Impact of vascular liver disease on the menstrual cycle and metabolic status in premenopausal women

Posted October 25, 2021

A recent study, which was conducted with the collaboration of INCT Hormona, evaluated the impact on the menstrual cycles and related endocrine abnormalities in women with vascular liver disease (VLD) and respective roles of liver function and portal hypertension. Portal hypertension is increased pressure within the system of veins that carry blood from abdominal organs to the liver.

The research “Impact of vascular liver disease on the menstrual cycle and metabolic status in premenopausal women” was published in Clinics and Research in Hepatology and Gastroenterology, and its full version may be read on the link: https://doi.org/10.1016/j.clinre.2021.101756

According to Dr. Anne Gompel, a Gynecological Endocrinology professor at Université Paris Descartes and a researcher in an international partnership between INCT and UFRGS, this is the first published article on this group of diseases. “There are articles on cirrhosis, which describe the consequences of anomalies in the metabolism of insulin and glucose on the liver, in growth hormone, amenorrhea. However, in addition to a considerable literature on nonalcoholic fatty liver disease, there was no information on the endocrinological impact of VLD or on menstrual cycle anomalies,” the specialist comments. The general coordinator of INCT, Dr. Poli Mara Spritzer, is coauthor of the survey.

Dr. Gompel explains that the survey was conducted through a single-center observational cohort study, with 47 premenopausal women with VLD who were followed from February 2009 to November 2016. According to the physical, VLD was associated with abnormal menstrual cycles in 53% of women, and clinical and/or biological hyperandrogenism and/or a polycystic ovary morphology was identified in 38%.

“We found the same endocrine abnormalities that were previously described occurring in cirrhosis, with an insulin resistance profile, but we do not know whether there are clinical consequences,” Dr. Gompel states. “We also observed resistance to grown hormone, although liver abnormalities were milder, suggesting more severe liver injuries than we thought,” she explains. “With regard to menstrual cycle abnormalities, there was a significant proportion of women with prolonged cycles, bleeding, and hyperandrogenism,” she comments.

The study concluded that endocrine abnormalities, prior described in association with cirrhosis, are also identified in patients with VLD, and require specific management. “Glucose intolerance profile is frequent, further studies are needed to assess significant consequences in the cardiovascular system,” Dr. Gompel concludes.