But here’s the good news: most of these infections are preventable with simple, daily habits. You don’t need to stop your medication. You just need to change how you care for yourself.

Why SGLT2 Inhibitors Cause Genital Infections

SGLT2 inhibitors work by making your kidneys dump extra sugar into your urine. That’s how they lower blood sugar. But that same sugar doesn’t just disappear-it stays in your genital area. Fungi like Candida thrive on sugar. Warm, moist skin? Perfect breeding ground. This isn’t about poor hygiene. It’s about biology. The drug creates an environment where yeast grows faster than your body can naturally control it.

Studies show women on SGLT2 inhibitors have a 3 to 5 times higher risk than those on other diabetes meds. Men aren’t immune either-especially if uncircumcised. The risk goes up with higher doses. Canagliflozin (Invokana) carries the highest risk, followed by dapagliflozin (Farxiga) and empagliflozin (Jardiance). But even the lowest-risk option still causes infections in up to 8% of women.

The scary part? A small number of people-about 2 in 10,000-can develop Fournier’s gangrene, a rare but life-threatening flesh-eating infection. That’s why prevention isn’t optional. It’s essential.

Hygiene: The #1 Prevention Strategy

Forget harsh soaps, alcohol wipes, or douches. Those irritate the skin and make things worse. The only thing you need is clean water and a few minutes a day.

• Rinse your genital area with lukewarm water every time you pee. Don’t wait. Don’t skip it. Just rinse.
• Do it again before bed. This removes any sugar that built up during the day.
• Women: Always wipe front to back after using the toilet. This keeps bacteria from your rectum out of your vagina.
• Men who are uncircumcised: Gently pull back the foreskin and rinse underneath. Don’t force it. Just clean what’s exposed.
• Use mild, unscented soap only if needed. Rinse thoroughly. Never scrub.

A 2019 study found that patients who rinsed after every void and before bed cut their infection risk by 40%. One man in the study said, “I started doing it while brushing my teeth. Now it’s automatic.” That’s the key-tie it to something you already do.

What to Wear: Clothing Matters More Than You Think

Tight jeans, synthetic underwear, and damp workout clothes trap moisture. That’s a recipe for trouble.

• Wear cotton underwear. It breathes. It dries fast. It’s cheap.
• Avoid thongs. They push moisture and bacteria toward the genital area.
• Change out of wet swimsuits or sweaty gym clothes right away.
• At night, sleep in loose-fitting pajamas or nothing at all. Let the area air out.

One woman in her 60s told her doctor she switched from nylon to cotton after three yeast infections in six months. She hasn’t had another one in two years.

Hydration: Dilute the Sugar, Not the Problem

The more sugar in your urine, the worse the risk. Drinking enough water helps dilute it.

• Aim for 2 to 3 liters of water a day. More if you’re active or it’s hot.
• Don’t wait until you’re thirsty. Thirst means you’re already dehydrated.
• Limit sugary drinks. Even diet soda can make you hungrier for sugar, which raises blood glucose.

You don’t need to chug gallons. Just sip steadily. A glass with each meal and another between meals is a good start. If your urine is pale yellow, you’re doing fine. Dark yellow? Drink more.

Timing: When You Clean Is Just as Important as How

The biggest mistake people make? Waiting until they feel itchy. By then, the infection is already growing.

• Wash immediately after urinating. Sugar is fresh on your skin. Rinse before it dries.
• Wash before bed. Overnight is when moisture builds up and yeast multiplies.
• Don’t wash more than twice a day. Overwashing can strip natural oils and cause irritation.

A 2022 study in Diabetes Care showed that patients who got a 5-minute counseling session when starting SGLT2 inhibitors were 45% more likely to stick with the hygiene routine. Write down the steps. Put a sticky note on your bathroom mirror. Set a phone reminder for bedtime. Make it part of your routine.

What If You Still Get an Infection?

Most cases are mild. You’ll feel itching, burning, redness, or thick white discharge. It’s not pleasant, but it’s treatable.

• See your doctor. Don’t self-treat with over-the-counter creams unless you’ve had this exact infection before.
• Antifungal creams or oral pills usually clear it up in 3 to 5 days.
• Don’t stop your SGLT2 inhibitor unless your doctor says so. The benefits for your heart and kidneys are too important.
• If you get infections more than twice in six months, talk to your doctor. You might need a different diabetes drug.

One woman had three infections in a year. She switched from Invokana to Jardiance, started rinsing after every pee, and wore only cotton. She’s been infection-free for 18 months.

Who Should Be Extra Careful?

Some people are at higher risk:

• Women with a history of recurrent yeast infections
• People with poor mobility or difficulty reaching their genital area
• Those with high HbA1c levels (over 8%)-more sugar in urine
• Elderly patients or those with dementia

If you’re in one of these groups, talk to your doctor before starting an SGLT2 inhibitor. They may recommend a different drug or suggest a caregiver help with hygiene routines. Occupational therapy can teach safe, effective cleaning techniques for people with arthritis or weakness.

The Bigger Picture: Why This Drug Still Matters

Yes, SGLT2 inhibitors can cause infections. But they also save lives.

• They reduce heart failure hospitalizations by up to 38%.
• They slow kidney disease progression by 30%.
• They help you lose 2 to 3 kilograms of weight.
• They lower blood pressure by 3 to 5 mmHg.

The American Diabetes Association now recommends them as first-line therapy for people with diabetes and heart or kidney disease. That’s because the benefits far outweigh the risks-for most people.

In 2022, over 15 million Americans were on SGLT2 inhibitors. Only 15% stopped because of infections. The rest kept taking them-and stayed healthier.

Final Checklist: Your Daily Routine

Here’s what to do every day:

1. Drink 2-3 liters of water.
2. Rinse genital area with water after every bathroom trip.
3. Rinse again before bed.
4. Wear cotton underwear.
5. Change out of wet clothes right away.
6. Wipe front to back (women).
7. Retract foreskin and rinse underneath (uncircumcised men).
8. Don’t use scented products or wipes.

Do this for 30 days. You might not notice a difference right away. But after a month, you’ll feel more confident. And you’ll likely avoid an infection that could have cost you time, money, and comfort.

SGLT2 inhibitors aren’t perfect. But they’re powerful tools. And with a few simple habits, you can use them safely-for years.