Glycomet is a drug that is also called Biguanide. It’s a hypoglycemic agent that reduces the concentration of glucose in the blood by suppressing gluconeogenesis in the liver, reducing the absorption of glucose from the digestive tract, and increasing its utilization in tissues in patients with diabetes mellitus. The drug reduces the concentration of Thyroglobulin, cholesterol, and LDL (determined on an empty stomach) in the blood serum and does not change the concentration of lipoproteins of other densities. Glycomet stabilizes or reduces body weight. The pills don’t cause hypoglycemic reactions and improve the fibrinolytic properties of the blood.
Glycomet
| Package | pill | Total price | Save | Order |
|---|---|---|---|---|
| 500mg × 120 Pills | $0.20 | $23.62 + Bonus - 7 Pills | - | Add to cart |
| 500mg × 180 Pills | $0.17 | $30.11 + Bonus - 11 Pills | $5.40 | Add to cart |
| 500mg × 270 Pills | $0.15 | $39.86 + Bonus - 11 Pills | $13.50 | Add to cart |
| 500mg × 360 Pills | $0.14 | $49.60 + Bonus - 11 Pills | $21.60 | Add to cart |
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Product description
Glycomet is a generic powerful medication that is used mostly to control the levels of glucose in patients suffering from diabetes type II.
Usually, a great deal of those who suffer from this disease may significantly decrease the most hazardous risks if they start dieting. In those cases when the alimentary therapeutics proves itself inefficient, it is essential to use the blocking agent present in the drug’s composition to achieve reliable control.
By decreasing the amount of the released sugar, the medicinal product simultaneously lowers your appetite and lowers the cholesterol levels. Thanks to this effect, this pharmaceutical substance is effectively used as an additional component in the insulin therapy of diabetes type I in patients with excess weight.
Safety information
The following illnesses and conditions must be considered a reason to avoid treatment with the medication:
- hypersensitivity to the components of the medication;
- fever;
- renal dysfunction;
- cardiac or respiratory failure;
- pulmonary diseases;
- moderate hepatic impairment;
- severe infectious diseases;
- alcoholism;
- dehydration caused by severe diarrhea or vomiting;
- all conditions associated with hypoxia;
- pregnancy;
- acidosis;
- renal infections.
- The duration of the treatment is determined depending on the severity of the illness, your tolerability, and your body weight.
- The dose of the drug is calculated by the professional therapists for each patient, depending on the level of glucose.
- The starting dose for adults is 500-1.000 mg/day. After 10-15 days, it may be increased based on the statistically correct assumption that the potential for further medical activities requires more intensive therapy.
- In order to reduce the possibility of hazardous outcomes, the daily dose should be divided into two-three less powerful doses.
- The maintenance dose of the drug is usually 1.500-2.000 mg/day. The maximal allowed dose must not exceed 3.000 mg/day.
Side effects
Following the prescription proposed by the primary care doctor will allow you to avoid most of the frequently occurred negative reactions that may be expected when using the medicine. Common negative reactions include nausea, a noticeable lack of appetite, vomiting, diarrhea of different origin, abdominal pain, and headache. These symptoms occur especially at the beginning of treatment and, as a rule, disappear on their own.
Patients over the age of sixty who perform heavy physical work also must avoid taking this medication because its use under these conditions may lead to the development of the lactic acidosis.
Rare negative reactions include rashes, itching, and acute chest pain.
Undesired effects connected with various metabolic disorders include diathesis (requires the immediate discontinuation of the therapy) and hypovitaminosis B12, which usually occurs as the result of the prolonged treatment.
Some of the additional symptoms may develop as a result of the drug’s interaction with alcohol, more precisely moderate muscle pain, prolonged periods of weakness, dizziness, or difficulty sleeping. Stop drinking while using the medication and report to your physician the moment you detect one of these symptoms to avoid dangerous effects.
Coumadin - anticoagulant of indirect action. It is taken for treatment and prevention of a deep vein thrombosis and embolism of a pulmonary artery, the transitory ischaemic attacks and an ischemic stroke, secondary prevention of myocardial infarction and prevention of tromboembolic episodes after a myocardial infarction, prevention of tromboembolic episodes at patients with fibrillation of auricles, cardiac valve damage or with the fitted prosthesis heart valves.
Avapro - the remedy which is used separately or in combination with other drugs for treatment of high blood pressure. It is also used for treatment of diseases of kidneys caused by diabetes mellitus 2 type (the state at which the organism can't use insulin normally and, therefore, can't control amount of sugar in blood) and high blood pressure. Irbesartan in a class of the drugs called antagonists of receptors of angiotensin II. It works by blocking of effects of some natural substances which tighten blood vessels that allows blood flow more smoothly and the heart works more effectively.
Enhances the protective mechanisms of the gastric mucosa by increasing the formation of gastric mucus and of glycoproteins in it, as well as stimulation of bicarbonate secretion and endogenous Pg synthesis in it, promotes healing of its injuries (including scarring of stress ulcers), and the cessation of gastrointestinal bleeding. The list of indications includes: gastric ulcer and duodenal ulcer, hyperacidity of gastric juice, heartburn (associated with hyperchlorhydria), symptomatic and stress ulcers of the gastrointestinal tract.
Astelin belongs to antihistamines which purpose is to block histamines in the human organism. It’s a spray that deletes nasal congestion, itching, and sneezing. The medicine is effective in case of infection, inflammation, and allergic reaction which result in itching, stuffy, and runny nose. Medics usually prescribe it for adults and children above five (in case of seasonal allergy) and above twelve (in case of vasomotor rhinitis that constricts and dilates a vein, artery, or capillary in the nasal cavity).
Ventolin is a medicament for eliminating asthma attacks (bronchial) and other reversible diseases with bronchial obstruction.
The main active substance is salbutamol.
Antidepressant; a specific inhibitor of serotonin reuptake by neurons of the brain. Has no stimulating or sedative effect, does not affect choline, muscarin-, histamine- and adrenergic processes. The therapeutic effect develops 1-4 weeks after the initiation of therapy.
Zoloft is an antidepresant stopping the reuptake of serotonin, which is performed by the neurons that isolated it. As a result, the concentration of the neurotransmitter increases in the synaptic cleft and the main cause of depressive states, the serotonin deficiency, is eliminated.
Geodon - antipsychotic medicine (neuroleptic). It is taken at treatment of schizophrenia and similar mental disorders (treatment and prevention of aggravations), stopping of psychomotor excitement at patients with schizophrenia.
Endep - tricyclic antidepressant. The mechanism of antidepressive action is connected with increase in concentration of noradrenaline in synapses and/or serotonin in CNS (decrease in return absorption). Accumulation of these neurotransmitters results from inhibition of their return capture by membranes of presynaptic neurons.
An oral hypoglycemic means, which inhibiting the intestinal alpha-glycosidase, reduces the enzymatic conversion of di-, oligo - and polysaccharides to mono-saccharides, thereby reducing the absorption of glucose from the intestine and postprandial hyperglycemia. It is used to treat diabetes, of type 2 under the ineffective diet, the course of which shall not be less than 6 months, type 1diabetes within the combination therapy.
Actos, which is pioglitazone - is prescribed to patients with diabetes of type 2 (both as monotherapy, and in a form of the combined therapy with sulphonylurea, metformin or insulin as additional medicine to dietotherapy and physical exercises). Pioglitazone represents peroral hypoglycemic medicine of Thiazolidinediones alignment which effect depends on insulin presence. It is a high-selective agonist of gamma receptors, activated by proliferator of peroxysom (PPAR-γ).
Augmentin - the Antibiotic of a broad spectrum of activity. It has bacterolytic (destroying bacteria) effect. It is active concerning a wide range of aerobic and anaerobic gram-positive and aerobic gramnegative microorganisms, including strains producing betalactamase. It is prescribed at diagnosing of bacterial infections caused by microorganisms, sensitive to drug: infections of upper respiratory tracts, bacterial infections of skin and soft tissues, infections of urogenital tract, sepsis, infection pelvic organs.
Cipro - the antimicrobic broad-spectrum agent derivative of fluroquinolone, suppresses bacterial DNA gyrase, breaks DNA synthesis, growth and division of bacteria; causes prominent morphological changes and fast death of a bacterial cell. It effects bactericidal at gram-negative organisms during a dormant period and deletion, on gram-positive microorganisms - only during deletion. During taking Cipro there is no parallel development of resistance to other antibiotics, which do not belong to group of inhibitors of a gyrase that does it highly effective in relation to bacteria which can be steady, for example to aminoglycosides, penicillin, cephalosporins, tetracyclines and many other antibiotics.
Ceftin - the antibiotic cephalosporin, is prescribed for treatment of Bacterial infections caused by sensitive microorganisms: respiratory diseases (bronchitis, pneumonia, abscess of lungs, a pleura empyema, etc.), ENT organs (sinusitis, tonsillitis, pharyngitis, otitis, etc.), urinary tract (pyelonephritis, cystitis, asymptomatic bacteriuria, gonorrhea, etc.), skin and soft tissues (face, pyoderma, impetigo, furunculosis, phlegmon, a wound fever, diamond-skin disease, etc.), bones and joints (osteomyelitis, septic arthritis, etc.), small pelvis (endometritis, adnexitis, cervicitis), sepsis, meningitis, Lyme desease (borreliosis), prevention of infectious complications at operations on Thoracic organs, abdominal cavity, pelvis, joints inc. at operations.
Trimox has an active ingredient called amoxicillin. It is an antibiotic of penicillin, which fights bacteria. Trimox is used to treat many different types of infection caused by bacteria such as tonsillitis, bronchitis, pneumonia, gonorrhea and infections of the ear, nose, throat, skin or urinary tract. This remedy is sometimes used together with another antibiotic called clarithromycin (Biaxin) to treat stomach ulcers caused by Helicobacter pylori infection. This combination is sometimes used with a gastric acid reducer, called lansoprazole (Prevacid).
Ciplox is a medicine which is antimicrobial of the fluoroquinolone group. The system of action is connected with exposure to DNA bacteria. The medicine eliminates microorganisms that are both at rest and reproduction. A range of action of the drug includes such types of negative and positive microorganisms: Shigella, Salmonella, Citrobacter, Klebsiella, Enterobacter, Serratia, Hafnia, Edwardsiella and others. It is resistant to Ureaplasma uralyticum, Nocardia asteroids, Treponema pallidum. Such defiance to the drug develops slowly and gradually.
Floxin - antimicrobic broad-spectrum agent from group of fluroquinolone. It is active concerning the microorganisms producing beta lactamelements and fast-growing atypical mycobacteria. It is taken at respiratory infection, the ENT organs, skin, soft tissues, bones, joints, abdominal cavity, urinary tract.
Flagyl - antiprotozoan and antimicrobic drug. It is prescribed at treatment of protozoan inspections (abenteric amebiasis, including amoebic abscess of liver, an intestinal amebiasis, trichomoniasis, giardiasis, balanthidiasis, lambliasis, skin leushmaniosis, mecotic vaginitis, mecotic urethritis), pseudomembranous colitis, gastritises, ulcer, prevention of postoperative complications (especially interventions at segmented intestine, perirectal area, appendectomy, gynecologic operations).
Cefixime is a medicine intended for the treatment of acute and chronic bronchitis, bacterial bronchitis, middle ear inflammation, pharyngitis and tonsillitis, bacterial infections of the urinary tract, cystitis, urethritis, pyelonephritis, cerivitis.
Suprax - is a semisynthetic antibiotic of the group of the third generation cephalosporins for oral administration. It has bactericidal action. The drug is formed on the basis of cefiximum under the name Suprax given by such companies:Wyeth, Elder Pharmaceuticals, Fujisawa, Gedeon Richter, Hikma Pharmaceuticals, Lederle, Lupin Pharmaceuticals, Sanofi-Aventis.
Stromectol - a medical preparation that effectively cope with many kinds of parasites. It is used to treat lice, scabies, as well as onchocerciasis (river blindness) and other nematodes in humans and animals. It is applied externally and internally, depending on the disease.
Avalide is an effective medicine which aim is to lower the blood pressure. Hypertension provokes serious diseases as strokes, heart attack, and problems with the kidney. An angiotensin receptor blocker and diuretic are the basic components of the drug. The first one relaxes the walls of the blood vessels letting the blood move freely without the pressure. The second component stimulates urination so that a patient can get rid of extra salt and water which also provoke high blood pressure.
"Loop" diuretic, used for edematous syndrome with CHF II-III st., liver cirrhosis, kidney disease; swelling of the lungs or brain; arterial hypertension, hypercalcemia. Causes a rapidly advancing, strong and short-term diuresis. Has natriuretic and chlororetic effects, increases the excretion of K +, Ca2 +, Mg2 +.
Exforge the combined antihypertensive which includes amlodipine and valastran. Valsartan - a specific blocker of AT1 receptors of angiotensin II. Amlodipin - calcium channel blocking agents of III generation, inhibits transmembrane receipt of Ca2+ in cardiomyocytes and smooth muscle cells of vessels, by weakening them.
A thiazide diuretic of the average intensity, applied in arterial hypertension, edema syndrome of different origin, gestosis and diabetes insipidus. Reduces reabsorption of Na+ at the level of the Henle loop cortical segment, without affecting its segment lying in the medulla of the kidney that detects a weaker diuretic effect compared with furosemide.
Caverta - another affordable version of Indian Viagra created by Ranbaxy, released as Caverta 100mg and Caverta 50mg.
Levitra - the main component - the active agent Vardenafil which promotes strengthening of blood circulation in generative organs of men. It allows to reach a high level erection at sexual stimulation, and also to increase sensitivity of head of a penis and to make sexual intercourse longer and more pleasant. The main feature of a drug Levitra - quickness of effect, duration of impact on an organism up to 12 hours and a very small number of side effects.
Inhibitor of H+-K+-ATP, the dextrorotatory isomer of omeprazole. Reduces the secretion of hydrochloric acid in the stomach by specific inhibition of the proton pump in parietal cells. The therapeutic use includes gastroesophageal reflux disease: erosive reflux esophagitis (treatment), prevention of relapse in patients with healed esophagitis, symptomatic treatment of GERD.
Blocks the final stage of HCl secretion, reducing basal and stimulated secretion, regardless of the nature of the stimulus. Prescribed for gastric ulcer and duodenal ulcer in acute phase, erosive-ulcerative esophagitis, reflux esophagitis, Zollinger-Ellison syndrome, stress ulcers of the gastrointestinal tract; eradication of Helicobacter pylori within a combination therapy, non-ulcer dyspepsia.
Aciphex - the medicine, normalizing acidity of a stomach, inhibitor of a proton pomp. It is prescribed at gastroduodenal ulcer in the exacerbation phase, gastroesophageal reflux disease; states which are characterized by pathological hyper secretion including Zollinger-Ellison syndrome. In combination with bactericide - Helicobacter pylori eradication at patients with gastric ulcer or chronic gastritis; treatment and prevention of recurrence of an ulcer at patients with gastric ulcer related to Helicobacter pylori.
A symptomatic medication against vomiting and nausea of various origins. Used at vomiting caused by radiation therapy or cytotoxic drugs intake, hypotony and atony of the stomach and intestines, biliary dyskinesia, reflux esophagitis, flatulence, aggravation of gastric ulcer and duodenal gut, when performing contrast studies of the gastrointestinal tract. It reduces the moving activity of the esophagus, increases the tone of the lower esophageal sphincter, accelerates gastric emptying, and accelerates the movement of food through the small intestine without causing diarrhea. Stimulates the secretion of prolactin.
Levaquin is used to treat infections of the lower respiratory tract, urinary tract, kidneys, skin, soft tissues, chronic bronchitis, acute sinusitis, chronic bacterial prostatitis and tuberculosis. The drug is a fluoroquinolone, a broad-spectrum antimicrobial bactericide. It blocks DNA gyrase and topoisomerase IV, disrupts supercoiling and cross-linking of DNA gaps, suppresses DNA synthesis, causes profound morphological changes in the cytoplasm, cell wall and bacterial membranes.
Sinemet - a combined remedy based on Levodopum + Carbidopum. In the treatment of Parkinson's syndrome and disease, Sinemet proved to be one of the most effective drug. The reviews are mostly positive, because it allows to reduce "inhibition" in patients who have been treated with other medications. For each patient, the dosage is selected individually, together with the frequency of admission.
An antiarrhythmic Ia class drug, a blocker of the "fast" Na+ channels. It has a membrane stabilizing, anti-arrhythmic, hypotensive and m-anticholinergic action. In normally functioning sinus node it causes acceleration of the sinus rhythm due to the antimuscarinic effect.
The drug dilates coronary vessels (mostly arterioles) and causes a significant increase in volumetric blood flow velocity. Increases the content of oxygen in venous blood of coronary sinus and its absorption by myocardium. Promotes the development of collateral coronary circulation, reduction in a systemic vascular resistance, improves microcirculation, has angioprotective action.
Dilantin - antiepileptic drug without the expressed somnolent effect; it has membrane stabilizing, antiarrhytmic and hypotensive effect. It is taken if it is diagnosed activated epilepsy, supraventricular and ventricular disturbances of a heart rhythm caused by intoxication cardiac glycosides.
Epitol - mood stabilizing agent and antiepileptic medicine. It is effective for treatment of epilepsy (excepting petit mal), maniacal conditions, prevention of maniac-depressive frustration, alcoholic abstinence, neuralgia of trigeminal and glossopalatine nerves, diabetic neuropathy.
Strattera - the drug with an international non-proprietary name of the active substance - Atomoxetine, it is intended as a sympathomimetic agent for the prevention and treatment of attention deficit hyperactivity disorder (ADHD) in children 6 years of age and older, adolescents and adults.
Zerit - treatment of infection caused by HIV, with severe clinical manifestations and ineffectiveness or intolerance of zidovudine, and other antiretroviral drugs. The nucleoside analogue of thymidine is phosphorylated by cellular enzymes to its active form - stavudine triphosphate. Suppresses reverse transcriptase of HIV, cellular DNA polymerases (beta and gamma), inhibits the synthesis of viral and mitochondrial DNA. It is active against HIV-1.
Flexeril - medicine acting against muscular spasms. It possesses sedative action, it is not recommended to be engaged in potentially dangerous types of activity if a person takes Flexeril. As well as in a case with narcotic analgetics, Flexeril is not recommended to take longer than seven days as in case of a long taking there can be a dependence.
Dutas is a mix of two medicines: dutasteride and tamsulosin hydrochloride. The drugs have complementary mechanisms of action, due to which there is a rapid weakening of urination. It reduces the risk of retention of the urine. It is not anticipated that the pharmacodynamic reactions of a fixed dosage mix of dutasteride-tamsulosin differ from those obtained with the simultaneous use of dutasteride and tamsulosin as separate elements. Dutasteride inhibits the activity of both the 1st and 2nd type of isoenzymes. DHT is an androgen that is responsible for prostate and the increase of BPH. It inhibits the activity of adrenoreceptors.
Actonel, which is risedronate - is prescribed for treatment and prevention of osteoporosis (post-menopausal, caused by corticosteroids), Paget disease. Risedronate binds to substance of a bone tissue, inhibits its resorption mediated by osteoclasts and reduces a bone turn (does not break process of formation of a bone). It increases the biomechanical strength and volume of bone mass. The maximum decrease in a bone turn is observed in 3-6 months, remaining at the same level during a course of treatment.
It is a powerful tool which lowers cholesterol in the blood, strengthens blood vessels and fights parasites. Lasuna balances coronary function prevents the accumulation of cholesterol on the walls of the coronary arteries. The medicine stabilizes blood pressure levels. It regulates the level of lipids in plasma, the number of platelets in the blood, cholesterol and blood sugar and strengthens immunity. Strong antioxidant properties eliminate free radicals that cause an imbalance in the normal functioning of blood vessels, which should fully narrow and expand for their natural work.
Sildalist - sildenafil plus tadalafil tablet, a preparation manufactured by Cipla Inc. One red colored rectangular pill is equivalent to 1 pill of sildenafil100mg and 1 pill of tadalafil 20mg mixed together. This is the most potent product to stop erectile malady. The task of Sildalist tablets is to make penis ready for a sex as soon as the user comes into a state of sexual arousal.
Synthroid finds use as a hormone-regulating agent for managing low levels of triiodothyronine/thyroxine. It also has a pronounced therapeutic effect on goiters of certain types. Synthroid often accompanies surgeries and other medical means of treating thyroid cancer. The drug compensates for the insufficient production of thyroid hormones by standing in their place as a synthetic substitution. Compensations of this kind help the patient’s body to restitute the normal rate of metabolism. Synthroid also helps to fight obesity due to its ability to remove the initial thyroid gland-related causes as such.
This medicine makes metabolism better, has cooling,febricide, urinative and nerve-strengthening properties. It is used to treat asthma, gruffness, mental disorders. It reduces anxiety in children, is used for any mental disquiet. Moreover, it is a strong blood-purifying agent with a specific effect in chronic diseases of the skin. The drug helps to create a balance between the left and right hemispheres of the brain. It is considered to be an effective means to restore hearing. .Brahmi perfectly relieves many types of headaches, normalizes cerebral circulation. It affects all tissues-elements except reproductive tissue, mainly blood and nerve tissue.
Urispas is an oral antispasmodic drug approved to prevent bladder spasms caused by urethral catheterization, infectious and /or inflammatory diseases of the urogenital system or neurological disorders.
Colospa - myotropic spasmolytic with selective effect on unstriated muscles of digestive tract. Eliminates a spasm, without influencing a normal peristaltics of intestines. Unlike cholinolytic medicine, Colospa does not affect at muscarinic receptor and does not cause characteristic of antispasmodics with muscarinic receptor action of side effects (feeling of dryness in a mouth, vision disorders, an urination delay) that allows for patients to take it at prostatauxe or glaucoma. Taking of Colospa is not followed by development of reflex hypotonia of intestines.
Shallaki offers a herbal cure for sore joints and is based on an extract from Boswellia serrate. Completely natural origin of the medicine guarantees its safety and pure benefits for the body. It is a powerful auxiliary remedy applied in the treatment of arthritis as well as prevention of joint conditions. Shallaki alleviates pain and swelling in areas of inflammation and lowers the overall level of triglyceride and cholesterol with high efficiency. Its health-promoting behavior makes it a great aid for weight reduction.
Anti-migraine drug. Specific and selective agonist of 5-HT1-serotonin receptors, localized predominantly in the blood vessels of the brain and it does not affect other subtypes of 5-HT-serotonin receptors (5-HT2-7). Causes narrowing of the vessels of the carotid arterial bed, that supply extracranial and intracranial tissues with blood (vasodilation of the meninges and / or their edema is the main mechanism of migraine development in humans) without significantly affecting cerebral blood flow.
Mobic is a nonsteroidal anti-inflammatory drug, which has anti-inflammatory, antipyretic, analgesic effect. It belongs to the class of oxicams; derived from the anoliefo acid. Used in symptomatic treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis (Bekhterev's disease) and other inflammatory and degenerative diseases, accompanied by pain syndrome.
An anti-migraine drug. Used for emergency treatment to eliminate migraine, with aura as well. A selective agonist of 5-hydroxytryptamine 1D receptors. The effect can be observed within 30 minutes after the intake.
Rizact -pills swallowed for the urgent care of the headache phase within the attacks of migraines. This Cipla product is a great painkillerthanks to an action of Rizatriptan, which is characterized by an analgesic effect.
Artane, which is trihexyphenidyl - has a prominent central and peripheral cholinolytic effect. It is prescribed to patients with the diagnosed Parkinsonism of various etiology and other diseases of extrapyramidal system which are followed by increase in a muscle tone and hyperkinesias (violent automatic movements owing to involuntary reduction of muscles).
Dapsone antibacterial agent, which is active concerning Mycobacterium leprae and tuberculosis. It has bacteriostatic action similar to antagonists of p-aminobenzoic acid.
The effect of clomipramine is to inhibit the opposite neurological catching of serotonin and noradrenaline. The most crucial is the suppression of serotonin recapture. In addition, the medicine has a broad range of other pharmacological actions: alpha 1-adrenoliticheskoe, anticholinergic, antigestagen and antiserotonergic. The pill acts on the depressive disorder in general. The difference is usually observed after 2-3 weeks of therapy. Acticine also has a specific influence on obsessive-compulsive disorders.
Differin is a white gel or cream. The drug is used to treat acne. It can also be used to combat comedones. Differin monotherapy is helpful in case of minor acne. For the treatment of severe and moderate degree of acne, the drug is used in conjunction with systemic drugs (antiandrogens, antibacterial agents). The drug is well tolerated. It rarely causes irritation, so its use is good even for those who have sensitive skin with acne. The gel is more suitable for oily skin and the cream suits better for dry skin.
Danazol is used in endometriosis (with concomitant infertility), benign neoplasms of the breast (fibrocystic mastopathy), primary menorrhagia, premenstrual syndrome, primary premature puberty, gynecomastia.