Association between Menopause and Frozen Shoulder in Women: A Hospital-Based Cross-Sectional Observational Study

Abstract

Background: Frozen shoulder is a common musculoskeletal disorder characterized by progressive shoulder pain and restriction of both active and passive movements. Women, particularly during the menopausal transition, appear to be affected more frequently. Declining estrogen levels may influence collagen metabolism, connective tissue remodeling, and inflammatory pathways, thereby increasing susceptibility to adhesive capsulitis. However, evidence regarding this association remains limited.
Objective: To evaluate the association between menopausal status and frozen shoulder among women attending the outpatient department of a tertiary care hospital.
Materials and Methods: This hospital-based cross-sectional observational study was conducted over 18 months and included 35 women aged 40–70 years. Participants were classified as premenopausal or postmenopausal based on menstrual history. Demographic and clinical characteristics, menopausal status, body mass index (BMI), diabetes mellitus, pain severity, and shoulder range of motion were assessed. Statistical analysis included the Chi-square test, independent Student’s t-test, and multivariable logistic regression. A p-value <0.05 was considered statistically significant.
Results: Frozen shoulder was diagnosed in 21 (60.0%) participants. The prevalence was significantly higher among postmenopausal women than premenopausal women (78.3% vs. 25.0%; χ² = 8.97, p = 0.003). Women with frozen shoulder were significantly older than those without the condition (55.7 ± 4.1 vs. 50.9 ± 4.3 years, p = 0.002). On multivariable logistic regression analysis, postmenopausal status remained independently associated with frozen shoulder after adjustment for age, BMI, diabetes mellitus, and hypertension (adjusted OR = 5.84; 95% CI: 1.28–26.63; p = 0.023).
Conclusion: This study demonstrated a significant association between menopausal status and frozen shoulder among the women included in the study. Postmenopausal women showed a higher prevalence of frozen shoulder than premenopausal women, suggesting that menopausal hormonal changes may contribute to the development of the condition. Larger multicenter prospective studies with longer follow-up are warranted to further validate these findings.