Frozen Shoulder and Menopause: Why Women in Midlife Are Affected and What Helps

Frozen shoulder (adhesive capsulitis) causes shoulder pain and gradually worsening stiffness. It typically affects people aged 40 to 60, and is more common in women and in people with diabetes. A link with falling estrogen is being studied, but evidence is limited. It usually improves over one to three years, helped by physiotherapy.

How strong is the evidence? Limited for a menopause link. The age and sex pattern, and the benefit of physiotherapy, are well established.

What does frozen shoulder feel like?

It usually develops in three overlapping stages:

Common signs include difficulty putting your hand behind your back, fastening clothes, reaching up, or sleeping on the affected side.

Is frozen shoulder linked to menopause?

Frozen shoulder peaks in the same age range as menopause, and is more common in women, which has led researchers to look at estrogen. The Menopause Society highlighted the first study of this in 2022:

• The Duke University study looked at nearly 2,000 postmenopausal women aged 45 to 60. Frozen shoulder was diagnosed in 3.95% of those using HRT, compared with 7.65% of those not using it.
• It wasn’t a statistically significant difference, probably because of sample size. A follow-up pilot study similarly found non-users had about twice the odds, but again not significantly.

Researchers note that estrogen supports connective tissue and reduces inflammation, but more research is needed. HRT isn’t a recognized treatment for frozen shoulder.

Other risk factors

• Diabetes, type 1 or 2
• Thyroid problems, overactive or underactive
• Heart disease and some other conditions
• Previous shoulder injury or surgery, or periods of immobility
• Dupuytren’s contracture
• Previous frozen shoulder. NHS information notes that about 10% of people later develop it in the other shoulder.

If you develop frozen shoulder, it’s worth checking for diabetes. See recommended health checks.

What else can cause shoulder pain?

• Rotator cuff problems: pain lifting the arm, but movement is often preserved when someone else moves it
• Arthritis of the shoulder
• Bursitis or calcific tendinitis
• Trapped nerve in the neck: pain spreading down the arm, with tingling
• Polymyalgia rheumatica: stiffness in both shoulders and hips, usually over 50
• Referred pain, including, rarely, from the heart or lungs

See joint pain and muscle aches.

What will a clinician assess?

Frozen shoulder is usually diagnosed by examination: both active and passive movement are restricted, especially rotating the arm outward. X-rays or scans may be used to rule out other causes. Blood tests may check for diabetes and thyroid problems.

What treatments help?

• Physiotherapy: exercises to keep the shoulder moving and gradually improve range. NHS information emphasizes staying active and following a physiotherapist’s advice.
• Pain relief: simple painkillers or anti-inflammatories, if suitable.
• Steroid injections: can relieve pain and help you do exercises. They’re usually offered alongside physiotherapy, and aren’t used once only stiffness remains.
• Hydrodistension: injecting fluid, steroid and local anesthetic to stretch the joint capsule. It’s offered in some hospitals.
• Surgery or manipulation: for severe cases that don’t improve.

Practical tips

• Keep moving within your comfort. Gentle, regular movement is better than resting the arm completely.
• Use heat before exercises and cold packs for pain.
• Sleep with a pillow supporting the arm.
• Adapt tasks: use your other arm, wear front-fastening clothes, and keep things within reach.
• Treat poor sleep, which is common with shoulder pain. See sleep problems.

Gentle movements a physiotherapist may suggest

Always check with a physiotherapist before starting, and stay within a comfortable range:

1. Pendulum swings: lean forward, supported by your good arm, and let the affected arm hang and swing gently in small circles.
2. Table slides: sit at a table and slide your hand forward on a towel, then back.
3. Assisted raises: use your good arm to help lift the affected arm, or use a stick.
4. Outward rotation: with your elbow at your side, rotate your forearm outward using a stick held in both hands.
5. Towel stretch: hold a towel behind your back with both hands, and gently pull upward with your good arm.

Little and often, several times a day, usually works better than occasional long sessions.

When should you get help?

Book an appointment if shoulder pain or stiffness lasts more than a few weeks or limits daily activities.

Seek emergency care if you have:

• Sudden shoulder or arm pain with chest pain, breathlessness, sweating or nausea

See a clinician promptly if you have:

• A hot, red, swollen shoulder, or fever
• Shoulder pain after a fall or injury, or you can’t lift your arm
• Stiffness in both shoulders and hips, with morning stiffness, especially over 50
• Arm weakness, numbness or tingling

Questions to ask

1. Is this frozen shoulder, or something else?
2. Should I be checked for diabetes or thyroid problems?
3. Can I be referred to a physiotherapist?
4. Would a steroid injection help at this stage?
5. How long is recovery likely to take?

Related symptoms

Joint pain · Muscle aches · Sleep problems

Frequently asked questions

Can menopause cause frozen shoulder?

It peaks in women aged 40 to 60, and researchers are investigating a link with estrogen, but the evidence is still limited.

Does HRT prevent frozen shoulder?

One study found fewer cases in HRT users, but the difference wasn’t statistically significant. HRT isn’t a recognized treatment.

How long does frozen shoulder last?

Often two to three years, although up to 40% of people have symptoms for longer.

Should I rest my frozen shoulder?

Gentle, regular movement is usually better than complete rest. A physiotherapist can advise.

Can frozen shoulder affect both shoulders?

It can. NHS information notes that about 10% of people later develop symptoms in the other shoulder.

References

1. Duke Health: Hormone therapy appears to reduce risk of shoulder pain in older women
2. The Menopause Society: Press release on hormone therapy and adhesive capsulitis, 2022
3. Pilot study on hormone therapy and adhesive capsulitis. PubMed, 2026
4. North Bristol NHS Trust: Frozen shoulder and hydrodistension (risk factors, recovery)
5. Sherwood Forest Hospitals NHS: Frozen shoulder
6. NHS Lanarkshire: Frozen shoulder

Editorial status: evidence-based educational article. Last evidence check: September 10, 2026.