Frozen Shoulder

Alex Oh • 27 June 2026


Frozen shoulder (adhesive capsulitis): it's a condition where the shoulder capsule thickens and tightens, causing pain and progressively worsening stiffness, typically progressing through freezing, frozen, and thawing phases over 1-3 years.


Primary (idiopathic) frozen shoulder

No clear cause — it just develops, often gradually. This is the more common and mysterious category, but it's strongly associated with certain risk factors:

  • Diabetes — one of the strongest known links; the incidence rises to 10-20% in people with Type 2 diabetes, and even higher in some Type 1 populations
  • Thyroid disorders — both hypo- and hyperthyroidism are associated with increased risk
  • Hormonal changes — particularly the estrogen decline of perimenopause/menopause, as we discussed; women aged 40-60 are disproportionately affected


The following tests can be helpful to assess risk factors:


Reproductive/ovarian function

  • Estradiol (E2) — the main estrogen; useful for assessing ovarian function, menopause status, and cycle tracking
  • FSH (follicle-stimulating hormone) — rises as ovarian reserve declines; the key marker for confirming perimenopause/menopause, especially when paired with symptoms
  • LH (luteinizing hormone) — useful alongside FSH; an elevated LH:FSH ratio is also relevant in PCOS workups
  • Progesterone — checked mid-luteal phase (around day 21 of a 28-day cycle) to confirm ovulation occurred

Androgens (relevant for PCOS, hirsutism, low libido, or unexplained acne/hair changes)

  • Total and free testosterone
  • DHEA-S (adrenal androgen)
  • SHBG (sex hormone-binding globulin) — needed to interpret free testosterone properly, since it determines how much testosterone is "active" vs. bound

Thyroid (almost always worth including, since thyroid dysfunction mimics or worsens many "hormonal" symptoms — including, notably, frozen shoulder risk)

  • TSH — first-line screen
  • Free T4, sometimes Free T3
  • Thyroid antibodies (TPO, thyroglobulin) if autoimmune thyroid disease is suspected


Insulin and fasting glucose / HbA1c — not a "hormone test" in the strict sense, but relevant in PCOS and metabolic-related hormonal symptoms


As in most cases, it is best to address symptoms of shoulder pain and stiffness as soon as possible.  Getting the proper diagnostic and lab testing is essential.  Please feel free to contact us if you have any questions.