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Dr. Marjorie Crandall, Owner, Yeast Consulting Services

Dr. Crandall, Founder of Yeast Consulting Services


Ruling Out Yeast Infection as a Possible Cause of Vulvar Pain

Marjorie Crandall, Ph.D.

The typical woman with vulvar pain recently had yeast vaginitis and was treated with an antifungal for a short time. After her severe symptoms of itching and vaginal discharge resolved, she was left with vulvar redness and burning.

This residual inflammation can be due to yeasts remaining inside the cells of vulvar and vaginal tissues. During the previous active infection, yeasts had invaded underlying vulvar and vaginal tissues, and penetrated inside epithelial cells. Now these yeasts are not growing, but are continuously releasing yeast digestive enzymes and toxic metabolic products that cause chronic tissue irritation. I coined the phrase latent intracellular yeast infection for this condition.1

The medical term for this low grade yeast infection is chronic atrophic erythematous candidiasis, in which atrophic means not feeding, not growing; and erythematous means red tissue. The textbook example of this red form of yeast infection is the typical red, burning gums of people with false teeth, called denture stomatitis.

I propose that such an inactive yeast infection can also account for the typical red, burning vulvas in women who have vulvodynia or vulvar vestibulitis.

You are probably wondering how to diagnose this intracellular yeast infection. Since yeasts are in the tissues and not on the surface, vulvar and vaginal swabs give negative results when tested by microscopy or culture. Furthermore, there are too few yeasts to show up in biopsies. Hence, the diagnosis of the red form of yeast infection is based strictly on clinical signs and symptoms, history of vaginal yeast infections, and predisposing risk factors for candidiasis.

In my Candida Information Packet, I recommend the following treatments for vulvodynia:

  • long term, daily antifungal treatment with systemic antiyeast medications
  • hydrocortisone cream for vulvar burning
  • testing and treatment for Candida allergy
  • avoiding all risk factors that cause yeast infections such as antibiotics and estrogen
  • lifestyle changes to avoid contact dermatitis caused by spermicides, deodorants, etc.


Your recovery from vulvodynia after following my recommendations will confirm the diagnosis of inactive yeast infection.

1. Crandall, M. (1991) Allergic Predisposition in Recurrent Vulvovaginal Candidiasis. Journal of Advancement in Medicine 4: 21-38.

Dr. Crandall is a microbiologist and founder of


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