One of the main functions of the liver is to regulate the hormone levels, including that of the female sex hormone – estrogen. Although the liver doesn’t produce any hormones on its own, any liver complication directly disrupts the hormonal balance in your body. Women diagnosed with liver complications may experience an array of menstrual complications. Therefore, understanding how liver diseases affect menstrual health is essential for proper management and treatment of both conditions.
Liver and estrogen regulation
The liver plays a major role in the metabolism of sex hormones, says Dr Joy Varghese, director of hepatology and transplant hepatology at Gleneagles Global Health City, Chennai. The organ decides how hormones should be broken down and used for bodily functions or deactivated and expelled from the system.
“The liver generates sex-hormone-binding globulin (SHBG) which regulates estrogen levels. When the liver isn’t working properly, estrogen is reabsorbed through the digestive tract. It then accumulates in the body, resulting in estrogen dominance,” says Dr Krishanu Banik, consultant, gastroenterology and hepatobiliary sciences, Fortis Hospital, Kolkata. Sex hormone-binding globulins are proteins made in the liver to which sex hormones get attached and circulate in the body.
How liver affects menstrual cycle
Liver diseases can impact the duration and frequency of menstruation. They impact ovulation and fertility and may cause excessive uterine bleeding too.
“This leads to irregular periods or bleeding due to sex hormones deficiency and reduced blood clotting property of blood, which is caused by the reduced synthesis of clotting factors from the damaged liver,” says Dr Varghese. The liver produces pro-coagulants and anti-coagulants that play a major role in the thickening of blood. Liver cirrhosis impairs blood circulation leading to both excessive bleeding and clotting.
How liver affects fertility
“Women with liver disease may experience hormonal imbalances that can affect ovulation and fertility,” says Dr Banik.
“If a person has a congenital liver disease, it affects the normal menstrual cycle. These problems lead to a condition called abnormal uterine bleeding, so the person bleeds because of inherent liver diseases,” says Dr Sangeetha Rajendran, consultant obstetrician and gynecologist, Promed Hospital, Chennai.
She adds that tablets that stop bleeding only provide temporary relief. The continuous bleeding makes conception difficult. If identified late, liver diseases may cause bleeding and irregular menstrual cycle, decreasing the chances of pregnancy.
Liver diseases also cause nutritional deficiencies which significantly impact menstrual health. “Deficiencies in vitamins and minerals such as iron, calcium, and vitamin D can lead to menstrual irregularities, heavy bleeding and increased risk of developing conditions such as osteoporosis,” says Dr Banik.
Common liver diseases that affect menstrual health
- Cirrhosis: Affects the liver’s ability to metabolise hormones, leading to irregular menstrual cycles or heavy bleeding. “Cirrhosis causes permanent liver damage which causes the sexual hormones metabolism to be deranged, leading to irregular menstrual cycle,” says Dr Varghese.
- Wilson’s disease: A genetic disorder in which copper accumulates in the body. “The excess copper is stored in the liver, brain and the female reproductive system, which affects menstrual cycle,” says Dr Varghese.
- Hepatitis (all variants): Hepatitis also causes hormonal imbalance. “Hepatitis can lead to liver inflammation, resulting in abdominal pain, nausea and vomiting during menstruation,” says Dr Banik.
- Fatty liver disease: Leads to irregular menstrual cycles. “Fatty liver disease can also cause anemia, which can result in fatigue, weakness, and heavy bleeding during menstruation,” says Dr Banik. He adds that non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases that affects menstrual health.
Improving liver and menstrual health with healthy lifestyle
Several lifestyle changes such as maintaining a healthy weight, avoiding alcohol and drugs that can damage the liver, and adopting a healthy diet rich in fruits, vegetables and whole grains help manage liver diseases and improve menstrual health.
Regular exercise helps improve liver function and regulate menstrual cycle. In addition, techniques such as meditation, yoga and counselling can help reduce stress and improve overall health.
However, it is important to consult with a healthcare provider before making any significant changes to your lifestyle or diet.
Takeaway
Liver diseases can affect hormonal regulation, menstrual health, and fertility. It directly affects the regulation of estrogen, leading to multiple issues with menstruation from irregular periods to excessive bleeding. Lifestyle modifications along with the required medical attention and physical activity can help manage the symptoms.
