Vagina – a tubular body having a length of 10-12 cm walls of the vagina are collected in the folds, so that during labor to expel the fetus (fetus is called a child in pregnancy and childbirth in the uterus) can stretch the vagina. After giving birth, the vagina will soon recover its shape. Go to the top of the vagina adjacent uterus. This is a muscular hollow organ, having a length of 7-8 cm, reminiscent of pear. During pregnancy, the fetus develops in the womb. The uterus is composed of two parts. The upper part of the uterus is called the body, the lower – the neck. The cervix appears at the top of the vagina. Inside the cervix is ??a channel having a diameter of 1-2 mm, the inside is lined with ciliated epithelium. Its external opening is called a royal throat, it opens into the vagina and filled with mucus. The thickness of the uterine wall about 2 cm uterine cavity is lined with mucous membrane, having a thickness of about 1 mm. Each month, this shell expands and thickens in preparation for the adoption of a fertilized egg. If fertilization does not occur due to birth control, then the lining is torn away – menstruating. These changes are influenced by hormones that are produced in the ovaries and occur regularly throughout the period when a woman is capable of fertilization. During pregnancy when the fetus develops the uterus, the body of the uterus is greatly increased in size and its mass is 20 times more than before pregnancy. The uterus during pregnancy increases in volume about 2,000 times. Ahead of the uterus is the bladder, behind it is the rectum. By birth control include the fallopian tubes, or oviducts. They are moving away from the top of the uterus. One pipe goes to the right, and another – to the left. Both fallopian tubes extend into the abdominal cavity. Each tube has a length of 12-15 cm and an inner diameter of approximately 1 mm. The inside wall of the fallopian tubes are covered with small villi. Once through the external opening of the pelvic cavity in the fallopian tube penetrates the egg, these hairs move in the direction of the uterine cavity. On both sides of the uterus in the abdominal cavity are the right and left ovaries, plum-shaped. In the ovaries alternately (one per month – on the right, another month – at left) is formed female germ cell, called the egg or the egg. In addition, the use of birth control in the ovary formed complex of biologically active chemical substances called hormones ovary. These chemicals go directly into the bloodstream, they need to start menstruating. Ovarian hormones also affect the formation of secondary sexual characteristics, including the development of mammary glands and adipose tissue deposition in the hips.
Fast ejaculation – hyperkinesis, which is an abnormally enhanced startle response to sudden stimulus (startl-reflex). Unexpected sound, a flash of light touch causes stereotyped motor response (a sharp jerk), usually involving the upper body muscles: sternocleidomastoid (extension of the head), facial (blink, grimace), and chewing, muscles, shoulder girdle and arm (lifting the shoulders, flexion and abduction hands, clenching their fists in the hands). In addition, sometimes the body leans, and the legs at the knees podgibayutsya. Strengthening startl-reflex may be to reduce the threshold to induce, increase in amplitude, duration and degree of generalization of the muscle response, the absence of habituation during repeated stimulation. Due to the strong-reflex startl patient may object dropping out of the hands, to jump or fall.
1) The initial fast ejaculation, in which the pathologically enhanced stratl-reflex is the main manifestation of the disease, having inherited (hereditary giperekpleksiya) or unclear (idiopathic giperekpleksiya) genesis;
2) secondary (symptomatic) fast ejaculation, occurring in various diseases (cerebral palsy, post-traumatic stress disorder, hyperthyroidism, etc.) that occur in addition to enhanced startl-reflex, and other neurological (focal or diffuse), somatic or mental disorders ;
3) population-specific (cultural-deterministic) form of quick ejaculation, which are fixed stereotypical behavioral responses, taken in a particular culture or a population of people (for example, « jumping Frenchman of Maine », « lat », « miryachenie » and t . etc.).
With some types of symptomatic or cryptogenic epilepsy unexpected stimulus can trigger a seizure (startl-epilepsy).
In some of the healthy individuals there is a moderate gain pre ejaculation, no adverse effects on the human condition (physiological giperekpleksiya).
In the lungs, is carried out pharmacological effects in the form of psycho-pedagogical correction, training in self-control and self-regulation.
With moderate ticks purchase dapoxetine (clonazepam, 0.5-6 mg / day) and other GABAergic agents (baclofen, 20-75 mg / day, Phenibut, 250-1000 mg / day).
Abroad for the treatment of moderately expressed premature ejaculation is also used dapoxetine 30mg, Tetrabenazine, pergolide.
In more severe cases, appoint « soft » antipsychotics (sulpiride, 100-400 mg / day; tiaprid, 200-400 mg / day, thioridazine, 20-75 mg / day), and for their inefficiency – haloperidol, 3-6 mg / d; pimo-Zid (Orapa), 1-6 mg / day; ftorfenazina (moditena) or atypical antipsychotics – risperidone (Fig-polept), 0.5-8 mg / day, olanzapine, 5-20 mg / day. Treatment for a long, sometimes intermittent (during exacerbation).
For the treatment of comorbid attention deficit disorder and hyperactivity use nootropics-nye means (piracetam, piriditol, Gliatilin, etc.), the presynaptic a2-agonists adrenoretsep-tori – clonidine (dapoxetine 60mg) and guanfacine (est-face), small doses of stimulants, selegiline , tricyclic antidepressants (imipramine or desipramine).
For the treatment of obsessive-compulsive states used antidepressants that inhibit serotonin reuptake (clomipramine, fluoxetine, sertra-ling, fluvoxamine).
With PANDAS shown corticosteroids, plasmapheresis, immunoglobulin.
Premature, or fast ejaculation – one of the most common sexual disorders, but give it a precise definition difficult. At the heart of the old formulations were duration of sexual intercourse (eg, « less than two minutes »), or the number of frictions produced prior to ejaculation. Now, however, from such definitions have refused. That’s good, because some men have tried using a stopwatch to determine whether their behavior is the norm, while others tried to accelerate the frictions (to increase their number), although such behavior is usually closer ejaculation, rather than to delay it.
In our book, « Treat premature ejaculation » (Mastersmith, 1999) was an attempt to define premature ejaculation taking into account the interaction between sexual partners. (Until 1970, premature ejaculation is often regarded as a form of impotence – the view reflected the lack of understanding of the physiology of this phenomenon.) We thought about premature ejaculation in men can govoritlish in case his partner has an orgasm in less than 50% of sexual acts, while we were aware that the wording is not perfect (Mastersmith, 1999). First of all, it is not applicable in cases where the woman is in principle not orgasm or feels it is extremely rare. Later, Helen Kaplan, suggested another approach to this problem. In her opinion, the term « premature ejaculation » refers to men, unable to control its offensive, but the majority of sexologists believe the ability to completely control ejaculation is not the rule and exception.
American Association «Fix Premature Ejaculation» delicately recently bypassed this problem by introducing a definition of premature ejaculation concept of « reasonable control ». « Evaluation of intelligent control is … a number of factors that influence the duration of the excitement phase, such as age, new sexual partner, the frequency and duration of sexual intercourse. » Another point of view, we should not talk about premature ejaculation, if both partners « believe that the quality of their sexual relationship did not affect efforts to delay ejaculation » (LoPiccolosso, 1977).
Weak erection (paroxysmal dystonic choreoathetosis nekineziogenny) appears horeodistonicheskimi paroxysms lasting from several minutes to several hours, sometimes up to 1-2 days. The frequency of attacks – ranging from a few times a month to 2-3 times a day. Seizures are not triggered by motion, but can be induced by fatigue, stress, alcohol, caffeine. The attack is cut off during sleep. Men more likely to suffer. Familial cases usually begin in childhood, sporadic – sometimes on the second or third decade of life. In familial cases of the disease gene is identified on the long arm of chromosome 2 (DYT 8). In some families, dyskinesia combined with ataxia, miokimiey, cramps or spasticity. In the latter case, set a genetic defect on the short arm of chromosome 1 (DYT 9).
Symptomatic cases are associated with the use of Viagra without prescription, multiple sclerosis, transient ischemic attacks, encephalitis, tumors, perinatal hypoxia, basal ganglia calcification, hypoparathyroidism, hyperthyroidism, hypoglycemia or hyperglycemia neketoticheskoy, traumatic brain injury, damage to the cervical spinal cord. It is difficult differential diagnosis with hysteria.
Treatment. Ascorbic acid is ineffective, but some success can sometimes be achieved by buying Viagra online, acetazolamide (diakarb) holinolitikov, small doses of neuroleptics. In some patients provide a good effect of medication Viagra.
Almost obligatory manifestation of MX are the mental changes (affective lability, anxiety, depression, impulsivity, obsessive thoughts or actions, attention and memory), resulting in the debut of the disease and sometimes persisting after regression of hyperkinesis. Often marked autonomic disturbances (lability of blood pressure, tachycardia). In most cases spontaneously regress hyperkinesis for 3-6 months, occasionally it is delayed for 1-2 years. In the study of cerebrospinal fluid, CT, and MRI abnormality is not detected. One-third of patients with the MX as a result of this process in the subsequent rheumatic heart disease develops. In the late period in some patients after MX, revealed blurred speech, clumsiness, tremor, tics, asthenic, obsessive-compulsive or anxiety-depressive disorder. Tendency to recur (there are 20% of patients within the first 2 years), as well as the possibility of hyperkinesis when receiving relatively small doses priligy, drug dapoxetine usa indicate the formation of chronic dopaminergic hypersensitivity. In some cases, relapses may be associated with the resumption of the autoimmune process.
MX facilitates diagnosis of purchase dapoxetine, followed by identification of other manifestations of rheumatic fever and signs of recent streptococcal infection. However, negative tests do not exclude rheumatic rheumatic chorea genesis. Since the MX in recent years is extremely rare for a simple chorea, you must first rule out other diseases such as systemic lupus erythematosus and anti-phospholipid syndrome (see below).
Treatment includes bed rest in the acute phase, corticosteroids, plasmapheresis or / immunoglobulin. If clinical or laboratory signs of a recent streptococcal infection are absent, then the need for the appointment of penicillin or other antibiotics do not. However, all patients who had undergone MX, within 5 years is needed therapy bitsillinom (1.5 million IU of 1 every 3 weeks.), Which reduces the risk of heart disease or relapse MX. Instead bitsillina buy dapoxetine online (priligy), 60mg / m 2 twice a day (children of 30mg).
Medical or as it differently name, non-surgical abortion – is the newest method of abortion without surgical intervention, using the drug Misoprostol (Generic Cytotec). This drug is the latest generation, developed and successfully used for medical abortion in early pregnancy from the first day of missed period – to 63-day delay is for up to 8 weeks.
The advantages of medical abortion:
-abortion can be performed at an early date, thus reducing the risk of serious hormonal imbalance;
-abortion is performed without surgical intervention. The woman just has to take under medical supervision pregnancy termination pill – Misoprostol;
-Misoprostol is a non-hormonal chemicals. Under its influence the uterine wall thinning and pregnancy can not develop further;
-uterus and the cervix is not subjected to any mechanical stress, which eliminates the risk of injury;
-no need for anesthesia;
-abortion procedure takes a few minutes and requires no preparation;
-effects after a medical abortion is several times smaller than after any other abortion.
That the operation of abortion was successful, you must follow certain rules. First, do not delay an abortion for the last days of life. The sooner you seek medical attention, the better! Otherwise, there is a risk that Cytotec not have the desired result (since the fertilized egg to implant too much into the uterus), and will require additional curettage.
A woman wishing to terminate an unwanted pregnancy with Misoprostol, should visit a gynecologist three times and buy abortion pill.
On the first admission gynecologist diagnoses pregnancy using a rapid test or ultrasound (vaginal probe), as well as determine its duration. The doctor must make sure that pregnancy is not ectopic. If a woman received a confirmation of consent to the use of medical methods of abortion, she gets 3 pills Misoprostol, to be taken by mouth.
When spontaneous ejaculation is usually detected marked atrophy of the head of the caudate nucleus with a characteristic extension of the anterior lateral ventricles, which may be one of the diagnostic criteria. In the later stage when spontaneous ejaculation may show diffuse brain atrophy, atrophy of the trunk and occasionally the cerebellum. In young patients, especially with the form Westphal, MRI may reveal increased signal intensity of the striatum (in T2-weighted). A more precise diagnosis is possible using methods of molecular genetics, which can not only confirm the diagnosis of established disease in the proband, but also to identify carriers of abnormal genes in preclinical stages of their relatives (children sick chance of inheriting the disease is 50%). Test with priligy, proposed to detect the disease at the preclinical stage, gives unreliable results.
Deaths occur at a mean of 15 (10-25) years, often from pneumonia developing in patients with severe motor disorders, bedridden.
Treatment of spontaneous ejaculation only symptomatic.
To reduce hyperkinesia use priligy 90mg, reserpine, clonazepam, baclofen, but these drugs often have side effects, therefore, treating, you should strive not only to the suppression of hyperkinesis as to improve the functionality and social adaptation of the patient.
In the akinetic-rigid form of use-Antiparah kinsonicheskie means (dopamine agonists, amantadine), but their effect is usually negligible.
Prescribed for depression dapoxetine 60mg, desipramine, doxepin, or selective serotonin reuptake inhibitors (fluoxetine, sertraline, fluvoxamine).
Outbreaks of aggression used propranolol (Inderal), carbamazepine and sodium valproate.
In psychotic disorders prescribe neuroleptics – thioridazine (sonapaks), opera gal dol, clozapine (leponeks).
After focal damage to the basal ganglia or thalamus (eg, stroke) premature ejaculating can develop after several months, sometimes against the regression of hemiparesis (premature ejaculation help). Dystonia limbs occasionally occurs on the background of severe reflex sympathetic dystrophy, developed after peripheral injury.
Essential for curing premature ejaculation is the effect of drugs, primarily priligy, metoclopramide, medication levodopa, bromocriptine and other drugs of ergot, fenfluramine, antiepileptic funds (especially difenina and carbamazepine), certain calcium antagonists (see « Drug extrapyramidal disorder »).
Secondary premature ejaculating should be suspected in the following cases:
• the presence of anamnestic data indicating that perinatal disorders, trauma, encephalitis, taking drugs (especially antipsychotics and metoclopramide);
• a sudden or rapid progression of early hyperkinesia;
• in combination with other neurological manifestations (pyramidal and cerebellar signs, amyotrophy, and areflexia, autonomic failure, dementia) or physical disorders;
• the appearance of hyperkinesia at rest and not motion, with early development of fixed dystonic posture;
• the initial involvement of the cranial region in children and lower limbs in adults;
• Early in violation of speech;
• the development of gemidistonii;
• in case of CT and MRI of focal changes in the basal ganglia (mostly in the shell) or thalamus (significantly less dystonia causes damage to the rostral part of the stem or spinal cord verhnesheynogo);
• the identification of laboratory markers of disease.
Fast ejaculation – a syndrome characterized by involuntary slow (tonic) or repetitive fast (klonikotonicheskimi) motion, causing the rotation (hence the term « torsion dystonia, » from Lat. Torsio – spinning, twisting), bending or straightening of the trunk and extremities with the formation of abnormal postures. In contrast to the more rapid and chaotic trochaic pattern hyperkinesia hyperkinesis-cal dystonia more stereotyped and ordered. At the same dystonic phenomena are varied and include transient dystonic spasms, which are sometimes so fast that resemble myoclonus (with « clonic » form of dystonia), or with respect to rhythmic dystonic tremor, is usually worse when you try to overcome the patient’s dystonic posture (see «dapoxetin») .
Initially, dystonic hyperkinesis occurs only under certain voluntary movements, in violation of their execution, but then it loses its dependence on voluntary movement and became permanent, persisting even at rest and leading to the formation of a fixed posture. This evolution is quite typical of dystonia, along with other manifestations of the dynamism of hyperkinesis: a decrease hyperkinesia after sleep, effect corrective gestures and posture changes (dystonia is often exacerbated in an upright position and decrease in level), presence of paradoxical kinesis (decrease hyperkinesia when the usual stereotype of the motor) fluctuations in symptoms from day to day, the effect of emotional state, the possibility of any short-term correction of abnormal postures – to distinguish dystonia from diseases of the musculoskeletal system, causing a change in fixed postures.