title: Dyspareunia and its comorbidities among Taiwanese women: analysis of the 2004-2010 Nationwide Health Insurance Database.
abstract: BACKGROUND
  Most of the existing studies on dyspareunia only focus on qualitative observations. These measurement tools may not reflect the actual situation of dyspareunia in Taiwan.
  
  
  OBJECTIVE
  This study aimed to estimate the incidence of dyspareunia in Taiwan and investigate dyspareunia-associated comorbidities using the National Health Insurance Research Database (NHIRD).
  
  
  METHODS
  This study is a population-based retrospective cohort investigation.
  
  
  METHODS
  We analyzed the 2004-2010 claims data on dyspareunia from the NHIRD. Dyspareunia was identified by outpatient visits using International Classification of Diseases, Ninth Revision, Clinical Modification (diagnosis code 6250). Patients who visited as outpatients with dyspareunia after the index date were considered to have comorbidities associated with dyspareunia medical conditions. The index events included vaginal disorders, vulvar disorders, uterine and ovarian factors, female genital organ and menstrual cycle disorders, menopause, and relative abdominopelvic organ disorders. The incidence of dyspareunia among different age groups was determined. The location and areas significantly related to the physical gynecology or relative pelvic organ causing the disease were also analyzed.
  
  
  RESULTS
  A total of 978 females of different ages had experienced dyspareunia. The incidence of dyspareunia was higher among individuals aged 30-34 years. The findings of this study indicated that dyspareunia was comorbid with menopause, pelvic floor dysfunction, and most gynecological infections. In particular, the more common physical causes of dyspareunia were introitus and vaginal infections (19.95%), menopause (16.80%), female genital organ and menstrual cycle disorders (15.22%), and female pelvic organ infections (13.65%).
  
  
  CONCLUSIONS
  This study posits that women of all ages (20-70 years) experience painful sexual intercourse. This large-scale nationwide claims-based study showed that menopause and pelvic infection disorder were dyspareunia-related comorbidities. Moreover, gynecological infections and pelvic floor dysfunctions were associated with dyspareunia.
authors.affiliation: Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Hsin-Li
authors.initials: HL
authors.lastname: Liu
authors.forename: Horng-Mo
authors.initials: HM
authors.lastname: Lee
authors.forename: Yueh-Chin
authors.initials: YC
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D004414:Dyspareunia / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005831:Genital Diseases, Female / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008593:Menopause; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D014621:Vagina / Q000503:physiopathology; D055815:Young Adult
keywords: Comorbidity; Disorder; Dyspareunia; Incidence