A 46-Year-Old Woman Comes to the Office Due to Sexual

question 22

Multiple Choice

A 46-year-old woman comes to the office due to sexual difficulties for the past year.  The patient rarely thinks about sex anymore and frequently declines sex when her husband tries to initiate.  She is attracted to her husband and worries that he assumes she is losing interest in him.  Although vaginal lubrication is adequate during sex and the patient can reach orgasm, she finds that her mind wanders during the experience.  She is unsure what is causing a decrease in her sex drive, although she notes that she received a promotion 3 months ago and has been working longer hours since then.  The patient describes her marriage as stable and loving.  She has a history of a depressive episode and currently takes bupropion.  Physical examination and laboratory studies, including thyroid function tests, show no abnormalities.  Which of the following is the most likely diagnosis?

• A)Adjustment disorder
• B)Antidepressant-induced sexual dysfunction
• C)Female orgasmic disorder
• D)Female sexual interest/arousal disorder
• E)Genito-pelvic pain/penetration disorder
• F)Normal menopausal changes

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