Is frozen shoulder more common in menopause?

Struggling with a niggling shoulder pain that just won’t shift? While we may assume that it’s down to poor posture, lifting something heavy or sleeping in an awkward position, our hormones could be to blame.

Menopause is notorious for symptoms like hot flushes and bad sleep, but many women also experience a condition called frozen shoulder.

While research is limited, studies show that post-menopausal women on hormone replacement therapy have a lower risk of developing the condition compared to those who aren’t taking HRT.

But it’s not something we simply have to accept as part of ‘getting older’. Here, Helen O’Leary, a physiotherapist at Complete Pilates, explains the options available.

What is frozen shoulder?

Put simply, frozen shoulder is caused by inflammation of tissue around the shoulder joint.

“This tightens and limits movement,” explains Helen. “It can go away on its own, but it could last anywhere between six months and two years.”

It’s a condition that can also be incredibly painful.

“At the more severe end of the spectrum, it can lead to difficulties with everyday activities like brushing and drying hair and getting dressed,” adds Helen.

How can I tell if I have frozen shoulder?

As Helen explains, it can often be tricky to pinpoint.

“Frozen shoulder can present with similar symptoms to other problems such as rotator cuff related pain,” she says.

A common symptom is pain down the outside of your arm that gets worse when you lift your arm overhead, out to the side or behind your back. You might also notice it when sleeping on your back.

“One of the biggest signs that points towards frozen shoulder is a loss of range in external rotation,” Helen adds. “Stand with your elbows tucked into your sides, as if you’re holding a tray in front of you. Without moving your elbows, move your forearms out to the sides. If this movement is more restricted on one side, you might be dealing with frozen shoulder.”

Seeing your GP or a physiotherapist can help to get a clear picture of what’s going on.

Why are menopausal women prone to frozen shoulder?

It may come as no surprise that hormonal shifts are to blame. Fluctuations during menopause can impact every part of the body, including joints and muscles.

“Falling oestrogen levels can lead to a reduction in extensibility of the collagen that makes up the joint capsule,” Helen explains. Lower levels of oestrogen can also lead to inflammation around the joint.

“Oestrogen helps with blood circulation to the soft tissues, and so falling levels could impair blood supply,” Helen says. “There may also be a link with blood sugar levels – frozen shoulder is more common in diabetic people, and following menopause, there is often a slight rise in blood glucose, and increased insulin resistance. All these things may combine to increase the risk.”

Can taking HRT help?

It depends on the root cause. If lower oestrogen levels are to blame, HRT may indeed help. A small study published in 2023 found that women not taking HRT had a higher chance of developing frozen shoulder, compared to women taking it.

“More research is needed, but in theory, women who take HRT, may be preserving their oestrogen levels, thereby having a protective effect against frozen shoulder,” says Helen.

What should you do if you think you have frozen shoulder?

If you’re struggling with shoulder pain, it’s important to see a professional as soon as possible.

“Don’t wait to see if it goes away,” says Helen. “Early identification is key.”

The good news is that there are a number of treatment options available. This might be with a steroid injection, or pain relief. There’s plenty you can do at home, too.

“Ice and heat packs can be really helpful too,” Helen says. “Ice will help a painful, inflamed shoulder, where heat may make it easier to do stretches for increasing your movement.”

Certain exercises may help with easing pain, but it’s wise to work with a professional to avoid aggravating symptoms.