Infertility/Fertility/Group A Strep

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Question
Hello,
I have had two C&S confirmed vaginal swabs growing Group A Strep [GAS]and received treatment between for recurrence of initial GAS [I believe it was Strep A but swab not cultured].
The last infection was diagnosed as a PID [based on blood work and physical symptoms].
I am a 56 and until Nov/12 have never had any problem with infections or Gyne issues. Postmenopausal for last ten years.
The symptoms I experienced before going to Emerg with PID [04/13] continue....pubic bone pain, yellow discharge [scant to moderate], lower abdominal and mid abdomen discomfort. My Dr.is investigating an extruded disc at L1-L2. I am going to try an ilioinguinal nerve block to see if this relieves the pelvic symptoms.
At this point I can't read my body very well, I just know something's not right.
My question is three part.
1. Have you heard of recurrent GAS in women my age and why does this recur? My gyne had no answer....could my partner or I be a Strep carrier?
2.Could I still be harbouring a mildly chronic form of GAS
infection?
3. Can the Ilioinguinal nerve become entrapped with so many infections [treated for BV three times, Strep A three times in last eight months]
Also had an endometrial biopsy which showed 4+ acute inflammatory cells [vag swab +for BV one week prior].
Thank you in advance for your comments.

Answer
Hello Kathy from Canada,

This question is probably better answered by an infectious disease specialist rather than a gynecologist but I'll tell you what limited information I know regarding your issues.

1.  Group A strep is a very common pathogen and ready found in multiple areas including the skin.  It is not usually associated with gynecologic, pelvic or vaginal disease.  I wonder if the cultures were contaminants.  If is very easily treated with penicillin type antibiotics.  I would not expect this to be the source of a PID, if that is in fact what you had (PID is overly diagnosed).
2.  Bcause it is so common, just about anyone can get a culture positive for this bacteria.  Can you be harboring it chronically?  I would say this is a possibility.
3.  No.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate.  

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Edward Joseph Ramirez, MD, FACOG

Expertise

I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.

Experience

I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

Publications
American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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