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Deep Disease

Why do I get shoulder pain during my period?

The short answer

Shoulder pain around your period can come from irritation caused by endometriosis on or near the diaphragm, the muscle between your abdomen and chest. This referred pain can affect the right shoulder or arm and may worsen with deep breathing or coughing.

Medically reviewed by Dr. Steven Vasilev MD
Advanced Endometriosis Minimally-Invasive Robotic Excision Surgeon, Director of Lotus Endometriosis Institute · Updated Oct 2026

Shoulder pain that predictably shows up around your period can be a “referred pain” pattern, meaning irritation somewhere else is felt in the shoulder. One important (and often overlooked) explanation is endometriosis on or near the diaphragm, the muscle that separates your abdomen from your chest. When endometriosis involves the diaphragm, symptoms can include right-sided shoulder or arm pain, upper abdominal or chest discomfort, and pain that may worsen with deep breathing or coughing, often clustering around menstruation.

Because diaphragm and thoracic (chest) involvement are less common, they’re frequently missed, especially if pelvic symptoms get all the attention or if imaging doesn’t clearly show the cause. In rare situations, endometriosis can extend into the chest and be associated with cyclical chest pain, shortness of breath, or even recurrent lung collapse around periods. If your shoulder pain is cyclical, especially if it’s right-sided or comes with chest/upper-abdominal symptoms, our team can help you connect the pattern, evaluate for diaphragmatic or thoracic involvement, and discuss options such as targeted imaging and, when appropriate, minimally invasive surgical evaluation and excision by an experienced team.

Where to go from here

Understand it, compare it with what you're feeling, then talk it through with us.

Step 1 · Understand

Understand the condition

Step 2 · Compare

Symptoms it can relate to

Step 3 · Speak with Us

Period shoulder pain isn’t “normal.”

Cyclic shoulder pain can be a clue to diaphragm or thoracic endometriosis causing referred pain. Our specialists can evaluate deep disease and discuss imaging, medical options, and excision surgery if needed.

Questions people ask next

All deep disease questions
  • Is my shoulder or chest pain from diaphragmatic endometriosis?

    Diaphragmatic endometriosis can cause shoulder or chest pain that tends to be cyclical and frequently right-sided, flaring before or during your period. Many non-gynecologic causes can also explain this pain, especially if it’s left-sided or not tied to your cycle.

  • Can endometriosis cause shoulder pain during periods?

    Yes, endometriosis can cause shoulder pain during your period, most commonly when it affects the diaphragm, especially on the right side. Shoulder pain can have many causes, but a clear pattern linked to your menstrual cycle is an important clue.

  • Is shoulder pain more common with right-sided diaphragmatic endometriosis?

    Often, yes: people with diaphragmatic endometriosis frequently report right-sided shoulder pain. Left-sided or bilateral pain can also happen, so the side alone cannot confirm or rule out diaphragmatic involvement. The pattern, especially flares with your menstrual cycle, matters.

  • Can adenomyosis cause shoulder pain?

    Adenomyosis alone is less likely to fully explain shoulder pain, since it usually causes symptoms centered in the uterus. Shoulder pain that flares around your period can be a clue to overlapping endometriosis, including near the diaphragm.

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Lotus Endometriosis Institute provides California-based surgical evaluation and advanced excision care for patients with suspected endometriosis, adenomyosis, complex pelvic pain, and related conditions.


Many patients contact us from outside California to learn whether traveling for in-person evaluation and possible surgery may be appropriate.

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