Comorbidity profiles among women with postcoital bleeding: a nationwide health insurance database

Arch Gynecol Obstet. 2017 Apr;295(4):935-941. doi: 10.1007/s00404-017-4327-7. Epub 2017 Feb 28.


Purpose: Most of the existing studies on postcoital bleeding (PCB) in Western countries. To date, no study has focused on the various PCB-related comorbidities in Taiwan women. This work aims to analyze and compare the presence or absence of PCB among Taiwanese women with gynecological comorbidity.

Methods: This study is a population-based retrospective cohort investigation. Outpatients with PCB after the index date were considered. A total of 2377 female patients with PCB (ICD-9 626.7) were identified using a nationwide outpatient sample from 2001 to 2010. For comparison, 7131 cases were randomly matched with the study group in terms of gender and age.

Results: The PCB incidence rate was 39-59 cases/100,000 Taiwanese women, with mean age (±SD) of 36.74 ± 10.79 years, median age of 36 years, and mode age of 29 years. Women with PCB exhibited 1.47-fold risk of cervical dysplasia and 1.59-fold risk for malignant neoplasm of cervix. Young women with PCB showed high risk of cervical cancer. The most common benign diseases among PCB- related comorbidities were cervical erosion and ectropion (20.66%), followed by vaginitis and vulvovaginitis (19.18%). Comparison between PCB and non-PCB groups indicated several significant high-risk comorbidities including cervical polyps, cervical erosion, leukoplakia of cervix, intrauterine contraceptive device, cervicitis, vaginitis, menopause, dyspareunia, and vulvodynia.

Conclusions: This study provides evidence that PCB-related comorbidities manifested benign diseases (51.58%), lower genital tract infection (46.11%), and cervical cancer (2.31%). Thus, healthcare providers must ensure that appropriate routine screening tests and counseling are given to women with PCB.

Keywords: Cervical dysplasia; Cervical erosion; Comorbidity; Gynecology infection; Postcoital bleeding.

MeSH terms

  • Adult
  • Aged
  • Comorbidity
  • Female
  • Humans
  • Insurance, Health
  • Intrauterine Devices / adverse effects
  • Menopause
  • Middle Aged
  • Polyps / epidemiology
  • Polyps / pathology
  • Reproductive Tract Infections / epidemiology
  • Reproductive Tract Infections / pathology
  • Retrospective Studies
  • Sexual Dysfunction, Physiological / epidemiology*
  • Taiwan
  • Uterine Cervical Diseases / epidemiology
  • Uterine Cervical Diseases / pathology
  • Uterine Cervical Dysplasia / epidemiology
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervicitis / epidemiology
  • Uterine Cervicitis / pathology