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And on top of all this, some research suggests that lower estrogen levels may also promote fibrosis (a buildup of thick, stiff, scar-like tissue) within the shoulder joint

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AA received research grants and lecture or advisory board fees from MSD, AstraZeneca, Novartis, Boehringer Ingelheim, Sanofi, Mediolanum, Janssen, Novo Nordisk, Lilly, Servier and Takeda

doi:10.1016/b978-0-12-079035-7.50015-4

Experimental literature has also investigated VEGF and VEGFR2 signaling, growth hormone receptor expression in tendon fibroblasts, neurotransmitter modulation, and neuroprotective pathways involving the dopaminergic and serotonergic systems