The part that connects to the clavicle is less often affected. This muscle wasting pattern can contribute to a prominent horizontal anterior axillary fold. Beyond this point the disease does not progress further in 30% of familial cases. After upper torso weakness, weakness can "descend" to the upper arms (biceps muscle and, particularly, the triceps muscle). The forearms are usually spared, resulting in an appearance some compare to the fictional character Popeye, although when the forearms are affected in advanced disease, the wrist extensors are more often affected. Lower body and trunk
After the upper body, weakness can next appear in either the pelvis, or it "skips" the pelvis and involves the tibialis anterior (shin muscle), causing foot drop. One author considers the pelvic and thigh muscles to be the last group affected. Pelvic muscle weakness can manifest as pelvic tilt, causing the hips to be held in slight flexion. Pelvic weakness can also cause a Trendelenburgs sign. Weakness of the back of the thigh (hamstrings) is more common than weakness of the front of the thigh (quadriceps).Weakness can also occur in the abdominal muscles and paraspinal muscles, which can manifest as a protuberant abdomen and lumbar hyperlordosis. Abdominal weakness can cause inability to do a sit-up or the inability to turn from one side to the other while lying on ones back. Of the rectus abdominis muscle, the lower portion is preferentially affected, manifesting as a positive Beevors sign.
For a diagnosis of PMA to be made it is necessary to have a detailed history of the timing of menstrual cycles along with asthma symptoms experienced, and the peak expiratory flow rate (PMA may cause the PEF to be lowered in the premenstrual period). It is helpful in making a diagnosis to keep a diary of symptoms and peak expiratory flow (PEF) rates. Raynauds disease: is a circulatory disorder in which the smaller arteries that supply blood to the extremities – most often the hands, but it may also affect the, toes, the tip of the nose and the ears – become narrower reducing blood flow. This causes the extremities to become numb and to be cooler than the core body temperature. It can be triggered by exposure to stress and cold. Epilepsy
FibromyalgiaIt is associated with a number of mental health conditions including

Major depressive disorder
Anxiety
Bipolar disorder

Causes
The exact causes of menstrual migraine are not known for sure but there is a link between falling levels of the female hormone estrogen and the onset of a migraine attack. The estrogen level may fall after bleeding occurs during the menstrual cycle or when external sources of estrogen are no longer taken, like when a woman stops taking birth control pills or hormone pills in hormone replacement therapy. Diagnosis
The diagnosis of a menstrual migraine is made by keeping track of when the migraines occur for a period of at least three months.