Yes, Jardiance (empagliflozin) can cause genital yeast infections.
Genital mycotic infections are one of the most common adverse effects of Jardiance, occurring in approximately 4-5% of patients treated with the medication 1. This risk is significantly higher than placebo (approximately 1%) 2, 1.
Risk Profile by Sex
The infection risk differs substantially between sexes:
- Women: 5.4-6.4% develop genital yeast infections (primarily vulvovaginal candidiasis) 1
- Men: 1.6-3.1% develop genital infections (primarily balanitis/balanoposthitis) 1
Women face approximately 3-4 times higher risk than men 3, 4.
Why This Happens
Jardiance works by increasing glucose excretion in the urine 1. This creates a glucose-rich environment in the genital area that promotes yeast (Candida) overgrowth 5, 6. The mechanism is directly related to the drug's therapeutic action—you cannot separate the benefit from this particular risk.
High-Risk Populations
You are at increased risk if you have 5, 1, 7:
- History of chronic or recurrent genital yeast infections (most important predictor)
- Female sex
- Uncircumcised males
- Age ≥65 years (particularly in women)
- Taking multiple diabetes medications (3 or more agents in women)
Clinical Characteristics
The infections are typically 1, 4:
- Mild to moderate in severity (80-90% of cases)
- Responsive to standard antifungal treatment (topical azoles or oral fluconazole)
- Rarely require hospitalization (<0.1% of patients)
- Rarely lead to drug discontinuation (0.2% discontinuation rate)
However, recurrent infections can occur, particularly in those with prior infection history 8.
Prevention and Management
Before starting Jardiance:
- Screen for history of recurrent genital infections
- Consider alternative agents if high-risk features present 5
During treatment:
- Educate patients about proper genital hygiene 5, 1
- Maintain awareness that infections can occur even when blood glucose is well-controlled 8
- Treat infections promptly with standard antifungal therapy (topical azoles for 3-7 days or single-dose oral fluconazole 150 mg) 9, 10
- Do not routinely discontinue Jardiance for uncomplicated infections 5, 1
When to reconsider use:
- Recurrent infections requiring repeated treatment courses
- Severe infections requiring hospitalization
- Patient preference to discontinue
Important Context
While genital infections are common, the cardiovascular and renal benefits of Jardiance substantially outweigh this infection risk in appropriate patients 2, 5, 11. The drug reduces cardiovascular death by 38%, heart failure hospitalization by 35%, and kidney disease progression by 39% in high-risk patients 2. Most infections are easily managed without stopping the medication 1, 4.
The key is proper patient selection, education about hygiene measures, and prompt treatment when infections occur rather than avoiding this highly beneficial medication due to infection concerns 5, 6.