MSFinals-1703

A 52-year-old woman comes in for her routine cervical smear. She reports discomfort during the insertion of the speculum and reveals that she has been experiencing dyspareunia and a burning sensation when using tampons for the past few months. The pain can persist for several hours after sexual intercourse. She denies having any vaginal discharge, and her skin appears normal. What is the most probable cause of her symptoms?