Several physiologic and biochemical alteration occurring in menopause can affect the function of the liver and stimulate the development of liver disease. Menopause is a state of growing estrogen deficiency, which increases the probability of mitochondrial dysfunction, cellular senescence, reducing immune responses to injury, and imbalance between antioxidant formation and oxidative stress. These effect collectively can lead to increased risk of development of liver pathology, especially nonalcoholic fatty liver disease and hepatocellular carcinoma, long with increased progression of fibrosis in liver diseases observed in hepatitis C virus liver disease. Thus, identifying these mediating factors can recognize liver disease in perimenopausal and menopausal women which in turn, can provide an option for aggressive intervention in order to avert progression of liver disease to its more severe forms.

The management of NAFLD focusses on the regulation of the underlying metabolic features associated with NAFLD, such as obesity, diabetes mellitus, hypertension and dyslipidemia. It has been observed that the incidence and severity of NAFLD is increased among older women, especially in post-menopausal women. These challenges pose a significant need for the lifestyle modifications including weight loss and managament of other associated metabolic factors in peri-menopausal women in their early years of menopause in order to prevent development of advanced fatty liver disease in their older years of life.

Source: Brady CW. Liver disease in menopause. World J Gastroenterol. 2015;21(25):7613-7620.