Frozen Shoulder and Menopause: Why It Happens and What Helps

The short answer: Frozen shoulder is most common between ages 40 and 60 and in women, the same years as perimenopause and menopause. Falling estrogen may play a part, but no study has proven it. The condition has three stages and usually improves over one to three years. Gentle movement suited to your stage helps.

• Frozen shoulder (adhesive capsulitis) makes the shoulder painful and stiff. It is most common in people 40 to 60 and happens more often in women than men [1].
• A link with menopause is plausible but unproven. Frozen shoulder is on the list of aches and stiffness proposed as part of the "musculoskeletal syndrome of menopause" [4]. A 2022 study found women not on hormone therapy had higher odds of frozen shoulder, and the authors said more research is needed [6][7].
• There are three stages: freezing (painful), frozen (stiff) and thawing (slowly better) [1]. What helps depends on the stage.
• Most people improve over time. Estimates range from one to three years overall [1][2].
• In a large UK trial, physical therapy with a steroid injection, a procedure under anesthesia and keyhole surgery all worked well after a year [8].
• Chest pressure, trouble breathing, or arm and shoulder pain with sweating need a 911 call, not a shoulder exercise [9].

Possibly, but nobody has shown that menopause causes it.

What we do know is that the timing fits. OrthoInfo, from the American Academy of Orthopaedic Surgeons, says frozen shoulder is most common in people 40 to 60 and occurs more often in women than men [1]. Mayo Clinic says people 40 and older, particularly women, are more likely to develop it [2]. Perimenopause (the years before your periods stop) and menopause fall in the same age range.

Two further pieces of evidence point the same way, and both are limited:

• The "musculoskeletal syndrome of menopause." A 2024 paper in Climacteric proposes this term for a group of muscle, joint and tendon problems that can appear during the menopause transition. Frozen shoulder is on its list [4]. It is a proposed description, not a formal diagnosis. Harvard Health explains the idea in plain language as aches and stiffness that can come with menopause [5]. For the bigger picture, see our guides to musculoskeletal syndrome of menopause and why joints ache in perimenopause.
• A hormone therapy study. At the 2022 meeting of the North American Menopause Society, Duke researchers reported that postmenopausal women on hormone therapy had a lower risk of frozen shoulder than women who did not receive estrogen [6]. The press release describes a study of nearly 2,000 participants, found higher odds of frozen shoulder in women not on hormone therapy, and said the findings support, but do not prove, a protective effect [7]. It was a retrospective study, which can show a link but cannot show cause [6].

The researcher's explanation is that estrogen helps reduce inflammation and maintain connective tissue [6]. That is an idea about why, not something this study tested.

What this means: if you are in your 40s or 50s and your shoulder is getting stiff, menopause may be part of the picture, but it is not the only possible reason. Other things raise risk too, and we cover them next.

No one knows for certain, and age, hormones and other health conditions probably all play a part.

OrthoInfo says the exact cause is not fully understood [1]. The NHS says the cause is often unclear. The tissue around the shoulder joint becomes inflamed, then tightens and shrinks [3]. Here is what the sources say raises the odds:

• Age and sex. 40 to 60, and more often women [1][2].
• Diabetes. OrthoInfo says diabetes raises risk, and is also linked to greater stiffness that lasts longer [1].
• Other health conditions. Thyroid problems (overactive or underactive), Parkinson's disease and heart disease are also linked [1][2].
• Keeping the shoulder still. Mayo Clinic says holding a shoulder still for a long time raises risk. This can follow a rotator cuff injury, a broken arm, a stroke or surgery [2]. OrthoInfo also names immobilization after surgery, fracture or injury [1].
• Injury or surgery. The NHS lists an injury or surgery that limits normal arm movement as a possible trigger [3].

If your shoulder pain began after a fall, a lift or a specific injury, ask about a rotator cuff problem, which can look similar. Our rotator cuff injury page explains the difference. Your provider can examine the shoulder, and may use X-rays, an MRI or ultrasound to rule out other causes [1].

Hormone changes may be one risk factor among several. Having diabetes or a thyroid condition in midlife is a reason to mention your shoulder at your next visit.

Frozen shoulder moves through three stages: freezing, frozen and thawing [1][2].

The two sources do not match exactly, which is normal. Stages blur together, and no two people follow the same timeline. Both sources agree on the big picture: recovery can take one to three years [1][2].

Pain is often worse at night and can disturb sleep [2][3]. Many women in perimenopause already have broken sleep, so a stiff, aching shoulder at night can add to tiredness. If sleep is the main problem, a pillow under the sore arm is a common tip, though it is not from the sources above.

Does frozen shoulder go away on its own?

Usually, yes, over time. The NHS says it can take months or years to get better, and that pain and stiffness usually go away eventually [3]. Mayo Clinic says symptoms usually improve within one to three years [2]. OrthoInfo adds that some people have lasting stiffness, particularly those with diabetes [1]. Treatment is aimed at easing pain and keeping as much movement as possible while the condition runs its course.

Most people are treated without surgery. The main approach is physical therapy focused on flexibility, according to OrthoInfo [1].

• Pain relief. The NHS advises moving gently, avoiding painful movements, and trying paracetamol (acetaminophen) first, then an anti-inflammatory such as ibuprofen if it does not help [3]. OrthoInfo says anti-inflammatory medicines reduce pain and swelling [1]. Check with a provider or pharmacist about what is safe for you.
• Heat. The NHS suggests a heat pack or hot water bottle wrapped in a towel for up to 20 minutes [3]. OrthoInfo says heat may be used before stretching [1].
• Steroid injections. A steroid (cortisone) injection into the joint is an option [1][3]. Your provider can explain the pros and cons.
• Physical therapy. The NHS says physiotherapy usually lasts at least 6 weeks and may include stretching, strength exercises and posture advice [3].
• Procedures. If other treatment does not help, OrthoInfo says surgery may be considered, typically in the frozen stage. Options are manipulation under anesthesia and arthroscopy, often combined. A large injection of sterile fluid (hydrodilatation) may be used if other methods fail [1].

What did the biggest trial find?

The UK FROST trial, published in The Lancet in 2020, randomly assigned 503 adults at 35 UK hospitals to one of three treatments [8]:

1. Structured physical therapy (up to 12 weekly sessions) plus a steroid injection.
2. Manipulation under anesthesia with a steroid injection, then physical therapy.
3. Keyhole surgery to release the joint capsule, then physical therapy.

After 12 months, shoulder function improved in all three groups, and no treatment was clearly better for pain or function. Physical therapy was cheapest, had the shortest wait (about 14 days) and no serious adverse events, but 15% needed further treatment, compared with 7% after manipulation and 4% after surgery. Keyhole surgery had eight serious adverse events [8].

What this means: starting with physical therapy is a reasonable first step, and procedures are options if progress stalls. These were people referred to hospital specialists, and the follow-up lasted one year, so the results may not apply to everyone [8].

What about hormone therapy?

The research so far looks at prevention, not treatment. The 2022 study suggested a lower risk among women on hormone therapy, but the authors said more studies are needed [6][7]. We found no source showing hormone therapy treats frozen shoulder once it starts. Whether hormone therapy is right for you depends on your symptoms and health history, which is a conversation for you and your provider.

Match the effort to the stage: gentle when it is painful, steady stretching when it is stiff, and strengthening when it is loosening.

Two points before you start:

• The NHS advises following the plan your provider gives you, and not inventing your own strenuous exercises, since gym equipment can make pain worse [3].
• The moves OrthoInfo names are a doorway stretch for turning the arm outward, lifting the arm overhead while lying down, and a crossover arm stretch [1]. The reps, holds and stage pairings below are common clinical starting points, not from a trial. Please ask your provider or physical therapist to confirm they suit you.

Freezing stage (painful): keep it moving, stay gentle

1. Pendulum swing. Lean forward with your good hand on a table. Let the sore arm hang loose. Gently sway it in small circles, about 10 seconds each way. Do 2 or 3 rounds, a few times a day. We do not have a pendulum exercise page yet.
2. Crossover arm stretch. Bring the sore arm across your chest and use the other hand to hold it gently at the upper arm. Hold 15 to 20 seconds. Repeat 3 times [1].

Frozen stage (stiff): steady, comfortable stretching

1. Lying arm lift. Lie on your back. Hold the wrist of the sore arm with your other hand and slowly lift both arms overhead, as far as is comfortable. Hold 10 to 15 seconds. Repeat 5 to 8 times [1]. A warm shower or heat pack first can make this easier [1][3].
2. Doorway stretch for turning the arm outward. Stand in a doorway with the elbow of the sore arm bent to 90 degrees and your forearm against the frame. Gently turn your body away until you feel a stretch in the front of the shoulder. Hold 15 to 20 seconds. Repeat 3 times [1].
3. Wall slide. Face a wall with your hands on it at shoulder height, then slide the hands up as high as is comfortable. Hold 5 seconds and slide down. Do 8 to 10 repetitions. We do not have a wall slide page yet.

Thawing stage (loosening): add strength

1. Chest stretch. Opening the front of the shoulder helps posture and reach. See our chest stretch.
2. Thoracic rotation. A stiff upper back makes the shoulder work harder. See our thoracic rotation.
3. Wall scapular push-up. Stand an arm's length from a wall with your hands at shoulder height. Keeping your elbows straight, let your shoulder blades slide together, then push them apart. Do 8 to 10 repetitions. See our scapular push-up and build up from the wall version as it gets easier.

Our strength and mobility guide for menopause and range of motion glossary entry give wider context. Strength training in midlife gets its own guide in our upcoming post on strength training in your 40s and 50s.

Stop if you feel sharp or catching pain, pain that lingers for hours or is worse the next morning, new numbness or tingling down the arm, or chest or breathing symptoms. Back off to an easier version, and check with a provider or physical therapist if it keeps happening.

Kai, Loosn's AI physio coach, can help you pace movement around your own symptoms. It does not replace an assessment if your symptoms are severe, getting worse or unusual.

Loosn is not a diagnosis tool. Shoulder pain can have causes other than frozen shoulder, including problems with the heart.

Emergency: call 911 (or your local emergency number) if [9]:

• you have chest pressure, squeezing or fullness, especially lasting more than a few minutes or coming and going
• you are short of breath, with or without chest discomfort
• pain or discomfort in one or both arms, shoulders, back, neck or jaw comes with nausea, dizziness, a cold sweat or unusual tiredness

MedlinePlus advises calling 911 even if you are not sure it is a heart attack [9].

(Other common emergency numbers are 999 in the UK, 112 across the EU and 000 in Australia.)

Get help right away (emergency department or same-day urgent care) if [10]:

• the shoulder looks out of shape after an injury
• you suddenly cannot move or use the shoulder after a fall or injury
• you have severe pain or sudden swelling after an injury

See a provider soon if [3][10]:

• you have a fever with shoulder pain, or the joint is red, swollen or warm
• pain is severe at night and keeps you from sleeping
• pain is so bad you can barely move your arm or shoulder
• shoulder pain and stiffness are not going away
• pain continues after physical therapy has finished
• you have diabetes or a thyroid condition and your shoulder is getting stiff

Loosn is not a substitute for assessment when symptoms are severe, getting worse or unusual.

Can menopause cause frozen shoulder? 

Possibly, but it is not proven. Frozen shoulder is most common between ages 40 and 60 and in women [1][2], and researchers have linked falling estrogen to joint and tissue changes [4]. One study found women not on hormone therapy had higher odds of it, which does not show cause [7]. Diabetes and thyroid problems also raise risk [1].

How long does frozen shoulder last? 

Often one to three years in total, though it varies. OrthoInfo describes three stages and says full recovery can take up to three years [1]. Mayo Clinic says symptoms usually improve within one to three years [2]. The NHS says it can take months or years, and that pain and stiffness usually go away eventually [3].

Does hormone therapy help frozen shoulder? 

We do not know yet. A study presented in 2022 found women not on hormone therapy had greater odds of frozen shoulder, but the authors said more research is needed [6][7]. No source we read shows hormone therapy treats it once it starts. Whether it suits you is a decision to make with your provider.

What exercises help frozen shoulder? 

OrthoInfo lists three: a doorway stretch for turning the arm outward, lifting the arm overhead while lying down, and a crossover arm stretch [1]. Heat beforehand may help [1]. The NHS says to follow your plan, keep the shoulder moving, and avoid inventing strenuous exercises, since gym equipment can make pain worse [3].

Should I keep moving a frozen shoulder if it hurts? 

Yes, gently. The NHS advises moving the shoulder gently and avoiding painful movements [3], and Mayo Clinic notes that keeping a shoulder still for a long time raises the risk of frozen shoulder [2]. Stay within a tolerable stretch, and ease off if pain sharpens or lingers for hours afterward. That pain rule is a clinical rule of thumb.

When should I see a provider about shoulder pain? 

See a provider if shoulder pain and stiffness do not go away, if pain makes it hard to move your arm, or if pain continues after physical therapy ends [3]. Get help right away after an injury if the shoulder looks out of shape, you cannot use it, or swelling is sudden [10]. Call 911 for chest pressure, trouble breathing or arm pain with sweating [9].

Loosn pairs a short movement profile with a daily check-in and real-time form feedback, so you can pace your shoulder exercises around how you feel. Download the app to get started with Kai, Loosn's AI physio coach, and read how Loosn works. You can also explore our menopause hub.