A dull ache in the shoulder can escalate into a debilitating condition known as frozen shoulder, or adhesive capsulitis, which can significantly impede daily activities. For some women, particularly those between 40 and 60 years old, this condition may be linked to the hormonal changes associated with menopause.
Emma Mapp, a 52-year-old lawyer, experienced a gradual worsening of shoulder pain that prevented her from raising her arm or turning her neck. Her daily life was impacted, leading her to limit social engagements due to concerns about accidental bumps to her injured shoulder. She even wore a sling to signal her injury.
Frozen shoulder occurs when the capsule surrounding the shoulder joint becomes inflamed and thickens, restricting movement. While often caused by injury, such as a fall or a sudden strain, it is also noted to be more common in individuals with diabetes, possibly due to the effect of high blood sugar on surrounding tissues.
However, consultant orthopaedic surgeon Rajeev Sharma highlights that women in the 40-60 age bracket are particularly at risk. This demographic often coincides with the menopausal transition.
Research has begun to explore a connection between declining estrogen levels during menopause and an increased incidence of frozen shoulder. A 2023 study from Duke University involving nearly 2,000 women found that those not taking hormone replacement therapy (HRT) were 99% more likely to develop frozen shoulder compared to those on HRT.
Dr. Elise Dallas, a menopause specialist, explains that estrogen plays a crucial role in musculoskeletal health, including supporting connective tissue. As estrogen levels drop, collagen, a key component of muscles, ligaments, and tendons, can become stiffer, reducing joint flexibility. This hormonal shift can also lead to increased cytokines, compounds that promote inflammation in the shoulder joint.
Despite these findings, some experts, including Sharma, caution that the correlation between frozen shoulder and menopause might be circumstantial, given that the age group most affected is also the age group most likely to experience menopause. He suggests there may not be a direct causal link to hormonal changes.
Treatment for frozen shoulder focuses on symptom management while the condition resolves naturally. Common approaches include hydrodistension, where a mixture of saline, local anesthetic, and steroid is injected into the joint capsule to reduce pain and increase mobility. Steroid injections are often used to alleviate inflammation and pain, making the recovery process more comfortable.
Physiotherapy and exercises can also aid in maintaining shoulder strength, although they may initially increase pain during the acute phase of the condition. Mapp found temporary relief with various home remedies and painkillers but experienced significant pain, even when resting.
After an accidental fall in late 2023 led to an X-ray and MRI confirming her frozen shoulder diagnosis, Mapp was referred for a hydrocortisone injection. She described the injection as excruciating but reported significant improvement within a week. Over the following months, her shoulder mobility dramatically increased.
Mapp noted that in places like Indonesia and Singapore, frozen shoulder is sometimes referred to as "50s shoulder," suggesting a more widespread recognition of its potential link to menopause. A year later, her shoulder mobility has recovered to about 97%, allowing her to resume most normal activities, including aqua aerobics, though high-impact sports like tennis remain too painful.
She advocates for greater awareness, encouraging women experiencing shoulder pain during midlife to seek medical advice promptly.
