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A 27-year-old woman who has been involved in a hostile marital relationship two years ago is now in a relationship with new partner with whom she's quite happy. She complains that's she's unable to accept penile penetration during the sexual intercourse with her new partner. Pelvic examination revealed no evidence of anatomic abnormalities. What is the most likely diagnosis?

A- Hypoactive sexual desire disorder
B- Dyspareunia
C- Inhibited female orgasm
D- Vaginismus
E- Fetishism
 

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Vaginismus is a well described entity in women with previous painful sexual experiences and is attributed to reflex spasm of the pubococcygeal muscle, possibly secondary to an anxiety disorder (correct answer is D).

On the contrary, the term dyspareunia (choice B) is used to describe the pain that accompanies an organic underlying condition (infection, trauma, postmenopausal dryness, vaginal or cervical cancer etc).
 
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