Abstract

The plasma concentrations of estrogens as well as their relationship to testosterone are determined in male patients suffering from fatty liver, chronic hepatitis and cirrhosis of the liver. By stimulation and suppresion tests the contribution of the adrenal gland and the testes to the elevated estrogens are investigated, demonstrating that enhanced peripheral conversion of androgens to estrone rather than to estradiol appears to be more effective in sustaining plasma levels in hepatic cirrhosis. Futhermore, the effect of testosterone application was studied in male patients with alcohol-induced cirrhosis of the liver in order to realize possible side-effects of an androgenic substitution therapy. It is concluded that clinical signs of hyper-estrogensim and hypoandrogenism in male patients with hepatic cirrhosis may in part be attributed to the increase of estrogens and the decrease of total and free testosterone, as is best shown by the ration of the heterosexual hormones which are grossly shifted in favour of the estrogens.