A 35 year old G0P0 with autoimmune adrenal and thyroid disease presents with pain with sexual intercourse. She has vaginal dryness, decreased libido, poor sleep, and night sweats. She was previously on oral contraceptives for 10 years but stopped about 2 years ago. Since then, her periods have not been regular. Karyotype is normal. FSH is elevated. Pregnancy test is negative.
Challenge: What's your diagnosis?