Many women are referred into our clinic from physiotherapists who are treating frozen shoulder in women in their 40's and 50's. Although its not a symptom of the perimenopause or menopause frozen shoulder can arise due to the hormonal changes occurring during this time and their effect on the musculoskeletal system.
Frozen shoulder, also known as adhesive capsulitis, is a condition characterised by stiffness, pain, and limited range of motion in the shoulder joint.
While the exact cause of frozen shoulder is not fully understood, hormonal factors, including changes in oestrogen levels, may contribute to its development. Here’s how oestrogen could potentially play a role in causing or exacerbating frozen shoulder:
Impact on Connective Tissues: Oestrogen receptors are present in the connective tissues of the shoulder joint, including the joint capsule and ligaments. Oestrogen helps maintain the integrity and elasticity of these tissues. Changes in oestrogen levels, such as those occurring during menopause or in conditions associated with hormonal fluctuations, can affect the quality and function of the connective tissues. This may lead to increased stiffness and reduced flexibility in the shoulder joint, contributing to frozen shoulder symptoms.
Inflammatory Effects: Oestrogen has known anti-inflammatory properties. A decline in oestrogen levels, as seen in menopause, can lead to a relative increase in inflammation within the shoulder joint. This inflammation can contribute to the development of adhesive capsulitis, causing pain and restricting joint movement.
Collagen Metabolism: Oestrogen plays a role in collagen metabolism, influencing the synthesis and breakdown of collagen, a key component of connective tissues. Changes in oestrogen levels can alter collagen production and turnover, potentially affecting the structure and function of the shoulder joint capsule. Dysregulation of collagen metabolism may contribute to the development of frozen shoulder.
Muscle Tone and Function: Oestrogen influences muscle tone and function. Declining oestrogen levels can lead to changes in muscle strength and coordination around the shoulder joint. Weakness or imbalance in the muscles supporting the shoulder may contribute to abnormal joint mechanics and increase the risk of developing frozen shoulder.
Bone Health: Oestrogen deficiency, such as in menopausal women, can lead to bone loss (osteoporosis). Changes in bone density and strength around the shoulder joint may indirectly affect joint stability and function, potentially contributing to frozen shoulder.
It's important to note that while oestrogen may play a role in the development of frozen shoulder, it is likely just one of several contributing factors. Other factors such as age, genetics, previous shoulder injury or surgery, autoimmune conditions, and metabolic disorders may also influence the onset and progression of frozen shoulder.
HRT can help treat and relieve frozen shoulder in combination with other treatment options. Please speak to one of our menopause specialists about supporting your health.