Understanding the Overlap
As women now live a third of their lives after menopause, optimising health during this time is increasingly important. While hot flushes, insomnia, and mood changes are well-known menopausal symptoms, joint pain—especially frozen shoulder (adhesive capsulitis, AC)—is also common but less often discussed. Research estimates that 2–5% of the population experience AC, with women aged 40–65 at slightly higher risk (Celik, 2016).
Menopause: A Complex Transition
Menopause, defined as 12 months without menstruation, usually occurs between ages 45–55 (Australian Menopause Society). Symptom prevalence varies widely: 74% of women in Europe report symptoms, compared to 22–63% in Asia (Palacios et al., 2010). While vasomotor symptoms (hot flushes) are common in the West, joint pain and shoulder stiffness are more frequent complaints in East Asian cultures (Scheid, 2007). This difference may be influenced by genetics, diet, lifestyle, and cultural attitudes towards aging (Obermeyer et al., 2007).
Hormonal changes, particularly declining oestrogen and progesterone, impact not only reproductive health but also joint and tendon health. Collagen loss during menopause weakens connective tissues, making joints like the shoulder more vulnerable to stiffness and pain (Marcus, 2004).
Frozen Shoulder: Biomedical & Chinese Medicine Perspectives
AC is characterised by pain and restricted movement in the shoulder, often lasting 2–3 years (Reeves, 1975). It can be primary (idiopathic) or secondary to trauma or systemic disease. While its exact cause is debated, recent research highlights both inflammatory and fibrotic changes in the shoulder capsule (Xiao/Watson, 2016).
In Chinese medicine, AC is seen as a form of “painful obstruction syndrome” (bi zheng), where both internal deficiencies (Qi, Blood, Yin, Yang) and external factors (wind, cold, damp) contribute to pain and immobility (Maclean & Lyttleton, 2010). Emotional factors—like frustration or stagnation of Liver Qi—are also considered, especially around menopause when emotional changes are common (Scheid, 2010).
The Research: Patterns and Individualisation
Complementary Medicine Use: 63% of Australians use complementary medicine, and nearly half take supplements (Steele, 2018). Women are more likely to seek Chinese medicine for menopausal symptoms, especially when conventional options don’t meet their needs (Rayner et al., 2009).
Menopause & Chinese Medicine: Historically, menopause wasn’t viewed as a disease in Chinese medicine until the mid-20th century (Scheid, 2008). Modern TCM often attributes menopausal symptoms to Kidney deficiency, but experienced clinicians also consider Liver Qi stagnation, Chong and Ren Mai disharmony, and patterns of Blood stasis or phlegm (Scheid et al., 2017).
Herbal Medicine: Most research on Chinese herbal medicine for menopause focuses on tonifying Kidney Yin/Yang (Dong et al., 2014; Li et al., 2014; Su et al., 2013). However, real-world practice often requires more nuanced, individualised formulas (Scheid et al., 2017).
Hormones & Pain: Studies suggest oestrogen and progesterone modulate chronic pain. Oestrogen deprivation (such as with aromatase inhibitors for breast cancer) increases joint pain, while oestrogen therapy can reduce it (Crew et al., 2007; Hughes & Choubey, 2014; Voskuhl, 2015).
Cultural Differences: Cross-cultural studies show that how women experience and report menopausal symptoms—like joint pain or hot flushes—differs by country, lifestyle, and social context (Obermeyer et al., 2007; Palacios et al., 2010).
Clinical Approach: Treating the Whole Person
Chinese medicine excels when it comes to individualising care. Rather than rigidly applying biomedical labels, practitioners observe the patient’s unique pattern—whether it’s stagnation, deficiency, or a mix—and tailor acupuncture, herbal medicine, and lifestyle support.
For menopause and frozen shoulder, this might mean:
- Supporting Kidney, Liver, and Spleen function to nourish tendons and sinews
- Moving Liver Qi to address emotional stagnation and shoulder tension
- Resolving dampness or phlegm contributing to pain and stiffness
- Using both warming and cooling herbs, as indicated by the patient’s presentation
Key Takeaways
- Menopause and frozen shoulder often overlap due to shared hormonal, structural, and emotional factors.
- Research supports the use of complementary medicine—including Chinese medicine—for symptom relief, especially when care is individualised.
- A holistic approach, recognising the complexity of each woman’s experience, is essential for best outcomes.
References (selected)
Celik, D. (2016). [Adhesive Capsulitis].
Crew, K. et al. (2007). Pilot study of acupuncture for joint symptoms related to aromatase inhibitor therapy.
Dong, X.-L. et al. (2014). Combination treatment with Fructus Ligustri Lucidi and Puerariae radix for bone and mineral metabolism.
Hughes, G. C., & Choubey, D. (2014). Modulation of autoimmune rheumatic diseases by oestrogen and progesterone.
Maclean, W., & Lyttleton, J. (2010). Clinical Handbook of Internal Medicine.
Marcus, G. (2004). [Tendon and Connective Tissue Structure].
Obermeyer, C. M. et al. (2007). Symptoms, menopause status, and country differences.
Palacios, S. et al. (2010). Age of menopause and impact of climacteric symptoms by region.
Rayner, J. A. et al. (2009). Australian women’s use of complementary and alternative medicines to enhance fertility.
Scheid, V. (2007, 2008, 2010, 2017). Multiple works on menopause and Chinese medicine.
Steele, N. (2018). [Use of complementary medicine in Australia].
Su, J.-Y. et al. (2013). Perimenopause amelioration with TCM recipe.
Voskuhl, R. R. (2015). Estriol therapy for multiple sclerosis and other autoimmune diseases.
If you’re experiencing shoulder pain or other menopausal symptoms, Chinese medicine offers a holistic, research-informed approach to help restore balance and improve quality of life. Get it touch with us or book now on the link below.