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Case Reports
. 2025 Apr;18(2):352-356.
doi: 10.1007/s12328-024-02090-y. Epub 2025 Jan 6.

Hormone replacement therapy for steatotic liver management after surgical menopause

Yoshiaki Kobayashi  1 , Yuki Yamashita  2   3 , Takefumi Kimura  1   4 , Takanobu Iwadare  1 , Taiki Okumura  1 , Shun-Ichi Wakabayashi  1 , Hiroyuki Kobayashi  1 , Ayumi Sugiura  1 , Satoru Joshita  1 , Takeji Umemura  1   4
Affiliations
Case Reports

Hormone replacement therapy for steatotic liver management after surgical menopause

Yoshiaki Kobayashi et al. Clin J Gastroenterol. 2025 Apr.

Abstract

Although steatotic liver onset after natural menopause has been reported, evidence on the clinical course and treatment options for steatotic liver after surgical menopause is scarce. A 34-year-old woman with a history of severe obesity presented to our department with liver dysfunction following total hysterectomy and bilateral oophorectomy. Her serum estradiol level was notably low at 22 pg/mL, and a liver biopsy revealed significant fatty degeneration, lobular inflammation, hepatocyte ballooning, and stage F1 fibrosis. These findings supported a diagnosis of steatotic liver disease following surgical menopause. Subsequent initiation of hormone replacement therapy (HRT) with estrogen led to rapid improvements in liver function and steatotic liver symptoms. Steatotic liver disease should be considered in cases of liver impairment in postoperative menopausal patients, for which HRT represents a promising treatment option.

Keywords: Hormone replacement therapy; Steatotic liver disease; Surgical menopause.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that they have no conflicts of interest. Ethics approval and consent to participate: Ethics committee approval was not required for this case report. Consent for publication: Written informed consent was obtained from the patient for the publication of this case report and any accompanying images.

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