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Why are Liver Disease Symptoms Often Overlooked in Women? - Dr Akash Chaudhary

People often think of liver disease as a condition that is linked to excessive drinking of alcohol, getting hepatitis, or being overweight. But what many people don't know is that liver disease affects women differently than it does men, and their signs are often missed or given the wrong diagnosis.

From changes in hormones to conditions like liver problems caused by pregnancy, women have special problems that make it harder to diagnose and treat them.

Why do Women with Liver Disease Often Go Undiagnosed?

Women with liver disease are less likely to be identified because their symptoms are often subtle and confused with other health problems.

Fatigue, bloating, nausea, and changes in mood are all typical signs of a liver that isn't working right, but they are often mistaken for stress, hormonal changes, or digestive problems. Also, normal liver function tests might not always show early disease in women, which can delay diagnosis.

Another problem is the false belief that liver disease mostly affects men because men are more likely to get liver disease from drinking. But studies show that women are more likely than men to have liver damage from booze, medicines, and metabolic conditions, even when they are exposed to smaller amounts.

Why Pregnancy, PCOS, and Menopause are Bad for Liver Health

Throughout a woman's life, changes in her hormones can have a direct effect on how her liver works, which can sometimes cause or worsen liver disease. Let us look at some of the most important ones:

This is about "pregnancy and liver disease."

There are special liver problems that can happen during pregnancy that can be dangerous if they are not caught early. Here are some of them:

  • Intrahepatic Cholestasis of Pregnancy (ICP) is a disease in which bile flow is slowed down. This can cause severe itching, dark urine, and a higher risk of giving birth early or not at all.
  • HELLP Syndrome is a serious consequence of preeclampsia that includes problems with the liver, a low platelet count, and hemolysis, which is the breaking down of red blood cells. It can be life-threatening.
  • Acute Fatty Liver of Pregnancy (AFLP) is a rare but serious disease in which fat builds up in the liver and can cause it to fail if it is not treated quickly.

People often don't notice liver diseases related to pregnancy until they get really bad because they look like regular pregnancy symptoms like feeling sick and tired.

PCOS and Liver Disease

A lot of people know that Polycystic Ovary Syndrome (PCOS) can affect metabolism and fertility, but not as many people know that it can also cause liver disease.

Because of insulin resistance and metabolic problems, women with PCOS are more likely to get non-alcoholic fatty liver disease (NAFLD).

To be exact, up to 70% of women with PCOS can have fatty liver, which makes them more likely to get cirrhosis and liver failure in the long term.

Menopause and Liver Health

Besides protecting liver function, estrogen also helps regulate fat metabolism and inflammation. After menopause, estrogen levels drop, making women more likely to experience:

  • Fatty liver disease
  • Liver fibrosis (scarring of liver tissue)
  • Elevated liver enzymes, which may indicate liver damage

This means that postmenopausal women with liver disease may develop serious complications like cirrhosis more rapidly, even without major risk factors.

Women with Liver Disease Show Different Symptoms

In addition to biological differences, liver disease symptoms in women often differ from those in men, making early diagnosis more difficult. Key distinctions include:

  • Less noticeable jaundice: Women may experience itching as an early symptom instead of visible yellowing of the skin.
  • More pronounced fatigue: Women often report severe tiredness that affects daily activities, which may be misattributed to stress or anaemia.

4. Higher risk of autoimmune liver diseases: Women are more prone to conditions like primary biliary cholangitis (PBC) and autoimmune hepatitis, which can be misdiagnosed as thyroid or rheumatologic disorders.

5. Different response to alcohol and medications: Women's livers metabolize drugs and alcohol differently, making them more susceptible to liver damage even with lower exposures.

Why early diagnosis and awareness are so important

Since liver illness can go unnoticed for years, it is very important to find it early to avoid permanent damage. To keep their livers healthy, women can do the following:

1. Know your risk factors: If you have PCOS, a history of liver problems during pregnancy, talk to your doctor about liver screening.

2. Don't Ignore Symptoms: You shouldn't ignore symptoms like persistent tiredness, itching, bloating or feeling sick.

3. Regular Testing: Blood tests, ultrasounds, and FibroScan (a non-invasive test for liver stiffness) should be done regularly to help find liver disease early.

4. Healthy Lifestyle: Making healthy lifestyle choices, like eating well, working out regularly, and alcohol abstinence, can lower the chance of liver damage.

The liver health of women has been ignored for a long time, but more education and early screening can help avoid major problems. If we know how pregnancy, PCOS, menopause, and other things affect liver function, we can make sure that more women get the right evaluation and care at the right time.

If you or someone you know is feeling tired, itchy, or having stomach problems for no clear reason, don't be afraid to ask for a liver health check. Getting help for liver disease right away can make all the difference.

Disclaimer: The views expressed in this article are of the author and not of Health Dialogues. The Editorial/Content team of Health Dialogues has not contributed to the writing/editing/packaging of this article.
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