Frozen shoulder is a common, and extremely painful condition that both women and men are more prone to. However, frozen shoulder is 4x more common in women! And, it’s most common amongst women that are midlife and in the age range of 40-60.
That age range is significant to take note of. Because the 40-60 year old time period is the peak perimenopause to menopause to postmenopause transition time.
What is Frozen Shoulder?
Frozen shoulder otherwise known as adhesive capsulitis is a condition that can cause pain, stiffness and restriction in the capsule of the shoulder joint. It usually develops slowly, over time in the range of 1-3 years. And can affect one or both shoulders. Often at different times.
Symptoms of frozen shoulder can be:
- Dull or aching pain
- Sharp pain
- Stiffness
- Changes in range of motion
- In ability to fully raise the arm
- Sleep disruption or an inability to sleep due to pain
Generally speaking if you search traditional medicine circles about frozen shoulder there isn’t a lot of information about why it happens. Even the Mayo Clinic and Harvard state that it’s not fully understood why frozen shoulder happens.
Yet.. I think this is a big miss.
Keep reading, and I’ll explain.
We need to start with a bit of context around the midlife stages of a woman’s life first.
What are perimenopause, menopause and postmenopause?
Let me diagram it out a bit. I think it’s easier to understand with bullet points.
- Perimenopause – is anywhere from 4-10 years.
It usually happens in our mid 40’s, but it can happen earlier. This is 4-10 Years of estrogen and progesterone hormones that are rapidly declining. Testosterone may decline as well but it is usually slower to do so. This stage of life can cause us to feel off and not ourselves (to say the least). It can also bring up a long list of uncomfortable symptoms. - Menopause – is 1 day.
It is the day after a year of not cycling. So technically it’s day 366 of no-cycles. The average woman goes through Menopause at age 51. Again, this is average, some women go through it earlier, and some later. - Postmenopause – is day 367 and beyond.
So, to clarify further, that is one year of no-cycles, plus a day for menopause, and then we are postmenopause the rest of our lives.
What happens to our hormones during perimenopause, menopause and postmenopause?
When we go through the stages of perimenopause, menopause and postmenopause our body is shutting down its reproductive function. The millions of eggs we were born with have been used. And the process of releasing eggs is coming to an end.
When we stop releasing eggs, our progesterone production goes down dramatically. Because our progesterone production comes from the sack of the egg, called the corpus luteum.
Also during this time period, our cycles are also coming to an end. And our hormones are declining to deficient stages. This is a really key point, so I want to say it again. Our hormones are declining to stages of deficiency.
When our hormones decline to deficient stages, they lower to what will be a minimal state (unless we replace them, like with bioidentical HRT).
What effect does the loss of hormones have on our body?
When our hormones lower to deficient levels it affects our tissues, skin and hair. It also affects our brain, and cognitive health. Our bone and tooth health. It affects our cardiac health. Our bladder health. And our vaginal tissues which become less lubricated, thinner, dryer, and less elastic (remember this point).
Estrogen is anti-inflammatory and without it our body can move to a more inflammatory state.
The loss of estrogen, progesterone and testosterone affects our muscles, tendons, and connective tissues. These tissues are less supple, less elastic and less lubricated without hormones.
This can cause muscle pain, joint pain, muscle elasticity issues. And joint issues like frozen shoulder.
There is a new name for these conditions coined by Dr. Vonda Wright, whom I really respect, and it’s called Musculoskeletal Syndrome of Menopause.
The loss of hormones affects everything in our body.
Our hormones nourish and satiate every cell in our bodies.
So why do women get frozen shoulder in perimenopause, menopause or postmenopause?
When we enter perimenopause our estrogen and progesterone hormones are declining to deficient stages. Testosterone also will decline but of the three it is usually the last to decline, and for most women stays fairly steady through perimenopause, and maybe even menopause and postmenopause. Of course only testing can tell us what our levels truly are.
Our hormones nourish and hydrate our muscles, and connective tissues. When those hormones are no longer robust it can leave our tissues thirsty.
I believe it’s the loss of hormones that can cause frozen shoulder and musculoskeletal pain.
I’ll use a car engine analogy. It’s as if the engine has lost its lubrication fluids, and due to the loss of fluids, the moving parts are less flowing, flexible and moveable. And some may even seize up.
This is how frozen shoulder can happen.
My Own Frozen Shoulder and Muscle Pain Story
I wish I would have known the hormone deficiency connection when I went through frozen shoulder during the height of my perimenopause.
Five physical therapists later, I was still dealing with excruciating shoulder pain, and couldn’t raise my arm above my head. When I reached the end of my sessions with my 5th PT and was still in pain, the PT tried to gas light me, and tell me I wasn’t in pain. I still don’t quite understand his reaction.
I was also recommended to a surgeon that wanted to cut something out of my shoulder capsule, but didn’t have a lot to say about what the recovery and future for my shoulder would be. This didn’t offer me enough confidence, security or clarity, and I opted out of that.
Sheesh we need practitioners that see and hear us, don’t we?
Later, when I went through the perimenopause to postmenopause transition, I also gained excruciating back and muscle pain.
I started working with a lovely Integrative Physical Therapist, who was a beautiful advocate for women. She focused on the root cause of the pain issue I was dealing with. Yet, as we initially worked together, the exercises we did often left me in more pain hours later. Which of course was very confusing.
We came to figure out that my muscles and tissues had essentially lost their suppleness and stretch. Which left them like a piece of elastic that would stretch, but didn’t rebound and recover. So when I did stretch them, I would then have rebound pain that came a couple hours later as my tissues tried to return to their “resting” state.
As we tried to dig deeper, we shifted to doing craniosacral work along with somatics, which helped to quiet my tissues.
During this time, I had also begun a change with my Hormone Replacement Therapy. I chose a new method of HRT that would optimize my hormone levels so that I would get the best brain, bone and heart protection for myself. With this method, we also regularly tested my hormone levels, and continued to work towards optimization.
Prior to this, I had been prescribed the traditional “minimally dosed HRT” method. But I had been studying HRT with incredible mentors, and knew there was a different way that would support my body and my longevity on a much deeper level. I had spoken to my current practitioner about the optimal HRT that I wanted to switch to, but she wouldn’t discuss it with me. She also wouldn’t test my hormones even though I repeatedly asked for testing. And she let me go for 2 years with uncomfortable and embarrassing leaky bladder symptoms that I discussed at every appointment without addressing them. Leaving me to believe there wasn’t a solution, when there was.
I recognized this partnership was not working for me, and changed HRT providers. I found a practitioner that helped me with the optimized HRT that I wanted that support my brain, heart and bone health. This practitioner tested my hormones. And she listened to all of my concerns and addressed them.
But that’s not all this bioidentical optimizing HRT protocol did.
When my hormone levels were on their way to being optimized, my tissues began to change. It took about a year, and by the time my hormone levels were optimized my pain was down 90% and my frozen shoulder had resolved.
I clearly had Musculoskeletal Syndrome of Menopause.
But all of the practitioners I saw along the way, were not aware of this condition.
And could not figure out the excruciating pain I was dealing with.
Through trial and error, a practitioner willing to listen and explore, me being my own advocate, and paying attention to the changes in my body once my HRT was fully on board helped me to figure out what was happening.
My shoulder pain is totally gone. And back pain is mostly gone now. It comes back once in a while when I am more stressed and haven’t worked on my tissue softening practices.
Our bodies are the biggest truth tellers, sometimes we just have to be taught how to listen to them.
Why don’t we talk about frozen shoulder being related to perimenopause?
This is a really important question, and one as women we need to keep asking.
Here are some of the main reasons I think we don’t:
- Medical studies have been primarily focused on men.
- The medical community only began studying women in the late 80’s, but more so in the 90’s.
- There is only a snippet of education in medical school on menopause.
- There are very few studies done on menopause.
- The more prominent studies that were done on menopause and HRT caused decades of misinformation and misunderstandings around safety.
- There is still a vast amount of misinformation around midlife due to lack of study.
So let’s add all of that up… very few studies, very little education, misinformation… and I would argue that if we are rarely studying women, then we are not studying midlife women, which means we are not studying menopause.
You can read more about the misinformation around perimenopause in my “What is Perimenopause?” article.
Now… the good news is that perimenopause and menopause are getting a moment. Which is helping us now more than ever. And there are some prominent practitioners that are doing more education around menopause.
And… some are excellent!
And… some are still repeating and regurgitating outdated information and misinformation. Like my prior practitioner, who was well known in my community! But still using old school – fear based methods of support. Did I mentioned she even shamed my questions in front of her intern in my last appointment? Yikes!
So please be mindful about where you get your information and who you choose to support you. And if it doesn’t feel like a good fit. Trust your intuition. Move on, because you deserve an equal partner in your practitioner.
How do we resolve a frozen shoulder?
First, if you are dealing with frozen shoulder, I definitely feel for you.
I know how excruciating this can be.
Your inclination may be not to move your arm, but actually this can make it worse.
I recommend an Integrated Physical Therapist. An integrated PT looks at the whole body, the root cause and addresses issues from a broad spectrum, rather than just the pain and that specific location.
Exercises that focus on range of motion can be really helpful. I am not a PT, nor am I massage therapist or an acupuncturist but I can tell you that all of these practices helped me. I am a yoga teacher and trained in a variety of somatics and stress reduction practices so these are also practices that helped me, and that I bring in with my clients.
Below are the practices that I have found that have helped me with my frozen shoulder, and back pain caused by Musculoskeletal Syndrome of Menopause.
Let me highlight that stress reduction is a key factor to softening our tissues and helping.
So let’s start with a list of practices that focus on stress reduction that may help with the pain and stiffness of tissues.
- Stress reduction & trauma work – Talk therapy, EMDR, etc
- Somatic practices
- Craniosacral therapy
- EFT Tapping
- Massage
- Acupuncture
It’s also key to reduce inflammation in the body. I am not suggesting adding in a bunch of anti-inflammatory medications when I say this. Instead focus on daily practices that are anti-inflammatory.
Here is a list for you:
- Anti-inflammatory nutrition – whole foods, ample protein, antioxidant fruits, and veggies are best for this.
- Omega-3’s are anti-inflammatory, and help to reduce pain in muscles and joints. Please don’t skimp on your supplements. Skip the big box stores, as there are many fillers and additives, and just plain junk in these. Instead purchase therapeutic grade. Here is a link to my favorite: You can save 15% if you order through this dispensary.
- Magnesium Glycinate is also helpful for both stress reduction as it’s calming to the body, it supports our heart health, and it supports the softening of our tissues. Here is a favorite of mine. You can save 15% through my dispensary.
- Optimized Bioidentical Hormone Replacement Therapy / BHRT or HRT (don’t use synthetic HRT) can be safe for most women. Please make sure you are getting a deeply informed and educated practitioner.
Lastly here are some movement practices that may help.
- Stretching
- Yoga
- Qigong
- Pilates
- Resistance band practices like Dr. Vonda Wright’s practice that features Frozen Shoulder and strengthening the shoulder. Here is a link for you.
And of course, see an Integrative or Functional practitioner that can help you explore what would be best for you.
If you need further support, click the below link, and let’s get you started.
References
Wright, V. J., Schwartzman, J. D., Itinoche, R., & Wittstein, J. (2024). The musculoskeletal syndrome of menopause. Climacteric: The Journal of the International Menopause Society, 27(5), 1–7. https://doi.org/10.1080/13697137.2024.2380363
Mayo clinic. (2020, August 1). Frozen shoulder – Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/frozen-shoulder/symptoms-causes/syc-20372684
Publishing, H. H. (2021, August 17). How to release a frozen shoulder. Harvard Health. https://www.health.harvard.edu/pain/how-to-release-a-frozen-shoulder
Dr. Anna Cabeca. (2025, October 9). How to Support Vaginal Health Naturally: Dr. Anna’s Complete Protocol. Dr. Anna Cabeca. https://drannacabeca.com/blogs/sexual-health/how-to-support-vaginal-health-naturally-dr-anna-protocol?_pos=6&_sid=b04c94533&_ss=r
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