Super uncomfortable. Vaginal pain is not only painful in an intimate place; it also negatively influences the patient’s quality of life. One of the most common causes of vaginal pain and burning is a yeast infection called Candida, which can grow in the vagina.
They’re only tiny cells, but it aggravates the body which causes inflammation with redness and itching to try and get rid of the yeast. But often no candida is found in case of burning pain and no bacteria that explain the symptoms, then what? The vagina can look perfectly normal but still there is pain. This is a difficult case and often undervalued by the gynecologist.
With the availability of the natural pain relieving substance palmitoylethanolamide, which also has an anti-inflammatory effect, treatment of burning sensation and redness became possible. This supplement is produced in the United States and is available as PeaCure and as PEA cream.
The Italian remedies Normast and Pevilen stopped being available in 2012. In our opinion, PeaCure capsules are a better alternative, because they only contain pure palmitoylethanolamide and no chemical or pharmaceutical additives and fillers. Always use a dose of 1200mg per day. The local gel Saginil was replaced in 2012 with a local cream that contains PEA, the PEA cream. Furthermore, in case of vulvar burning pain the cream Baclofen seems like an exceptionally good choice. However, this is a cream that needs to be prescribed by a doctor.
This website, specifically written for women, contains a lot of information about women-specific symptoms: http://info4vaginalebrandpijn.wordpress.com/about/
Vaginal pain: something’s not right
Due to all kinds of factors, our body doesn’t easily succeed to kill the yeast infection. The majority of women will have an encounter with this yeast at some point in their lives. You notice something isn’t quite right in the vaginal region when you start to feel itching, painful or burning sensations in or around the vagina. Also the, normally clear, vaginal discharge will change color, scent and consistency.
This vaginal yeast infection is caused by the yeast named Candida albicans. However, remember that there are other causes besides this yeast infection!
Vaginal yeast infection
How do you recognize a vaginal yeast infection? A number of signs and symptoms are important here.
Symptoms of vaginal yeast infections
We will walk you through the symptoms more elaborately.
First of all the labia may look different, they become red and a little swollen. The sensation will also feel different, accompanied with the redness and swelling, you will notice itching and a burning pain on both the inside of the vagina as well as around the labia. This causes intercourse to be less enjoyable or even unpleasant.
The burning, itch and pain, even burning pain can also be quite unpleasant during urination.
- Red, swollen labia and itching
- Burning sensation and pain in the vagina
- Pain during intercourse
- Pain during urination
- Increase of and change of vaginal discharge
These types of complaints and symptoms can be caused by a vaginal yeast infection. If this is the case, go and see a doctor, who will probably perform an internal examination. Or, based on your complaints, immediately prescribe an antifungal cream.
No need to panic if your doctor needs to do an internal exam. You simple position yourself on a slightly odd chair. The doctor will insert a speculum in to the vagina and will examine the color and condition of vaginal wall and discharge.
A clear red coloration of the vaginal wall accompanied by a slightly abnormal discharge, for example more grainy or discolored, all indicate an inflammation due to yeast.
To be completely sure that the symptoms are caused by a yeast infection, a small quantity of discharge has to be taken from the vagina, which can be examined under a microscope. The yeast cells are easy to recognize under a microscope.
Not many doctors will do this however, but the occasional fanatic may. Usually the diagnoses is a so-called ‘ex juvantibus’ diagnoses. This is a fancy word that means when you got prescribed an antifungal cream and the symptoms disappear it was a yeast infection.
Vaginal pain, the cause of vaginal yeast
Experts say Candida albicans is a yeast that is ‘ubiquitous’, which means this yeast is present everywhere in the body including the skin, mouth, intestines and also the vagina. It’s kind of like a pet, or more like a houseplant. But this plant can take over your entire room and turn it in to a jungle.
If that happens you will get a yeast infection. The cause of infections is helped by a weakened immune system, which may be caused by diabetes, antibiotics or when the skin’s natural balance is disturbed by washing it with soap!
Don’t do it! You don’t brush your teeth with soap either. Put it away, no soap in the vagina. Frequent sexual intercourse can also damage the vaginal mucosa and initiate an infection. And lastly, hormonal preparations, like the pill, can disturb the vaginal balance.
Vaginal pain and burning but NO yeast infection, now what?
Pain in the vagina and NO infection
If there is no infection, but still pain in the vagina, what do you do? Doctors refer to this as vulvodynia, but that doesn’t give much away. The word only indicates there is pain in the vagina. You’d think that the cause should be easy to find, but that’s not the case.
Vulvodynia causes women to have long-term pain and burning complaints. Strangely enough these unexplained complaints are quite common. And because we are quite prudish, we wouldn’t be surprised if it’s even more common than what we currently think.
It’s estimated that 1 out of 25 to 50 women suffers from these chronic misunderstood pain complaints.
Characteristic for these complaints is that there are no infections, no neurological abnormalities and on top of that no anatomical abnormalities.
That’s great, you’re probably thinking, but what IS it?
Vaginitis: a war without an enemy
We suspect it’s a case of a war without an enemy. In other words, inflammation without infection. Bacteria, yeast or a virus are responsible for infections and cause an inflammatory response. If there is inflammation without infection we’re dealing with a war without enemy.
How can this be explained? It is thought that damage on the vaginal wall, for example by frequent sexual intercourse, can create a mild infection in the vagina. The continuous irritation of this mild chronic inflammation alarms the nervous system. This has been scientifically proven. Women with a localized provoked vulvodynia, as this is called, have an alarmed, hyperactive nervous system. The slightest stimuli alarm the body. 
Treatment of unexplained and burning vaginal pain: PEA cream, a local cream with pain relieving substance, and the PeaCure supplement
First we will share an example of how treatment with, in this case, a cream (INP based with PEA) containing amitriptyline made the symptoms disappear.
Research showed some positive results from strong painkillers like anti-depressants, however these often come with a range of negative side effects. At times it’s also suggested to use a lidocaine gel, which causes the skin tissue to go numb and that’s not very pleasant for the vagina. That’s why a number of pain relieving creams have been developed that are gentle on the vagina and effectively decrease pain and itching. These creams contain special substances that calm the tissue of the vagina and include the bodily fatty acid palmitoylethanolamide and a pain relieving substance. There’s also a pure PEA cream, which only contains PEA.
To treat the unexplained pain when gynecologists cannot find the cause, we have palmitoylethanolamide to our disposal, a natural pain relieving and anti-inflammatory substance. In the United States this is available as a supplement in capsules called PeaCure. The correct dose is 400mg three times a day.
On other pages of this website we elaborate more on PEA. PeaCure is available as a supplement from the organization Russel Science Ltd.
The topical INP based creams that have to be prescribed by doctors are described on www.stopdepijn.com. Contrary to the creams that contain corticosteroids, these creams have no negative effects on the vaginal wall and mucus membrane. The creams are only produced in a special pharmacy in Woerden and are sent after prescription.
Other PEA containing supplements are also available. We have studied and used all of them. The table below shows how much % of PEA is in each product. Normast and Pelvilen also contain a high percentage of non-natural substances. Only PeaCure contains only natural substances in a vegetarian capsule.
How do I inform my doctor if I’d like to take the PeaCure supplement?
The Institute for Neuropathic Pain (INP) designed a handout especially for doctors, which elaborates on all the experience that has been obtained with PEA. You can print the handout under this link and present it to your doctor. All information on PEA can be found on a separate website.
 Bohm-Starke N. | Medical and physical predictors of localized provoked vulvodynia. | Acta Obstet Gynecol Scand. | 2010 Dec;89(12):1504-10. doi: 10.3109/00016349.2010.528368.