The level of sexual hormones in women of reproductive age with cirrotic portal hipertension

Abstract

Background: Chronic liver diseases are commonly associated, in dependence of severity and duration of disease, with menstrual cycle disorders such as amenorrhea and anovulation. In most of cases the possibility of pregnancy is poor but sometimes these women become pregnant. The aim: To estimate the concentration of sexual hormones in women of reproductive age with cirrhotic portal hypertension, in dependence of functional liver reserve Child Pugh. Materials and methods: We selected 60 women of reproductive age with cirrhotic portal hypertension, caused by chronic virus hepatitis. The functional liver reserve was determined, according to the Child A/B/C -36/10/4. We tested the plasmatic levels of estrogen, progesterone, LH and FSH. Results: In the first group in 36 cases (60%), where the functional reserve of liver Child Pugh A, was good, the medium level of E2 in all the phases of menstrual cycle was at upper admissible range (130,7±30,5pg/ml). In the second and the third group with poor functional reserve Child B,C in 24 cases (40%) the level of estrogen have been increased in all the phases of menstrual cycle (366,6±46,3pg/ml). This fact can be explicated by functional insufficiency of the liver and perturbances of protein synthesis in liver, which cause severe pathogenetic infringements in estrogenic metabolism. The plasmatic medium concentration of progesterone in the first group was 34,5±3,6 n mol/1 and in group with poor liver reserve it was a breakdown of progesterone contents till 16,7±3,4nmol/l (p<0,05).There were no significant statistic difference between the levels of LH and FSH in presented groups (p>0,05). Conclusions: The increased value levels of estrogen and poor concentration of progesterone in women with cirrhotic portal hypertension, explain the absence of menstruation and anovulatory cycles in patients with poor liver reserve, which are the main factors of infertility in these patients.