Diaphragmatic endometriosis is a rare form of endometriosis where tissue that resembles the uterus lining grows on the diaphragm.

The diaphragm is the dome-shaped sheet of skeletal muscle that separates the abdomen from the chest and allows a person to breathe. When endometriosis affects the diaphragm, symptoms may include chest, shoulder, and neck pain.

In this article, we look at an overview of this condition, including its symptoms, complications, and the treatment of diaphragmatic endometriosis.

Is Diaphragmatic Endometriosis Common?

Diaphragmatic endometriosis is extremely rare. An estimated 0.6 to 1.5 percent of those who undergo surgery for endometriosis have this form. More usually, endometriosis affects the pelvic organs and structures close to the uterus.

Endometriosis is estimated to affect between 6 and 10 percent of women of menstruating age. Estimates are difficult, though, because some women who have no symptoms may never receive a diagnosis. Other women are suspected to have it based on symptoms, but may not have the diagnosis confirmed.

Symptoms

As well as discomfort and stiffness, the condition primarily causes pain, often described as a dull ache. The pain usually becomes worse at certain times of the menstrual cycle.

According to a 2007 study which looked at symptoms in 47 women, diaphragmatic endometriosis occurred only on the right in 66 percent of women, bilateral in 27 percent, and on the left in 6 percent.

Symptoms include:

• chest pain and stiffness
• shoulder pain and stiffness
• neck pain and stiffness
• difficulty breathing or a bloody cough in severe cases

Symptoms are usually worse during or before menstruation. This may be because the glands producing growth respond to reproductive hormones, meaning they cycle and shed along with normal endometrial tissues.

Symptoms of endometriosis affecting the pelvic organs include:

• pelvic pain
• pain in the lower back and abdomen
• pain during or after sex
• heavy, painful periods
• pain when going to the bathroom
• feeling extremely sick and fatigued

Fertility and Pregnancy

Diaphragmatic endometriosis often occurs with other kinds of endometriosis, which can sometimes result in difficulty becoming pregnant or infertility.

Surgery to remove tissue interfering with pregnancy may help increase the chances of conception.

Hormone therapies can help reduce the symptoms of endometriosis, but they cannot reverse infertility.

There may be a greater chance of pregnancy through in vitro fertilization (IVF), especially after surgery.

Complications

One complication of diaphragmatic endometriosis is an inability or difficulty becoming pregnant.

The surgical procedures used to treat endometriosis are associated with health risks, as with all surgeries.

Complications associated with endometriosis surgeries include:

• bleeding
• bruising
• infection
• organ or tissue damage
• regrowth of abnormal tissues
• blood clots in the legs or lungs

Diaphragmatic endometriosis may cause additional complications in very rare cases because of the role the diaphragm plays in breathing.

Additional complications include:

• restricted breathing
• collapsed lung
• fluid, blood, or air in the chest cavity

Endometriosis may also contribute to someone developing depression, as a symptom is a form of chronic pain. In these cases, a doctor may suggest a counselor or support group.