Link Between Frozen Shoulder and Menopause: What You Need to Know

Last updated 12.05.2023 | by Dr. Karen Pike | 11 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.


Research shows that up to 5% of people will suffer with a frozen shoulder at some point in their lives. Adhesive capsulitis, otherwise known as frozen shoulder, is often associated with getting older, but this common condition can also be connected to menopause.

This painful problem can interfere with your daily life, making simple tasks difficult or even impossible. So, learning how to spot the signs and symptoms of frozen shoulder, and knowing how to treat the problem, is essential. 

I’ve personally suffered from a frozen shoulder, and I’ve met numerous other menopausal women who have also endured the same issue.

However, most of them never connected the dots between their hormones, and their pain and stiffness. After all, when we think about menopause, we tend to imagine symptoms such as hot flashes, mood swings, weight gain, and fatigue; not joint issues such as frozen shoulders. Yet, believe it or not, there is a link.

So, are you a woman of menopausal age who has developed pain and stiffness in one shoulder? Are you wondering what you can do to ease your symptoms? If so, this post is for you.

Below, I’ll explain the connection between menopause and a frozen shoulder. Then, I’ll discuss the best ways to treat the problem so you can get back to living a pain-free, active life once again.

The Connection Between Frozen Shoulder and Menopause

While there’s no evidence that menopause directly causes a frozen shoulder, hormonal changes during menopause can contribute to the condition, and lead to various other musculoskeletal complaints.

Many women notice a sudden onset of pain and stiffness in the shoulder region during perimenopause. In fact, research shows perimenopausal women suffer from frozen shoulders more than any other demographic. Perimenopause is the build-up to menopause, and it’s a time when our hormones are in a constant state of flux.

During this phase of life, estrogen levels begin to drop. And while scientists still can’t find a direct link between these hormonal changes and a frozen shoulder, it’s clear that estrogen plays an important role in our joint health. 

Depleting estrogen can also make a preexisting condition worse. For some women, this type of joint pain may have been an ongoing issue for several years, and the hormonal shifts associated with menopause exacerbate the problem. This was certainly the case for me, as well as many of the women I’ve worked with.

So, I’ve dedicated some of my research to the potential connection between menopause and frozen shoulder and other joint problems. Here’s what I’ve found:

Estrogen Promotes Synovial Fluid

Synovial fluid is a viscous liquid that sits between joints. It lubricates and cushions the bones and stops them from rubbing against each other.

Estrogen is known to boost the production of synovial fluid. So, when estrogen levels begin to fall during perimenopause, this natural lubrication also begins to taper off. This can increase friction and lead to joint problems such as a frozen shoulder.

Estrogen Promotes Collagen

Collagen is a protein produced by the body that supports the health of connective tissues around the joints, keeping them thick, elasticated, and strong.

A decline in estrogen during perimenopause and menopause means that collagen also begins to diminish. As a result, tendons and ligaments may become rigid and weaker, contributing to pain, stiffness, and other classic frozen shoulder symptoms.

A lack of collagen also hinders the body’s ability to repair itself. This can impact the healing process and lead to longer recovery time.

Estrogen is Anti-Inflammatory

Inflammation is the driving force behind all kinds of aches, pains, and illnesses. According to research, a chronic state of low-grade inflammation can directly cause frozen shoulder.

Estrogen is known to have anti-inflammatory effects. During our fertile years, higher levels of estrogen help to keep this inflammation at bay. But when we lose that estrogen during menopause, inflammation increases, and issues such as a frozen shoulder become worse.

Other Contributing Factors

Common menopause symptoms can also contribute to joint pain and stiffness, including:

  • Insomnia

Lack of sleep drives inflammation, reduces our body’s ability to repair itself, and delays healing.

  • Fatigue

When we feel tired, aches and pains are more pronounced, making the discomfort accompanying a frozen shoulder even more challenging to manage. Fatigue also limits physical activity, which is an essential part of maintaining joint health and flexibility.

  • Weight gain

Weight gain is one of the most common symptoms of menopause. A high body mass index (BMI) can exacerbate joint discomfort and put additional pressure on various parts of the body, including the shoulder.

  • Stress

Many women find their stress levels increase during menopause. Both acute and chronic stress can cause muscle tension, inflammation, and pain, making preexisting frozen shoulder symptoms much worse.

Other Causes of Frozen Shoulder During Menopause

So we know that hormones can indirectly lead to frozen shoulder and make a frozen shoulder worse. However, several other potential causes could be to blame, including:

  • Diabetes
  • Overactive or underactive thyroid
  • Reduced mobility due to fracture, strain, surgery, or stroke
  • Scar tissue in the shoulder region
  • A pre-existing injury
  • Parkinson’s disease

When Are the Symptoms of a Frozen Shoulder?

A frozen shoulder usually presents itself as pain, stiffness, and a limited range of movement. It typically affects just one shoulder, and the symptoms can persist for several months or even years.

Personally, I had suffered from occasional stiffness in my left shoulder for several years before I entered perimenopause. The problem would arrive for several weeks at a time, but the pain was mild and manageable, and would soon disappear on its own.

However, once I hit my mid 40s, I developed a full frozen shoulder which interfered with all kinds of everyday tasks, from sleeping, driving, writing, typing, dressing, and even sitting comfortably in a chair. And so, I had to take additional steps to find relief (more on this below.)

The symptoms of a frozen shoulder usually follow a multi stage pattern.

The first symptom to arise is usually pain. You may notice that it gets worse at night, particularly if you lay on the affected arm.

Then, gradually over weeks or months, you may begin to notice stiffness and a limited range of movement alongside the pain.

After several months or even a year, the pain should begin to decrease. However, the stiffness and lack of movement usually remain, and sometimes, it gets worse. You may notice that the muscles on the affected arm become smaller due to underuse.

Eventually, after one to three years, the remaining pain, stiffness, and limited range of movement slowly begin to diminish, and the problem resolves itself.

How to Find Relief from a Frozen Shoulder During Menopause

How to Find Relief from a Frozen Shoulder During Menopause

If you’re suffering from a frozen shoulder during your menopausal transition, there are several things you can do to find relief. Here are some interventions which have worked for me and other women I’ve worked with.

Physical Therapy

Physical therapy is the most commonly prescribed treatment for a frozen shoulder.

Physical therapy for this type of ailment involves a blend of stretching and strengthening exercises to increase mobility and build up the muscle tissue around the shoulder.

A good physical therapist will also give you advice on how to correct poor posture that may be contributing to your problems. Plus, in some instances, they may also prescribe pain relief.

For me, working with a physical therapist was the single most effective intervention which helped to speed up my recovery.

Pain Relief

If the pain of a frozen shoulder is interfering with your daily life, your doctor or physiotherapist may recommend over-the-counter or prescription painkillers.

Anti-inflammatories such as ibuprofen and naproxen are particularly useful for this type of condition as they not only reduce pain but also lower inflammation, which causes stiffness and discomfort.

However, prolonged use of anti-inflammatories isn’t recommended, as they can damage the stomach and the kidneys.

Medications

Aside from the anti-inflammatories mentioned above, your doctor may also prescribe steroids or nerve blockers, which are injected into the affected area. Both of these treatment options can provide temporary yet long-lasting relief. However, they don’t address the root cause of the issue, and the problem is likely to return after several weeks or months.

Diet

A well-balanced healthy diet can dramatically improve the symptoms of joint issues, including frozen shoulder.

Processed foods high in sugar and additives are known to drive inflammation and make the pain associated with it much worse.

Recent research also suggests that gliadin, a type of protein found in cereals and wheat, can also exacerbate symptoms by increasing inflammation in the body[1].

So, cutting out these types of ingredients and switching to whole foods, which are high in protein and healthy fats, can make a big difference.

Calcitonin therapy

Calcitonin is a thyroid hormone that reduces excess calcium buildup in the blood, tissues, and joints. Calcium buildup can exacerbate symptoms of a frozen shoulder and lead to increased pain, inflammation, and stiffness. Recent research suggests that a calcitonin nasal spray which delivers low levels of this hormone can help to reduce frozen shoulder symptoms[2].

Magnesium

Calcitonin isn’t the only thing that can help prevent calcium buildup in the joints. Magnesium also serves the same function, and many of us are deficient in this essential mineral.

Magnesium is an especially important dietary component for menopausal women. That’s because during and after menopause, many of us take calcium supplements and eat a high-calcium diet to stave off osteoporosis. If left unchecked, this excess calcium can worsen joint pain and stiffness. 

Magnesium also helps to relax the muscles which can contract around the shoulder. Plus, it’s also associated with lowered levels of inflammation, and it reduces the body’s sensitivity to pain.

You can boost your body’s magnesium levels by eating a diet rich in beans, seeds, nuts, and leafy green vegetables. If your levels are consistently low, consider boosting your magnesium by taking a high-quality over-the-counter supplement. 

Surgery

If you’re suffering from a severe case of frozen shoulder and you’ve tried all available therapies without success, your doctor may recommend surgery as a last resort. 

A minimally invasive procedure called manipulation under anesthesia is often the preferred method, as it carries less risk than open surgery. When done correctly, manipulation under anesthesia can significantly improve the range of movement in your shoulder and reduce any associated pain.

Shoulder arthroscopy is another commonly used procedure that involves cutting through constricted areas in the joint capsule to release tension and increase the range of movement. This is typically done using very small incisions around the shoulder joint.

In some cases, manipulation under anesthesia and shoulder arthroscopy are used in conjunction with one another to provide the best possible outcome and maximum relief.

FAQs

Can hormone replacement therapy (HRT) treat a frozen shoulder during menopause?

Hormone replacement therapy (HRT) is used to alleviate many different symptoms of menopause. It works by replacing hormones such as estrogen and progesterone that the body no longer produces itself.
Since estrogen has a beneficial effect on joint health, HRT may also improve the symptoms of a frozen shoulder. However, it’s not a first-line treatment for the condition, and this type of therapy carries significant risks of side effects.

Will my frozen shoulder disappear after menopause?

Unlike many of the most common symptoms of menopause such as hot flashes, night sweats, and mood swings, joint issues such as frozen shoulder tend to carry on after the menopausal transition is complete.
However, a frozen shoulder often resolves itself within the space of a year or two, no matter what stage of menopause you’re in. This was certainly the case for me. Now, I experience no pain in my shoulder at all.

Can other joints be affected during menopause?

A dip in estrogen can have a knock-on effect on any joint in your body, not just your shoulder. Other commonly affected areas include the knees, spine, elbows, neck, and hands.

Conclusion

Frozen shoulder is a common ailment that affects many adults. And while it’s not one of the better-known symptoms of menopause, a rapid decline in estrogen can indirectly cause and exacerbate the condition.

If you’re suffering from a frozen shoulder, you’re probably frustrated and eager to find relief. The best course of action is to visit your doctor. They can assess your symptoms and confirm a diagnosis. Then, they can refer you to a specialist or prescribe a treatment plan that can help. 

For more in-depth information about how menopause affects our joint health, take a look at our comprehensive blog post here.

Author

  • Dr. Karen Pike

    Dr. Pike is a senior physician administrator and board-certified emergency room doctor actively working in northern California. She received her undergraduate degree at Dartmouth College, where she graduated Phi Beta Kappa and played collegiate soccer. She attended Georgetown University for medical school and performed her residency in emergency medicine at Stanford University. She was part of the first-ever, women-majority emergency medicine program in United States. Dr. Pike is also the primary medical consultant for “Grey’s Anatomy,” a role she has held since the pilot episode when she partnered with Shonda Rhimes as the show’s original medical consultant. At her hospital, she was the second woman Chief of Staff. Today serves as the Director of the Emergency Department. Whether in leadership or direct patient care, her dedication to excellence in communication, quality, and collaboration is unwavering.