Why frozen shoulder is so common during menopause, and what helps

Shoulder pain that creeps in, stiffens up, and lingers for months? 

If you’re in your 40s or 50s and struggling with limited shoulder movement and discomfort, especially at night,you might be dealing with frozen shoulder, a condition that tends to strike during the perimenopause and post menopause years.

Despite being relatively common, frozen shoulder remains poorly understood. But growing evidence suggests hormonal changes in perimenopause and menopause may play a role.

What is frozen shoulder?

Frozen shoulder, also called adhesive capsulitis, occurs when the capsule of connective tissue surrounding the shoulder joint becomes inflamed, thickened, and tight. This limits movement and causes persistent, often worsening pain.

Common symptoms include:

• Sharp pain at night, disturbing sleep
• Difficulty reaching behind (e.g. fastening a bra or seatbelt)
• Struggling with overhead tasks like hanging up washing
• Stiffness when getting dressed or brushing hair

Neck tension and headaches are also common, as nearby muscles work overtime to compensate for the lack of shoulder mobility.

Why does it happen around menopause?

Women aged 40–60 are most commonly affected - up to four times more likely than men. This peak overlaps with perimenopause and menopause, pointing to a hormonal connection.

Hormones like oestradiol, progesterone, and testosterone support joint lubrication, connective tissue integrity, and inflammation regulation. When these levels drop in midlife, joints may become more prone to stiffness, inflammation, and injury.

Other triggers and risk factors

Other known risk factors include:

• Thyroid disorders
• Diabetes (type 1 or 2)
• Previous shoulder injury or surgery
• Stroke
• Asian ethnicity

Often, frozen shoulder appears with no clear cause and typically affects one side at a time, though it may occur in the opposite shoulder later on.

What does recovery look like?

Frozen shoulder develops in stages:

1. Freezing phase – Pain builds and movement decreases
2. Frozen phase – Pain may ease, but stiffness remains
3. Thawing phase – Movement gradually returns

This full cycle can take 12 to 36 months. Some recover sooner, but for others, especially during menopause, it can take longer to fully resolve.

Getting a diagnosis

There’s no single test. Diagnosis is made through:

• A detailed medical history
• A physical examination, typically showing restricted range of motion
• Imaging (X-ray or ultrasound) to rule out other causes

What can help?

The NHS recommends a three-step approach:

1. Pain relief – Paracetamol or ibuprofen and rest from aggravating movements
2. Medical support – Steroid injections or prescription medication, if needed
3. Physiotherapy – Tailored stretching and strengthening exercises

Note: Avoid pushing through the pain in early stages, it can make inflammation worse. A physiotherapist can guide you safely through recovery.

Supporting recovery from within

Research increasingly shows that gut health plays a role in regulating inflammation, which may affect joint conditions like frozen shoulder. A healthy gut microbiome supports hormone metabolism and immune responses, both of which are essential during menopause.

Better Gut is a probiotic formulated specifically for women in midlife. It’s designed to support a balanced microbiome, which may help ease systemic inflammation and support overall joint and hormone health.

Final thoughts

Frozen shoulder can be slow to heal, but with the right support—pain relief, movement therapy, and internal balance—most women regain full function.

If you're noticing unexplained shoulder pain or stiffness during midlife, don’t ignore it. Gentle, consistent care and support can make a significant difference to your recovery and overall wellbeing.

Sources

1. NHS. Frozen Shoulder
2. Kelley MJ et al. Shoulder pain and mobility deficits: adhesive capsulitis. J Orthop Sports Phys Ther. 2013;43(5):A1-A31.
3. Hsu JE et al. Current review of adhesive capsulitis. J Shoulder Elbow Surg. 2011;20(3):502-514.
4. Zuckerman JD et al. Frozen shoulder: a consensus definition. J Shoulder Elbow Surg. 2011;20(2):322-325.
5. Clarke G et al. Gut microbiota: the neglected endocrine organ. Mol Endocrinol. 2014;28(8):1221-1238.