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Thoracic Endometriosis
Cyclical Chest Symptoms — Investigation & Treatment, London

If you experience chest pain, breathlessness, or a collapsed lung that occurs cyclically — around the time of your period — you may have thoracic endometriosis. An underdiagnosed condition investigated thoroughly and treated in close collaboration with specialist gynaecologists. Diagnostic delay of over 5 years is common. Cyclical chest symptoms page →

Last reviewed: April 2026 · Dr Lawrence Okiror FRCS(CTh) FRCSEd(CTh) · GMC 6150382

Condition

Thoracic endometriosis — endometrial tissue present in the chest cavity, most often on the diaphragm or pleura. Symptoms occur cyclically with the menstrual cycle: chest pain, breathlessness, or collapsed lung

Key presentation

Catamenial pneumothorax — a collapsed lung recurring around menstruation. Frequently misdiagnosed as ordinary spontaneous pneumothorax. Should be suspected in any woman with recurrent PTX

Treatment

Keyhole surgical removal of endometrial deposits combined with gynaecological hormonal suppression. Diaphragmatic defect repair and pleurodesis where indicated. Thoracic and gynaecological specialist collaboration

What is Thoracic
Endometriosis?

Endometriosis is a condition in which tissue similar to the lining of the womb grows in other parts of the body. When this occurs in or around the chest — including on the diaphragm, the pleura (lung lining), or within the lung itself — it is known as thoracic endometriosis.

Because the endometrial tissue responds to the same hormonal changes as the womb lining, symptoms typically occur in a cyclical pattern — appearing around the time of menstruation and improving between periods. This cyclical pattern is one of the most important diagnostic clues, and is often overlooked for many years. A BJOG 2024 study found diagnostic delay of over 5 years is common. Cyclical chest symptoms page →

Thoracic endometriosis is rare but likely underdiagnosed. Dr Okiror works closely with specialist gynaecologists at GSTT to ensure both the thoracic and gynaecological aspects of the condition are comprehensively managed.

Book a Consultation →
Symptoms that may indicate thoracic endometriosis
  • Chest pain occurring around the time of your period
  • Breathlessness that is cyclical or worsens at certain times of the month
  • Coughing up blood (haemoptysis) linked to menstruation
  • Recurrent pneumothorax (collapsed lung) around the time of your period
  • Known diagnosis of endometriosis with unexplained chest symptoms
A collaborative approach to care

Thoracic endometriosis requires both a thoracic surgical and a gynaecological perspective. Dr Okiror works alongside specialist gynaecologists at GSTT to ensure a comprehensive assessment and treatment plan — addressing both the chest manifestations and the underlying endometriosis together. This joined-up approach leads to better outcomes and reduces the risk of recurrence.

How is it investigated?

Investigation includes a detailed history, CT and MRI imaging, and in some cases bronchoscopy or thoracoscopy. Timing symptoms carefully in relation to the menstrual cycle is essential. Diaphragmatic endometriosis →

Questions About
Thoracic Endometriosis

Questions from patients investigating cyclical chest symptoms. See also the cyclical chest symptoms page → and pneumothorax page →

Book a Consultation →

Or call Jo Mitchelson:
020 7952 2882

How do I know if my chest symptoms could be thoracic endometriosis?
The key indicator is cyclical timing — symptoms that appear around menstruation and improve between periods. If you have chest pain, breathlessness, or a collapsed lung that follows this pattern, particularly if you have a known diagnosis of endometriosis, thoracic endometriosis should be investigated. A consultation with a detailed history is the important first step.
I have endometriosis — should I be worried about chest symptoms?
Not all chest symptoms in women with endometriosis are thoracic endometriosis — but if your symptoms are cyclical, they absolutely warrant investigation. Many patients with thoracic endometriosis have waited years for a diagnosis. An early and thorough assessment means earlier, more effective treatment.
What does treatment involve?
Treatment depends on the extent and location of the endometriosis. Options include hormonal medical therapy, keyhole surgical removal of endometrial deposits from the diaphragm or pleura, repair of diaphragmatic defects, and pleurodesis to prevent recurrent pneumothorax. Dr Okiror works with gynaecological colleagues to decide on the best combined approach for each patient.
Can thoracic endometriosis cause a collapsed lung?
Yes — catamenial pneumothorax (a collapsed lung occurring around menstruation) is one of the recognised presentations of thoracic endometriosis. It occurs when endometrial tissue creates holes in the diaphragm, allowing air to pass from the abdomen into the chest. Surgical repair of these diaphragmatic defects, combined with pleurodesis, is highly effective. Pneumothorax page →
Do I need a GP referral?
No. Self-referrals are welcome for private consultations. Appointments are typically available within 2–3 days. If you have been experiencing cyclical chest symptoms and would like a specialist opinion, please do get in touch — even if you are not sure whether your symptoms are related to endometriosis.

Book a Consultation

Appointments within 2–3 days. Self-referrals welcome. Surgery at London Bridge Hospital and Lister Hospital Chelsea.

Book a Consultation →

Jo Mitchelson, Private PA  · 020 7952 2882 · pa@lungsurgeon.co.uk

St Thomas' Hospital #1 UK · Guy's Hospital #2 UK · London Bridge Hospital #10 UK · Newsweek World’s Best Hospitals 2026

Related Conditions & Pages

Pneumothorax

Collapsed lung — including catamenial pneumothorax caused by thoracic endometriosis

Diaphragm Surgery

Diaphragmatic endometriosis — specialist surgical and gynaecological condition

Cyclical Chest Symptoms

Chest pain or breathlessness linked to the menstrual cycle — symptom entry point

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