How to Prevent SGLT2 Inhibitor Genital Infections with 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 get fungal infections. 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 your body.

Why SGLT2 Inhibitors Cause Genital Infections

SGLT2 inhibitors work by making your kidneys flush out extra sugar through urine. That’s how they lower blood sugar. But that same sugar doesn’t just disappear-it stays in your urine. And yeast, especially Candida, loves sugar. Warm, moist areas like the genitals become breeding grounds. This isn’t about being unclean. It’s about biology. The sugar in your urine feeds the yeast, and over time, that leads to itching, redness, swelling, or discharge.

Studies show women on these drugs have a 3 to 5 times higher risk than those on other diabetes medications. Men aren’t immune either, especially if uncircumcised. The risk goes up with higher doses. Canagliflozin (Invokana) at 300 mg has a 12% infection rate in women. Dapagliflozin (Farxiga) and empagliflozin (Jardiance) are slightly lower, around 8-10%. These aren’t rare side effects. They’re common enough that the FDA issued warnings in 2018 and updated guidelines again in 2019 and 2022.

Hygiene: The Most Powerful Tool You Already Have

You don’t need special products. You don’t need antiseptic wipes or harsh soaps. In fact, alcohol-based cleaners can irritate the skin and make things worse. All you need is clean water and a few minutes a day.

The most effective strategy? Rinse your genital area with water after every time you pee and before you go to bed. That’s it. A 2019 study found that patients who did this consistently cut their infection rates by 40%. In one group that stuck to it for 18 months, zero infections occurred.

For women: Always wipe front to back after using the toilet. This stops bacteria from the rectum from getting near the urethra or vagina. Don’t rush. Take your time. Use clean hands or a fresh cloth.

For men: If you’re uncircumcised, gently pull back the foreskin before washing. Rinse underneath. Don’t just spray water over the top-get in there. After washing, pat dry. Moisture is the enemy.

Wear cotton underwear. Not synthetic. Not tight. Cotton breathes. It lets air in and moisture out. Avoid leggings, tight jeans, or thongs during the day. At night, sleep without underwear if it’s comfortable. Less friction, less trapped sweat.

Hydration: Dilute the Sugar, Not the Problem

Drinking enough water isn’t just good for your kidneys-it’s a direct defense against these infections. When you’re well-hydrated, your urine is lighter, and the sugar is more diluted. Less sugar in the urine means less food for yeast.

Aim for 2 to 3 liters of water a day. That’s about 8 to 12 glasses. If you’re active, in hot weather, or have a fever, drink more. Don’t wait until you’re thirsty. Thirst means you’re already a little dehydrated.

Avoid sugary drinks. Soda, juice, sweet tea-they raise your blood sugar and make your kidneys work harder. That means more sugar in your urine. Stick to water, unsweetened tea, or black coffee. If you need flavor, add a slice of lemon or cucumber.

Timing: When You Clean Matters More Than How

It’s not enough to wash once a day. Timing is everything. The sugar in your urine peaks after meals and after you pee. That’s when yeast starts growing.

Rinse right after you urinate. Don’t wait until later. If you’re at work, keep a small bottle of water and a clean cloth in your bag. Even just a quick rinse with bottled water helps.

Before bed is just as important. Overnight, your body slows down. Sweat builds up. Yeast thrives. A quick rinse before sleep cuts the overnight exposure time.

If you’ve had an infection before, add one more step: wash again after sex. Sexual activity can push bacteria and yeast into sensitive areas. Cleanse gently afterward.

What Not to Do

Don’t use douches, scented wipes, or feminine sprays. These disrupt your natural pH balance and can trigger infections.

Don’t ignore early signs. Redness, mild itching, or a slight odor? Don’t wait for it to get worse. Over-the-counter antifungal creams (like clotrimazole or miconazole) work well for mild cases. Use them as directed. Most infections clear up in 3 to 5 days.

Don’t stop your medication because you’re scared. The benefits of SGLT2 inhibitors-lowering heart failure risk, protecting your kidneys, helping you lose weight-are huge. Millions of people use them safely. The infection risk is real, but manageable.

When to Call Your Doctor

Most infections are mild. But watch for signs of something serious:

• Severe pain or swelling in the genital area
• Fever or chills
• Red streaks spreading from the area
• Strong, foul odor
• Difficulty urinating

These could signal Fournier’s gangrene-a rare but life-threatening infection. It’s extremely uncommon (about 2 cases per 10,000 patients per year), but it needs emergency surgery. If you have any of these symptoms, go to the ER immediately.

Real People, Real Results

One woman in Perth, 62, started on dapagliflozin and got a yeast infection within weeks. She thought it was normal. She didn’t rinse after peeing. After her second infection, her doctor gave her a simple handout: “Rinse after every pee. Wear cotton. Drink water.” She started doing it. Six months later, she hadn’t had another one.

A man in his 50s with a history of recurrent infections switched from metformin to empagliflozin. He was nervous. He set phone alarms to remind him to rinse after every bathroom break. He started drinking more water. Within three months, his infections stopped. He says the routine feels natural now-it’s just part of his morning and night ritual.

Support and Resources

Your doctor should talk to you about this when they prescribe an SGLT2 inhibitor. But if they don’t, ask. The American Diabetes Association recommends a 5- to 7-minute counseling session at the start of treatment. Ask for written instructions. Many pharmacies now include prevention tips in the Medication Guide that comes with your prescription.

If you have trouble with mobility or dexterity, ask for help. Occupational therapy can teach you safe ways to clean yourself if bending or reaching is hard. You’re not alone. Many older adults need a little extra support.

Final Thoughts

SGLT2 inhibitors are powerful tools. They save hearts. They protect kidneys. They help people live longer. But they come with a small, manageable risk. The key isn’t fear. It’s awareness. You don’t need to change your life. Just add a few simple steps: rinse after peeing, drink water, wear cotton. Do that, and you’re doing more than preventing an infection-you’re taking control of your health.

If you’ve been avoiding SGLT2 inhibitors because of the infection risk, talk to your doctor again. With the right habits, you can get all the benefits without the downsides.