Frozen shoulder and menopause: is there a link?
Frozen shoulder mostly affects women aged 40 to 60, which overlaps with menopause, and some researchers think falling estrogen plays a part. That link is unproven: the evidence is mostly observational, so treatment focuses on pain relief and getting the shoulder moving.
See a doctor if shoulder pain and stiffness last more than a few weeks or stop you sleeping or dressing. Get help sooner if shoulder pain comes with fever, night sweats, unexplained weight loss, numbness or tingling down the arm, or after a fall. Get emergency help for shoulder or arm pain with chest pain, breathlessness or sweating.
What is frozen shoulder (adhesive capsulitis)?
Frozen shoulder, or adhesive capsulitis, is when the tissue around the shoulder joint becomes inflamed, then stiff and tight. It causes a dull, aching pain and a big loss of movement in all directions.1 Turning the arm outward is often especially hard.1
It affects about 2% to 5% of people. Most are women aged about 40 to 60.1 Everyday tasks like reaching up, fastening a bra or putting on a coat can become difficult.
It is usually described in three phases: painful, stiff, then recovering.1 Recovery can be slow. Newer research suggests movement may not fully return without treatment, and some people never regain full function.1
Is there a link with menopause?
The age pattern has led some experts to suspect a hormone link. Estrogen has anti-inflammatory effects, so losing it could, in theory, make the shoulder capsule more prone to inflammation and scarring.4
The best-known study came from Duke University and was presented at The Menopause Society's (then NAMS) 2022 meeting. It looked at nearly 2,000 women. Those who were not using hormone therapy had greater odds of frozen shoulder than those who were.2,3
This finding needs caution:
- It was a conference presentation, not a full peer-reviewed trial.3
- It was observational: it compared women who already did or did not use hormone therapy. This can show an association, not cause and effect.
- The researchers and The Menopause Society both said more research is needed.2,3
A 2025 review notes that the evidence for an estrogen link rests mainly on associations and on lab and animal studies. Not every postmenopausal woman gets frozen shoulder, so low estrogen alone cannot explain it.4 For now, the menopause link is a reasonable idea, not an established fact.
Known risk factors in women over 40
Most frozen shoulders happen with no clear cause.1 Some conditions make it much more likely:
- Diabetes: people with diabetes are about five times as likely to get frozen shoulder.1
- Thyroid problems: in one study, 27% of people with frozen shoulder had an underactive thyroid, compared with 11% of people without it.1
- Keeping the shoulder still for a long time, for example after an injury or surgery.4
- Autoimmune disease and metabolic problems such as metabolic syndrome.4
A doctor may suggest a blood sugar or thyroid test if you are at risk.1 Frozen shoulder is diagnosed by examination. X-rays are only needed to rule out other problems such as arthritis or a fracture.1
Other conditions can look similar, such as rotator cuff problems or a trapped nerve in the neck.1 General aches can also come from menopause joint pain.
Treatment options
Experts are still not sure which treatment works best. Many people do best with a combination.1
- Pain relief: anti-inflammatory painkillers are widely used, though evidence specific to frozen shoulder is thin.1
- Steroid injection into the joint gives better short-term pain relief than placebo, especially early on.1,2
- Physiotherapy: hands-on mobilization with exercises has fair evidence for improving movement. It may work better combined with an injection.1
- Hydrodilatation: injecting fluid to stretch the joint capsule. Small trials suggest it can speed recovery.1
- Surgery: manipulation under anesthesia or keyhole release may be considered if pain and stiffness stay severe after several months.1
Hormone therapy is not a treatment for frozen shoulder. Whether it lowers the risk is not known.2,3
What helps: options rated
| Option | Evidence | What the research shows |
|---|---|---|
| Steroid injection into the shoulder | Better than placebo for short-term pain relief in trials; long-term results vary.1 | |
| Physiotherapy (mobilization and exercise) | Fair evidence for improving movement and function; may work better with an injection.1 | |
| Hydrodilatation | Small randomized trials suggest faster recovery, mainly in the first three months.1 | |
| Manipulation or keyhole surgery | Moderate evidence for reducing pain and improving movement in people who do not improve with other care.1 | |
| Anti-inflammatory painkillers (NSAIDs) | Commonly used for pain, but there is little frozen-shoulder-specific evidence.1 | |
| Hormone therapy (HRT) to prevent frozen shoulder | One observational study presented at a 2022 conference linked hormone therapy use with lower odds. It is unproven, and HRT is not prescribed for this.2,3 |
Ratings explained: how we rate. Always talk to a doctor or pharmacist before starting a medicine or supplement.
Related
Sources
- Adhesive capsulitis: diagnosis and management, American Family Physician (2019)
- Hormone therapy may help prevent frozen shoulder (press release), The Menopause Society/NAMS (2022)
- Hormone therapy may prevent shoulder pain and loss of motion in menopause, Contemporary OB/GYN (2022)
- Navarro-Ledesma S. Frozen shoulder as a systemic immunometabolic disorder: the roles of estrogen, thyroid dysfunction, endothelial health, lifestyle, and clinical implications, Journal of Clinical Medicine (2025)