If you've ever struggled to put on a bra, reach behind your back, or lift your arm without searing pain in your shoulder, you're not alone. Frozen shoulder strikes women in midlife at alarming rates, yet for decades, medicine dismissed it as a mystery condition with no known cause. Orthopedic surgeon Dr. Jocelyn Wittstein saw what others missed: her patients with frozen shoulder were almost all women between forty and sixty, experiencing hot flashes, night sweats, and other symptoms of perimenopause and menopause. What she discovered is changing how we understand the impact of declining estrogen on women's joints, bones, and muscles.

Dr. Wittstein is a practicing orthopedic surgeon, researcher, and associate professor at Duke University, specializing in sports medicine and the female athlete across the lifespan. She's also a former collegiate gymnast and mother of five. Her research focuses on frozen shoulder, ACL injuries in female athletes, and the musculoskeletal syndrome of menopause. As president of the Forum for Women in Sports Medicine, Dr. Wittstein is changing how we understand the intersection of hormones, movement, and independence in women's bodies.

In this conversation, Dr. Mary Claire Haver and Dr. Wittstein explore how declining estrogen during perimenopause and menopause impacts joints, bones, muscles, and connective tissue. They discuss why frozen shoulder disproportionately affects women in midlife, with some Asian cultures having their own term for it that translates to fifty year shoulder. Dr. Wittstein explains the critical window for treatment, why early intervention can be transformative, and how hormone replacement therapy may prevent it, with preliminary data suggesting women using systemic estradiol have half the risk of developing frozen shoulder. She shares why physical therapy during the inflammatory phase can worsen it and how to recognize the early warning signs.

Guest links:

Jocelyn Ross Wittstein, MD (Duke Health)

Jocelyn Wittstein, MD (Instagram)

Duke Female Athlete Program

Milken Institute Women’s Health Initiative

Books
“The Complete Bone and Joint Health Plan: Help Prevent and Treat Osteoporosis and Arthritis,” by Dr. Jocelyn Wittstein and Sydney Nitzkorski, MS, RD

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