Are Men More Susceptible to Liver Disease Than Women?

When it comes to keeping you healthy, your liver plays an important role. It’s the biggest organ in your body and helps keep your blood free from toxic substances. Your liver also helps with digestion by breaking down the food you eat and storing the energy for later.

But your liver can become vulnerable to illness and disease. Some people get certain liver diseases from their parents, known as genetic liver disease. Viruses cause other conditions. Some behaviors — like taking drugs or drinking too much alcohol — may also cause liver disease.

Both men and women can develop liver problems. Researchers continue to study differences in gender and liver disease. Liver disease rates by gender may vary, but there’s plenty both men and women can do to help keep their livers healthy.

What Is Liver Disease?

There are more than 100 types of liver disease. According to the American Liver Foundation, 1 in 10 Americans has some form of liver disease.

These conditions are either chronic (over a long time) or acute (sudden). Liver diseases include:

  • Alcohol-related liver disease: Liver damage that develops when a person drinks too much alcohol. Left untreated, alcohol-related liver disease causes inflammation and scarring in the liver.
  • Autoimmune liver diseases: Illnesses that develop when your immune system attacks your liver.
  • Liver cancer: A disease caused when liver cells grow in abnormal ways. You might be at higher risk for hepatocellular carcinoma if you have another chronic liver condition.
  • Cirrhosis: Permanent damage that occurs when liver tissue becomes scarred. Cirrhosis is the end stage for many chronic liver conditions.
  • Nonalcoholic fatty liver disease (NAFLD): A disease caused by fat that builds up in the liver cells. In simple fatty liver, you have too much liver fat, but your liver cells aren’t damaged. In nonalcoholic steatohepatitis (NASH), you have too much fat, as well as inflammation and damage.
  • Viral liver disease: Liver diseases caused by viruses, including hepatitis A, hepatitis B, and hepatitis C.

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How Does Your Sex Influence Your Risk of Liver Disease?

Certain factors increase the risk of developing liver disease in both sexes, including:

  • Being overweight.
  • Drinking too much alcohol (more than two drinks per day for men and one drink per day for women).
  • Having diabetes.
  • Injecting drugs.
  • Having unprotected sex.

Generally, liver disease symptoms occur in both men and women. Some people have no symptoms at all, while others may have:

  • Pain and swelling in the abdomen.
  • Jaundice (yellowing of the eyes or skin).
  • Fatigue.
  • Nausea or vomiting.
  • Itching.
  • Dark urine.
  • Light-colored stools.

Overall, doctors diagnose about 21,000 Americans with primary liver cancer each year. About four million people in the U.S. have hepatitis C and one million have hepatitis B. And, about 20% of U.S. men and women have fatty liver.

Researchers continue to study gender and liver disease. Though men are more likely to develop certain types of liver disease, women are more likely to develop other liver conditions.

Men and liver disease

According to the National Institute of Diabetes and Digestive and Kidney Diseases, males are at higher risk of cirrhosis. Men are also twice as likely as women to have primary liver cancer (especially hepatocellular carcinoma).

According to the CDC, men are more likely to die from chronic liver disease and cirrhosis than women are.

Men also had higher death rates from cirrhosis caused by alcohol-related liver disease. It’s more common for men to use alcohol excessively. More than 30% of adult men had five or more drinks in one day at least once during the previous year.

According to a study in the journal Hepatology, NAFLD is more common in men than in women of child-bearing age. But after women reach menopause, NAFLD becomes more common in women.

Women and liver disease

According to the same study, researchers think hormones cause higher rates of NAFLD in postmenopausal women. After menopause, women who take hormones have lower rates of NAFLD than women who don’t.

Overall, women are more likely to die from NAFLD than men are. Researchers suspect that liver metabolism may factor into gender and liver disease.

There are also gender differences in alcoholic liver disease. Women who drink alcohol excessively are more likely to have liver damage than men who do. According to the Centers for Disease Control and Prevention (CDC), women’s bodies react to alcohol differently. The metabolization process of alcohol in women causes longer-lasting effects.

Women are also more likely to have autoimmune diseases that can affect liver health. According to the American Liver Foundation, autoimmune hepatitis affects women four times as often as it affects men. Women are also more likely to develop primary biliary cholangitis and noncancerous liver tumors.

Liver Disease Treatment and Outlook

Chronic liver disease and cirrhosis affects about 4.5 million U.S. adults, according to the National Center on Health Statistics. Between 1980 and 2018, 30,583 Americans died from these conditions. Liver disease and cirrhosis were the eighth leading cause of death for men (19,768) — the ninth for women (10,815).

If you have liver disease, talk with your doctor about treatment options. You may become a candidate for a liver transplant, including living-liver donation.

Generally, treatments for men and women with liver disease are the same. But a study found that women face disparities in accessing livers from deceased donors for liver transplants.

How You Can Help Prevent Liver Disease

You can reduce your risk of developing liver disease by taking certain actions, including:

Living a healthy lifestyle

Eat a nutritious diet and get regular exercise. Try to maintain a healthy weight to reduce your risk of obesity and diabetes, both of which put you at risk for liver disease.

Avoiding drugs and limiting alcohol

Protect yourself from hepatitis B and C by not using injectable drugs. Limit the amount of alcohol you drink.

If you do drink, avoid having many drinks at one time (binge drinking). Binge drinking is five or more drinks for men and four or more drinks for women on the same day.

Protecting yourself from infection

Talk with your doctor about vaccinations you should get to help protect your liver from hepatitis A and hepatitis B. Use condoms during sex. Blood and semen can contain viruses that cause liver disease.

Limiting exposure to environmental toxins

You can help keep your liver healthy by avoiding toxic substances, such as pesticides and industrial chemicals.

If you have a family history or lifestyle factors that increase your liver disease risk, talk to your doctor. They may recommend making certain changes based on your gender and overall risk for developing liver disease.

American Cancer Society, Liver Cancer Risk Factors, https://www.cancer.org/cancer/liver-cancer/causes-risks-prevention/risk-factors.html

Centers for Disease Control and Prevention, National Center for Health Statistics, Women's Health, https://www.cdc.gov/nchs/fastats/womens-health.htm

Centers for Disease Control and Prevention, National Center for Health Statistics, Men's Health, https://www.cdc.gov/nchs/fastats/mens-health.htm

Hepatology, Sex Differences in NAFLD: State of the Art and Identification of Research Gaps, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766425/

Institute for Health Metrics and Evaluation, Men Twice As Likely As Women to Die of Liver Cirrhosis, https://www.healthdata.org/news-release/men-twice-likely-women-die-liver-cirrhosis

National Institute of Diabetes and Digestive and Kidney Diseases, Cirrhosis, https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis

Centers for Disease Control and Prevention, Liver Cancer, https://www.cdc.gov/cancer/liver/index.htm

American Liver Foundation, Frequently Asked Questions, https://liverfoundation.org/for-patients/about-the-liver/frequently-asked-questions/#1504366267416-f5db8a99-419f

National Institute of Diabetes and Digestive and Kidney Diseases, Liver Disease, https://www.niddk.nih.gov/health-information/liver-disease#topics

Centers for Disease Control and Prevention, Leading Causes of Death and Numbers of Deaths By Sex, Race, and Hispanic Origin: United States, 1980 and 2018, https://www.cdc.gov/nchs/data/hus/2019/006-508.pdf

Society of Women's Health Research, Exploring the Role of Sex and Gender Differences in Liver Health, https://swhr.org/exploring-the-role-of-sex-and-gender-differences-in-liver-health/

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