Chest Pain During Your Period
Chest pain that comes back with your period, and for some around ovulation, can be a sign of endometriosis on the diaphragm or, more rarely, inside the chest. It's often felt under the right ribs and worse with deep breaths. Because chest pain can also be an emergency, heart and lung causes are always checked first.
- How common
- Uncommon
- When
- Before and during your period
- Where
- Chest, under the right ribs
Medically reviewed by Dr. Steven Vasilev, MD
Board-Certified Gynecologic Oncologist & Integrative Medicine Diplomate, Advanced Robotic Endometriosis Excision Surgeon, Director of Lotus Endometriosis Institute · Updated Oct 2026
Where you feel it
Front view of the upper body. The lining of the right lung is highlighted.
- Lung liningrarer, usually right
- Diaphragmthe most common source
- Left chestheart is checked first
When it flares
It can start in the days before bleeding and eases afterward; some people feel it around ovulation too. Chest pain that doesn't follow your cycle still deserves a prompt check.
Does this sound like you?
Tap any that fit. We'll turn them into a note you can bring to your visit.
None of these? If your chest pain worries you, it's still worth a conversation. Speak with us
When to get help
If your chest pain keeps coming back with your period or around ovulation, see an endometriosis specialist. Endometriosis on the diaphragm is easy to miss, and normal heart and lung tests don't rule it out.
Keep track
For two or three cycles, note the cycle day, where it hurts, how it feels and what sets it off. It's the most useful thing to bring to your first visit.
Speak with Us
Book a visit if it:
- Comes back with your period or ovulation
- Comes with shoulder pain or pelvic symptoms
- Keeps coming back after normal tests
Your first visit
We go through your history and your notes, then map out next steps together, whether that's tests, imaging or treatment.
When it needs a specialist: Diaphragm endometriosis surgery
What it feels like
How patients often describe it
- It stabs when I breathe in deeply.
- It's like a tight band around my ribs.
- It burns or pulls near my breastbone.
- It feels like heartburn or a pulled muscle.
Many people describe sharp pain with deep breaths or a deep ache under the right ribs. It's often worse when you cough, laugh, stretch or lie flat, and it can travel to the shoulder, neck or upper back. Some feel it only during their period; for others it starts in the days before bleeding and eases afterward, and some notice it around ovulation too.
Why it happens
Endometriosis on the diaphragm
Chest pain from endometriosis most often comes from the diaphragm, the dome-shaped muscle under your lungs, usually on the right side. These lesions respond to your hormones and become inflamed around your period, and every deep breath, cough or twist pulls on them. The pain can be felt low in the chest, under the ribs or in the shoulder.
It can be on the left too, but left-sided pain more often has another cause, including the heart, so that's checked first.
Endometriosis inside the chest
Less often, endometriosis inside the chest (thoracic endometriosis) grows on the lining around the lungs and can cause chest pain with each period. It can also collapse a lung around a period, causing sudden sharp chest pain and shortness of breath that need emergency care.
Adenomyosis and other contributors
Adenomyosis doesn't spread to the chest, but it often occurs alongside endometriosis, and its heavy bleeding can lead to anemia, which may bring chest tightness, a racing heart and breathlessness, often during or after a heavy period.
Ongoing pain and inflammation can also make the chest wall and diaphragm more sensitive.
Learn moreEndometriosisAdenomyosis
“Chest pain should always be checked for heart and lung causes first. If it keeps coming back with your period after those tests are normal, tell your doctor. That pattern points us to the diaphragm and, less frequently, to the chest and lungs.”
Why it's often missed
Chest pain has many causes, so this one is easily put down to heartburn, a pulled muscle, gallbladder trouble or anxiety. The clue that points to endometriosis is timing: pain that comes back with every period, often under the right ribs and worse with deep breaths.
Tests often miss it too. Chest CT and MRI can miss small lesions, and many are only found when a surgeon deliberately looks at the diaphragm during laparoscopy.
How it's diagnosed
Rule out other causes first
Heart and lung problems are checked first, then stomach, gallbladder and muscle causes. Your doctor may order an ECG, a chest X-ray or blood tests.
Track two or three cycles
Note the cycle day, where it hurts and what sets it off. Pain that lines up with your period is one of the biggest clues a specialist can get.
Imaging where it helps
MRI or CT can show some lesions and help plan surgery, but a normal scan doesn't rule them out.
See an endometriosis specialist
An endometriosis-focused evaluation looks beyond the pelvis and can confirm and treat diaphragm disease with laparoscopy. It starts with a detailed conversation about your history, so bring your notes.
Treatment options
Once urgent causes are ruled out, treatment depends on what's driving your pain, and often combines several approaches.
- Medical
Hormonal therapy
Quiets the cycle so flares can come less often or hurt less, though it doesn't remove lesions.
Hormonal Therapy - Medical
Pain relief
Targeted pain management and a plan for flares while the cause is found.
Pain Management - Surgical
Excision surgery
Removes lesions at the root when pain persists or keeps coming back. Diaphragm surgery takes specific experience, and sometimes a chest surgeon joins the team.
Surgery overview - Support
Supportive care
Gentle rib and diaphragm movement, pain-free breathing, sleep and stress support, and acupuncture.
Integrative Medicine
Chest pain around your period?
We look for endometriosis where it's often missed, including the diaphragm.
Schedule a ConsultationPrefer to talk it through? Call or text us.
Questions people ask
Is my chest pain cyclical and possibly endometriosis-related?
Chest pain is cyclical when it predictably flares at the same point in your menstrual cycle, and endometriosis could be contributing. Tracking timing, location, triggers, and breathing-related symptoms for 2–3 cycles can help clarify the pattern.
Can endometriosis cause rib or shoulder pain?
Yes, endometriosis can sometimes cause rib or shoulder pain, most commonly when it involves the diaphragm, the muscle under your lungs. Symptoms that predictably flare just before or during a period can point toward endometriosis in the diaphragm or chest.
Can adenomyosis cause chest pain?
Adenomyosis can contribute indirectly to chest pain through heavy bleeding and anemia, which may lead to chest tightness. It doesn’t directly create disease in the chest, but coexisting endometriosis can, in rare cases, affect the diaphragm or chest and cause cyclical chest or shoulder pain.
Can endometriosis cause heart palpitations?
Yes, some people with endometriosis report heart palpitations, especially during pain flares, stress, or hormonal shifts. Palpitations are not specific to endometriosis; new or worsening palpitations, or those with chest pain, shortness of breath, or fainting, deserve prompt evaluation.
When are thoracic symptoms an emergency?
Sudden, severe chest pain, new or worsening shortness of breath, or faintness should be treated as an emergency, especially around your period. These symptoms can rarely reflect a lung complication linked to endometriosis and need immediate evaluation.
Often happens with
Read more
Sources & medical review
Reviewed by Dr. Steven Vasilev, MD, Board-Certified Gynecologic Oncologist & Integrative Medicine Diplomate, Advanced Robotic Endometriosis Excision Surgeon, Director of Lotus Endometriosis Institute. Last reviewed Oct 2026; next review Oct 2027.
- Piccus R, Mann C, Sutcliffe RP. Diagnosis and treatment of diaphragmatic endometriosis: results of an international patient survey. Eur J Obstet Gynecol Reprod Biol. 2021;260:48–51.
- Naem A, Roman H, Martin DC, Krentel H. A bird-eye view of diaphragmatic endometriosis: current practices and future perspectives. Front Med (Lausanne). 2024;11:1505399.
- Gil Y, Tulandi T. Diagnosis and treatment of catamenial pneumothorax: a systematic review. J Minim Invasive Gynecol. 2020;27(1):48–53.