Last Tuesday you couldn't fasten your bra. Stood in the bedroom for five minutes trying different angles, tears pricking your eyes because the pain in your right shoulder was that bad. Yesterday you gave up trying to hang the washing and got your daughter to do it instead. This morning at 3am you woke up because you rolled onto that shoulder and the pain shot straight through you like an electric shock.
You've Googled "frozen shoulder perimenopause" about six times this week (and yes, we know you did it at 2:47am last night when you couldn't sleep). You've started having irregular periods. Your GP mentioned perimenopause at your last appointment but nobody said anything about your shoulder potentially seizing up like this.
And honestly? You're starting to panic a bit. Because if this is what perimenopause does to one shoulder, what else is coming?
We see you. And we need to talk about frozen shoulder.
What Even Is Frozen Shoulder?
The medical term is adhesive capsulitis, which basically means the tissue around your shoulder joint has become inflamed and stuck together. Your shoulder has a capsule of connective tissue surrounding it, keeping everything moving smoothly. When frozen shoulder strikes, that capsule thickens and tightens, and develops adhesions (sticky bands of tissue that shouldn't be there).
The result? Your shoulder literally freezes up. The pain can be excruciating. The stiffness makes simple tasks impossibly difficult.
Reaching up to get something from a high cupboard. Putting on a coat. Doing up a zip at the back of a dress. Washing your hair. All of these become either painful or completely impossible.
The Symptoms Go Way Beyond "A Bit Stiff"
We know you're probably worrying about whether what you're experiencing is actually frozen shoulder or something else entirely. Here's what frozen shoulder typically feels like:
Pain that's worse at night. You might wake up multiple times because you've rolled onto your affected shoulder. The pain can be sharp, aching, or both. Some women describe it as a deep toothache in the shoulder that never goes away.
Stiffness that gets progressively worse. At first you might just notice slight difficulty reaching behind your back. Within weeks or months, you might struggle to lift your arm above shoulder height in any direction.
Difficulty with everyday tasks. Fastening your bra behind your back. Reaching into the back seat of your car. Putting dishes away in high cupboards. Getting dressed. Brushing your hair.
Sleep disruption. The pain at night can be relentless. You might find yourself propping your arm on pillows, avoiding lying on that side entirely, still waking up in pain.
Why Does This Happen During Menopause?
So, here's where it gets interesting (and frustrating, because we still don't have all the answers).
Frozen shoulder is most common in women aged 40 to 60. That's not a coincidence. That's exactly when perimenopause and menopause happen.
Research shows that around 70% of women experience musculoskeletal symptoms during the menopause transition. Joint pain, muscle aches, frozen shoulder, all of it. Women are affected more often than men when it comes to adhesive capsulitis, and it peaks during midlife.
The Estrogen Connection
Your body's estrogen levels are dropping. Dramatically. And estrogen does way more than you probably realise.
Estrogen helps regulate inflammation throughout your body. It keeps connective tissue healthy and flexible. It affects how your tendons, ligaments, and joint capsules function. When estrogen levels plummet during perimenopause, your joints become more prone to inflammation and stiffness.
Think of it like this. Your shoulder capsule is meant to be stretchy, like a balloon that expands easily. But without enough estrogen, that tissue can become thicker, tighter, more inflamed. The capsule shrinks. Adhesions form. Movement becomes restricted.
We can't say definitively that menopause causes frozen shoulder (and we know you want certainty, but the research isn't quite there yet). What we can say is that the hormonal changes happening in your body right now are very likely contributing to why this is happening.
Other Risk Factors That Make It More Likely
Frozen shoulder doesn't just appear randomly. Certain things increase your risk:
Diabetes. If you have diabetes, you're more susceptible to frozen shoulder. The reasons aren't entirely clear, but the link is well-established.
Thyroid conditions. Both underactive and overactive thyroid problems seem to increase risk.
Previous shoulder injury or surgery. Even minor shoulder injuries can trigger frozen shoulder months later, especially if you've kept your shoulder still for an extended period.
Prolonged immobilisation. If you've had to keep your arm in a sling or haven't moved your shoulder much for any reason, you're at higher risk.
Basically? Your hormones are changing, your connective tissue is more vulnerable, and if you have any of these additional risk factors, your shoulder is even more likely to freeze up.
The Three Phases (And Yes, It Really Does Take That Long)
Frozen shoulder doesn't happen overnight. It progresses through three distinct phases, and understanding where you are in the process can help you know what to expect.
The Freezing Phase (2-9 Months)
This is where you are right now if the pain has recently started getting worse. Your shoulder becomes progressively more painful and stiff. The pain is often worst at night and with sudden movements. You might find yourself unable to sleep on that side at all.
This phase is characterised by inflammation. Your shoulder capsule is actively inflaming, thickening, and starting to shrink. Movement becomes increasingly limited.
The Frozen Phase (4-12 Months)
The pain may actually start to ease during this phase, which sounds like good news except the stiffness gets dramatically worse. Your shoulder might feel "locked" in certain positions. You might have almost no ability to rotate your arm outward or lift it above a certain height.
Daily activities become incredibly difficult. This is the phase where women often struggle to do up bras, reach into back pockets, or wash their opposite armpit.
The Thawing Phase (12-42 Months)
Finally, gradually, your shoulder starts to loosen up again. Movement slowly returns. Pain continues to fade. But here's the frustrating bit: this phase can take one to three years.
Some women regain full movement. Others are left with some permanent restriction. About 2-5% of adults develop frozen shoulder, and while most eventually recover, it's a slow process.
What Actually Helps (And What You Can Do Right Now)
We know you want this fixed immediately. We get that. But frozen shoulder doesn't work that way, and anyone who promises you a quick cure is lying.
What we can offer you is a clear path through treatment options that genuinely help, based on which phase you're in.
Pain Relief Strategies
In the early freezing phase:
Start with regular paracetamol, taken at consistent intervals up to the recommended daily dose. If that doesn't touch the pain, try ibuprofen or another NSAID. Heat packs can help soothe the surrounding muscles (wrap a hot water bottle in a tea towel and apply for up to 20 minutes at a time).
Avoid movements that cause sharp pain. This isn't about being weak or giving in. Your shoulder capsule is inflamed right now, and pushing through severe pain can make the inflammation worse.
When to See a Menopause Specialist
If you're experiencing frozen shoulder alongside other perimenopausal symptoms, you need to see a menopause specialist, not just your GP. Here's why: menopause specialists understand the hormonal connections and can assess whether hormone replacement therapy might help prevent further musculoskeletal issues.
Menopause specialists have specific training that many GPs don't. They can look at your whole hormonal picture, not just your shoulder in isolation.
Book an appointment if:
- Your frozen shoulder coincides with irregular periods, hot flushes, or other menopause symptoms
- You want to discuss whether HRT might help
- You're concerned about developing frozen shoulder in your other arm
- The pain is significantly affecting your sleep and quality of life
Physiotherapy (This Is Non-Negotiable)
Physiotherapy is the cornerstone of frozen shoulder treatment. A physiotherapist will assess how much movement you currently have, then design exercises specifically for your stage.
In the early inflammatory stage, exercises focus on maintaining what movement you have without aggravating the inflammation. In the frozen stage, they'll work on gradually increasing your range of motion. In the thawing stage, you'll focus on strengthening and regaining full function.
Many physiotherapists work at GP surgeries. In some areas, you can self-refer directly without seeing a GP first. You can also seek private physiotherapy if NHS wait times are too long.
Steroid Injections
If pain relief and physiotherapy aren't enough, your GP or specialist might recommend a steroid injection into your shoulder joint. These can significantly reduce inflammation and pain, particularly in the early freezing phase.
They don't cure frozen shoulder. But they can make the pain manageable enough for you to engage with physiotherapy and maintain movement. Some women need multiple injections over the course of treatment.
What About HRT?
Here's where it gets complicated (and we know you want a straightforward answer).
We don't have definitive proof that HRT prevents or treats frozen shoulder. What we do have is observational research suggesting women taking HRT may be less likely to develop it. One study found women not taking HRT had 99% greater chance of developing frozen shoulder compared to those who were taking it.
But that's a small study. We need more research.
If you're experiencing other menopause symptoms and frozen shoulder, HRT might help by reducing overall inflammation and supporting connective tissue health. But you shouldn't start HRT solely to treat frozen shoulder.
Talk to a menopause specialist about whether HRT makes sense for your overall symptoms and health profile. The frozen shoulder benefit, if there is one, would be a bonus rather than the main reason.
Surgery (Last Resort Only)
In severe cases where conservative treatment hasn't worked after 12-18 months, surgery might be considered. This is usually keyhole surgery where the surgeon releases the tight capsule.
Surgery isn't a magic fix. Recovery takes time, and you'll still need extensive physiotherapy afterward. But for some women whose shoulders remain severely restricted, it can help restore movement.
Can You Prevent It Happening in Your Other Shoulder?
About 10% of people who develop frozen shoulder in one arm will eventually develop it in the other. That risk is higher if you have diabetes.
We can't guarantee prevention, but there are things that might reduce your risk:
Keep moving. Regular shoulder exercises and gentle stretches can help maintain flexibility. Even if your affected shoulder is frozen, keep your other shoulder mobile.
Manage underlying conditions. If you have diabetes or thyroid problems, keeping them well-controlled may reduce your risk.
Consider your overall hormone health. Work with a menopause specialist to address hormonal changes that might be contributing to inflammation throughout your body.
Don't immobilise unnecessarily. If you injure your good shoulder, resist the temptation to keep it completely still. Gentle movement within pain limits is protective.
When to Worry (And When It's Just the Normal Miserable Process)
We know you're probably catastrophising every twinge (and honestly, at 3am when you can't sleep because of the pain, who wouldn't?).
Here's when you need urgent medical attention:
- Your shoulder is hot, red, or swollen (this suggests infection, not frozen shoulder)
- You develop a fever alongside the shoulder pain
- The pain is sudden and severe following an injury
- You're experiencing unexplained weight loss or night sweats
These symptoms suggest something other than frozen shoulder and need immediate assessment.
If your shoulder pain is gradually worsening over weeks, with increasing stiffness but no fever or redness, that fits the typical frozen shoulder pattern. Still miserable. Still needs treatment. But not an emergency.
The Realistic Timeline (Because We're Not Going to Lie to You)
Most frozen shoulders take 1-3 years to fully resolve. Some improve faster with treatment. Some take longer. About 80% of people regain near-normal or normal function with appropriate care.
The first few months are usually the most painful. The middle phase is the most frustrating because you're stuck with severe stiffness even as pain eases. The final thawing phase brings gradual improvement, but it's slow.
If you're in month three of excruciating pain and you're thinking "I cannot do this for three more years," we hear you. But with proper treatment, most women see significant improvement within 6-12 months, even if complete resolution takes longer.
This isn't forever. It feels like it right now, but it isn't.
What You Need to Do Next
Your immediate next steps:
Book an appointment with a menopause specialist if your frozen shoulder is happening alongside other perimenopausal symptoms. They can assess your overall hormonal health and discuss whether HRT might help prevent further musculoskeletal issues.
Get referred to physiotherapy. Don't wait for the pain to become unbearable. Early physiotherapy intervention can help maintain movement and potentially shorten the overall duration.
Manage the pain proactively. Regular paracetamol, heat packs, and avoiding aggravating movements. Don't try to push through severe pain.
Keep your other shoulder mobile. Gentle daily stretches and exercises can help reduce the risk of frozen shoulder developing on the other side.
Frozen shoulder is genuinely miserable. The pain disrupts your sleep, your mood, your ability to do basic tasks. The slow timeline is frustrating. The uncertainty about whether it will ever fully resolve is anxiety-inducing.
But it does get better. With the right support and treatment, most women regain good shoulder function. You're not going to be stuck like this forever, even though it feels that way at 3am when you can't sleep.
¹- Wright VJ, Schwartzman JD, Itinoche R, Wittstein J. The musculoskeletal syndrome of menopause. Climacteric. 2024;27(5):466-472. https://doi.org/10.1080/13697137.2024.2380363
²- NHS. Frozen shoulder. Available at https://www.nhs.uk/conditions/frozen-shoulder/ nhs.uk+1
³- Saltzman E, Kennedy J, Ford A, Reinke E, Green C, Poehlein E, et al. Is hormone replacing therapy associated with reduced risk of adhesive capsulitis in menopausal women? Poster 188: The Orthopaedic Journal of Sports Medicine. 2023;11(7)(Suppl 3):S00174. https://doi.org/10.1177/2325967123S00174 SAGE Journals+1
⁴- Biglia A, Morandi V, Zanframundo G, Donati D, Maggiore F, Vita F, Sammarchi L, Pagani C, Cavagna L, Galletti S, Montecucco C. Adhesive capsulitis of the shoulder: retrospective review. PubMed. 2023. Available at https://pubmed.ncbi.nlm.nih.gov/36595199/
⁵- The Chartered Society of Physiotherapy. Shoulder pain - treatment of shoulder pain. Available at https://www.csp.org.uk/conditions/shoulder-pain/treatment-shoulder-pain CSP
⁶- Cambridge University Hospitals NHS Foundation Trust. Frozen shoulder. Available at https://www.cuh.nhs.uk/patient-information/frozen-shoulder/ Cambridge University Hospitals
⁷- The Chartered Society of Physiotherapy. Find a physiotherapist. Available at https://www.csp.org.uk/public-patient/find-physiotherapist/find-physio CSP
⁸- Saltzman E, et al. Is hormone replacing therapy associated with reduced risk of adhesive capsulitis in menopausal women? The Orthopaedic Journal of Sports Medicine. 2023;11(7)(Suppl 3):S00174. https://journals.sagepub.com/doi/10.1177/2325967123S00174 SAGE Journals
⁹- NHS Lanarkshire. Frozen shoulder – MSK physiotherapy service. Available at https://www.nhslanarkshire.scot.nhs.uk/services/physiotherapy-msk/frozen-shoulder/
