Perimenopause, Menopause and Frozen Shoulder

Frozen shoulder, medically known as adhesive capsulitis, is a debilitating condition characterized by stiffness, pain, and restricted range of motion in the shoulder joint. While the exact cause of frozen shoulder remains elusive, emerging research suggests that hormonal imbalances, particularly involving estrogen, testosterone, and progesterone, may contribute to its development.

1. The Role of Estrogen in Shoulder Health:

Estrogen, often regarded as a quintessential female hormone, plays a multifaceted role in the human body, extending beyond its reproductive functions. Among its various physiological effects, estrogen exerts significant influence on the integrity and function of connective tissues, including those surrounding the shoulder joint. Connective tissues such as tendons, ligaments, and joint capsules rely on estrogen for maintaining their elasticity, strength, and overall structural integrity.

2. Estrogen Deficiency and Connective Tissue Changes:

When estrogen levels decline, as seen in menopause or conditions associated with hormonal imbalances, such as polycystic ovary syndrome (PCOS) or hypothalamic amenorrhea, it can lead to adverse changes in connective tissues. These changes may include alterations in collagen metabolism, increased stiffness, and susceptibility to inflammation and adhesions. Consequently, the shoulder joint may become more prone to developing the characteristic features of frozen shoulder, including pain and restricted mobility.

3. Inflammatory Response and Hormonal Imbalance:

Estrogen possesses anti-inflammatory properties, helping to regulate the body's immune responses and mitigate excessive inflammation. Estrogen deficiency disrupts this delicate balance, potentially exacerbating inflammation within the shoulder joint. Chronic inflammation is thought to contribute to the pathogenesis of frozen shoulder, further underscoring the significance of hormonal influences in this condition.

4. Hormonal Changes and Tissue Repair:

Additionally, estrogen deficiency may impact the levels and activity of growth factors such as insulin-like growth factor-1 (IGF-1), which play pivotal roles in tissue repair and regeneration. Alterations in IGF-1 signaling, stemming from hormonal imbalances, could impede the natural healing processes within the shoulder joint, prolonging the course of frozen shoulder or exacerbating its severity.

5. The Role of Testosterone and Progesterone:

While estrogen deficiency has been extensively studied in relation to shoulder health, it's essential to consider the potential influence of other hormones such as testosterone and progesterone.

Testosterone contributes to muscle strength and bone density, indirectly affecting shoulder stability and function. It also possesses anti-inflammatory properties, which may impact inflammatory responses in the shoulder joint. Progesterone, on the other hand, may influence joint laxity and tissue elasticity, potentially affecting shoulder function and susceptibility to injury.

Dr Purity Carr

GP & Menopause Doctor

Harvey, WA 6220