Can endometriosis cause rib or shoulder pain?

Yes. Endometriosis can sometimes cause pain under the ribs or in the shoulder—most commonly when it involves the diaphragm (the muscle under your lungs) or, more rarely, structures inside the chest. People often describe this as right-sided upper abdominal/rib pain, chest tightness, or shoulder/arm pain that can worsen with deep breathing or coughing.

A key clue is timing: symptoms that predictably flare just before or during a period can point toward diaphragmatic or thoracic endometriosis. In very rare cases, chest involvement can also cause shortness of breath, recurrent “mystery” chest symptoms, or even a lung collapse that repeats around menstrual cycles.

If you’re noticing this pattern—especially if you also have pelvic endometriosis symptoms—our team can help connect the dots and evaluate the full picture. When appropriate, we plan surgery with careful inspection of the diaphragm and coordinate imaging and specialty support if there’s concern the disease extends into the chest.