Frozen Shoulder and Menopause

If you’re a woman in midlife and feel a constant dull ache in your shoulder, or the joint locks up with stabbing pain when you try to raise your arm, it could be menopause at work. Frozen shoulder affects women at two to four times the rate of men, and studies show it’s most common during perimenopause and the years that follow.

Frozen shoulder can restrict your mobility, making everyday movements like reaching for your glasses or leashing your dog painful—and sometimes impossible. “As soon as I raised my arm any higher than shoulder height, I’d feel a sharp, electric ‘zing’ that radiated from my shoulder down my entire arm,” says Tracy, who developed frozen shoulder when she was 45. “It was like someone zapped me with a cattle prod.”

The exact causes of frozen shoulder are still somewhat of a mystery, but because it primarily impacts women between 40 and 60, experts believe there’s likely a link to the decline of hormones like estrogen during the menopause transition.

We explore the reasons lower levels of estrogen might trigger frozen shoulder during menopause, plus expert-recommended treatments and ways to feel better.

What Causes Frozen Shoulder in Menopause?

Frozen shoulder is the #1 cause of shoulder pain in perimenopausal women and women in the first decade of menopause, says orthopedic surgeon Jocelyn Wittstein, M.D. It’s considered a symptom of the musculoskeletal syndrome of menopause, a constellation of muscle, bone, and joint issues tied to declining estrogen levels.

What is frozen shoulder?

Frozen shoulder is a condition in which the shoulder joint experiences stiffness and a restricted range of motion, with pain that can range from a dull ache to a sharp stab.

Also known as adhesive capsulitis, frozen shoulder affects the shoulder capsule, a layer of connective tissue that surrounds the joint.

When frozen shoulder develops, here’s what happens:

• The shoulder capsule tissue thickens and tightens, sometimes forming bands of scar tissue called adhesions.

• The amount of lubricating synovial fluid in the joint decreases.

• The combination of scar tissue and minimal synovial fluid results in stiffness and a noticeable loss of movement.

  
  

Hormone fluctuations, menopause, and frozen shoulder

Although the exact role declining estrogen plays in the development of frozen shoulder is unclear, preliminary research by Wittstein and her fellow researchers at Duke University found that women who used hormone replacement therapy (HRT) were half as likely to get frozen shoulder as those who didn’t. While the difference wasn’t great enough to draw definite conclusions, it’s a promising finding that should spur larger investigations.

“Estrogen plays a role in stimulating bone growth, reducing inflammation, and promoting connective tissue integrity,” Wittstein explains. Declines in estrogen allow fibroblasts, cells that make the shoulder joint thicker and less flexible, to proliferate. Less estrogen also means more inflammation.

Signs of Frozen Shoulder

Frozen shoulder often starts as stiffness and pain that gradually worsens over time, restricting your range of motion.

It presents in three phases:

Freezing (one to nine months): During this initial inflammatory phase, the shoulder is stiff, and pain gradually increases. Pain might be worse at night, due to positioning difficulty.

Frozen (up to six months): As the joint lining becomes thick and fibrotic (stiff), the shoulder may hurt less, but it is very stiff, restricting range of motion and interfering with normal activities.

Frozen (up to six months): As the joint lining becomes thick and fibrotic (stiff), the shoulder may hurt less, but it is very stiff, restricting range of motion and interfering with normal activities.

Thawing (six months to two years): As the shoulder gradually loosens, pain starts to recede, and range of motion begins to return, eventually going back to normal.

Each stage of frozen shoulder during menopause can last months or even longer. “The whole process can take several years to resolve,” says Wittstein.

Does Estrogen Help Frozen Shoulder?

There are estrogen receptors in the lining of the shoulder joint, and we know that estrogen reduces inflammation, but the data isn’t yet clear on whether estrogen can help treat frozen shoulder. “I think time and more data will prove that estrogen therapy reduces risk and helps with frozen shoulder,” says Wittstein. “There is a lot of basic science to suggest it should. Estrogenblocking agents have been shown to increase joint inflammationin animal studies, and administration of estrogen has been shown to reduce inflammation.” In human studies, menopausal women who took hormone therapy had less joint pain, which returned when the hormones were stopped, she says.

Wittstein’s own preliminary research suggests hormone replacement therapy (HRT) may protect against the condition. Her observational study of 2,000 women between the ages of 45 and 60 found that less than 4 percent of those who had received hormone replacement therapy were diagnosed with frozen shoulder, while nearly 8 percent of women who hadn’t received HRT developed the condition.

A 2025 study in rats offers some clues to how estrogen may be protective. It found that estradiol helped prevent and even reverse fibrosis and scar tissue associated with frozen shoulder.

How to Treat Frozen Shoulder in Menopause

In its early stages, frozen shoulder treatment during menopause is usually focused on pain relief, and often includes a combination of approaches:

• Hot and cold compresses to reduce pain and swelling

• Pain relievers like NSAIDs or acetaminophen to ease discomfort

• Transcutaneous electrical nerve stimulation (TENS), which blocks nerve impulses and reduces pain

• Corticosteroid injections to reduce inflammation, pain, and stiffness in the shoulder capsule

“If treated within a few months of the onset of symptoms and before the shoulder freezes up, a steroid injection can completely reverse and cure the condition in a matter of a week,” says Wittstein. “Occasionally, symptoms recur and a second injection is needed.”

Once you reach the “frozen” phase and are no longer in pain, physical therapy or Pilates can help increase range of motion, says Wittestein. (During the early, inflammatory phase, however, physical therapy can increase inflammation and pain in a frozen shoulder, she says.)

In more severe cases of frozen shoulder, a surgeon can manipulate the joint while the patient is under anesthesia to restore range of motion sooner.

The Bottom Line

Evidence strongly suggests a link between estrogen decline in menopause and the risk of frozen shoulder, a condition that causes pain and stiffness and can last for months or years. Although early studies are promising, it’s unclear if HRT is safe and effective for frozen shoulder. For now, heat and ice, pain relievers, steroid injections, and physical therapy are the go-to treatments.