USMLE Step 1 Question of the Week #11

A 27-year-old woman comes to the clinic and complains of difficulty with sexual intercourse. History taking proves to be difficult as she is very unwilling to discuss her perceived reasons for the difficulties. She claims that she is in a new relationship and met her current partner two weeks ago. In addition, she reports that she has never had any problem in initiating and maintaining sexual activity in her past relationships and that the lack of desire has also never been a problem. Apart from this, she states that she was sexually abused when she was a child but does not want to talk about it at all. Her chief complaint is that she has pain and stiffness during intercourse and that this has started only with this relationship. On examination, the physiciannotices some resistance during vaginal examination and the patient also complains of pain when he attempts this examination. What is the most likely diagnosis?

A. Dyspareunia

B. Vaginismus

C. Hypoactive sexual disorder

D. Sexual aversion disorder

E. Female sexual arousal disorder

QID #809

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