what causes fatty liver a woman

What Causes a Fatty Liver In a Woman?

Last modified on October 20th, 2023

Fatty liver is an increasingly common condition where too much fat builds up in your liver. The reasons someone might develop a fatty liver depend on a wide variety of factors. So what causes a fatty liver in a woman?

We explore the topic below and offer insight into what women should know about fatty liver.

Understanding Fatty Liver Disease

Before going into specifically what causes a fatty liver in a woman, what is it?

Fatty liver disease or steatosis occurs when too much fat builds up in your liver.

When your liver is healthy, it has a small amount of fat.

It’s problematic when those fat levels reach 5-10% of your liver’s weight.

Your liver has important, life-supporting roles.

The liver produces bile to help digestion, makes proteins, and stores iron.

Your liver also turns nutrients into energy, creates the substances that help your blood clot, and helps you avoid infections by removing bacteria and toxins from your blood and making immune factors.

For most people, fatty liver disease won’t necessarily prevent it from functioning normally or cause major problems, but the condition progresses and worsens for 7-30% of people.

There are three phases or stages of progressive fatty liver disease.

First is steatohepatitis, when the liver becomes inflamed and swollen.

The tissue of the liver is damaged.

In the next stage, there’s scar tissue where your liver is damaged, which is fibrosis.

The third stage is when the scar tissue replaces healthy tissue, cirrhosis of the liver.

Cirrhosis results from severe damage, and the scar tissue replacing your healthy liver tissue will impact the functionality.

Your liver function can eventually be blocked altogether.

Cirrhosis can cause liver cancer and liver failure.

There are two types of fatty liver. The first is alcohol-induced, caused by drinking heavily.

The second type, called nonalcoholic fatty liver disease or NAFLD, is more common.

This condition occurs in people who aren’t heavy drinkers and affects one in three adults in the United States. NAFLD affects one in 10 children in the U.S. Obesity and diabetes are risk factors.

You are at a higher risk of developing fatty liver disease if you’re Hispanic or Asian, or a post-menopausal woman.

If you’re obese, a high level of belly fat increases the risk, as does having high blood pressure, high cholesterol, or diabetes.

Symptoms of fatty liver can include abdominal pain or fullness in the upper right side of your belly.

Nausea, weight loss, and loss of appetite may come from fatty liver.

Other symptoms include tiredness, yellowing skin or whites of the eyes, mental confusion, and weakness.


Fatty liver can be a progressive condition. It’s primarily related to lifestyle.

For example, heavy alcohol use can cause fatty liver. If you have metabolic disease or are overweight, you may be at risk for nonalcoholic fatty liver disease (NAFLD).

Symptoms include nausea, weight loss, and feelings of pain or fullness in the upper right side of the abdomen. 

Diagnosing Fatty Liver

Fatty liver disease has no symptoms for many people, but higher liver enzyme levels may be an indicator.

Elevated liver enzymes can show the organ is injured.

A doctor might use a couple of different tests to confirm a diagnosis.

An ultrasound or CT scan is a way to get a picture of your liver.

Your doctor might order a liver biopsy, a tissue sample, to determine the extent of liver disease.

There’s also a FibroScan, a special ultrasound that can determine the amount of scar tissue and fat the liver contains.

What Causes Fatty Liver in a Woman?

What causes fatty liver in a woman can be similar to the causes in men, with a few exceptions.

The general causes of fatty liver include:

  • Drinking too much alcohol changes the liver’s metabolic processes, leading to fat accumulation.
  • Obesity
  • Types 2 diabetes
  • High levels of fat in the blood—especially triglycerides
  • Insulin resistance syndrome
  • Certain medicines
  • Infections like hepatitis C
  • Rare genetic conditions


For both men and women, risk factors for developing fatty liver include diet, being sedentary, and being overweight or obese.

Other causes of fatty liver include type 2 diabetes, high levels of fat in the blood, infections, and certain medicines. 

Fatty Liver in Postmenopausal Women

Post-menopausal women are more at risk of developing nonalcoholic fatty liver disease.

An endocrine hormone, estradiol, declines significantly after a woman goes through menopause.

This hormone is the major one involved in regulating the female reproductive cycle.

Researchers think the loss of protection from estrogens and other factors might contribute to the increased risk of NAFLD among post-menopausal women.

Researchers believe that normal-weight post-menopausal women with normal insulin, glucose, and lipid levels are at low risk.

Fatty Liver and PCOS

Research shows that women with polycystic ovary syndrome (PCOS) are at a higher risk of developing nonalcoholic fatty liver disease.

When you have PCOS, you have a hormone imbalance with insulin resistance that interferes with ovulation and fertility.

It’s believed that fatty liver affects anywhere from 15-55% of women with PCOS, depending on the diagnostic criteria used.

As mentioned, NAFLD can occur because of the excess fat stored in the liver, causing damage and inflammation.

Your liver isn’t meant to store fat, which is why it’s harmful.

The factors in women with PCOS that contribute to the fatty liver include excess abdominal weight and high triglycerides.

Having high LDL cholesterol and low HDL levels, diet, a sedentary lifestyle, and genetics also play a role.

There’s also evidence that high androgen levels contribute to fat storage in the liver.

Fatty Liver in Pregnancy

One other topic to discuss when answering what causes fatty liver in a woman is being pregnant.

A rare but serious condition is called acute fatty liver of pregnancy or AFLP.

The liver cells have too much fat, causing damage.

Doctors don’t know the exact cause, but it could be a genetic problem with how the liver breaks fats down.

The risk factors for AFLP include having your first pregnancy, being pregnant with a boy, pregnancy with twins or more, and being thin.

Symptoms of AFLP include nausea and vomiting, upper right side belly pain, feeling unwell, confusion, tiredness, and headache.

It can also cause the eyes, skin, and mucus membranes to turn yellow.


Women tend to have more hypothyroidism than men, and the thyroid hormones play a key role in fat metabolism in the liver.

Thyroid hormones also change hepatic fat accumulation, which could lead to fibrosis in some women.

Can You Reverse Fatty Liver?

With NAFLD, you can often take steps to reverse the condition and prevent further complications and damage.

Some of the general lifestyle changes you can make that can help with NAFLD include:

  • Losing weight. Research shows weight loss is the number one best thing you can do to get control of NAFLD or reverse it. Even losing 3% of your body weight can help your liver health significantly.
  • Treating other health conditions may help fatty liver. For example, ensure you receive appropriate treatment if you have polycystic ovary syndrome, hypothyroidism, diabetes, high cholesterol, or sleep apnea.
  • Changing your diet can help lower the fat in your liver and help your overall health and wellness. The Mediterranean diet appears to be helpful for liver health.
  • Reduce your alcohol intake or stop altogether.
  • Consider drinking coffee if you don’t already. Coffee may stimulate liver enzymes that fight inflammation. In one research report, among people with NALFD, regular coffee consumption helped reduce liver damage.


There are things you can do to reverse fatty liver. One of the most important is losing weight. Even losing just a relatively small percentage of body fat can stop or reverse fatty liver. 

Natural Remedies and Supplements for Fatty Liver in a Woman

You should talk to your doctor if you believe you have symptoms of fatty liver, but there are certain things you can do in addition to lifestyle changes that might help improve the health of your liver, including certain supplements.

Some of the supplements you might consider for fatty liver include:

Vitamin E

Vitamin E is a nutrient that has antioxidant properties. It’s important for reproduction, blood, the brain, skin, and vision.

Studies show vitamin E could improve the symptoms of nonalcoholic fatty liver disease.

The vitamin may also have other benefits, including reducing the risk of Alzheimer’s disease.

Milk Thistle

Milk thistle has been an herbal remedy for thousands of years, particularly for liver, kidney, and gallbladder conditions.

A flavonoid in milk thistle called silymarin may help protect the liver from toxins.

Silymarin is an anti-inflammatory and antioxidant, and it may help the liver grow new cells to repair itself.

Fish Oil

Omega-3 fatty acids are found in cold-water fish such as trout, tuna, and salmon.

They’re beneficial for reducing insulin, inflammation, and triglycerides in women with fatty liver or PCOS.

A fish oil supplement is a good way to get enough of these healthy fats because it’s hard to get adequate amounts from diet alone.

In one study published in the Journal of Clinical Endocrinology and Metabolism, women with PCOS who were supplemented with four grams of fish oil for eight weeks saw a significant decline in liver fat and triglycerides.


Curcumin is a compound found in turmeric.

Turmeric may help reduce the inflammation related to NAFLD because of the curcumin.

In a study from 2021 of 64 people with NAFLD, liver enzymes dropped significantly in the group taking two grams of turmeric a day compared to a placebo.

There were also declines in serum levels of cholesterol and triglycerides in the turmeric group compared to the group given a placebo.


Choline is a supplement that can help reduce the risk of fatty liver disease.

It plays a vital role in the function of not just your liver but also your brain.

You might consider a supplement if you don’t get enough choline in your diet. This essential nutrient is found in foods like meat, fish, poultry, dairy, and eggs.

You use it to function your life, muscles, central nervous system, and cellular formation and repair.

Your body also breaks choline down and converts it to energy.

Reishi Mushroom

Recent research shows that taking a reishi mushroom supplement can help liver health.

Also known as Ganoderma luccoidum, reishi may help with nonalcoholic fatty liver by helping improve the activity of energy-metabolizing enzymes.

Other benefits of this powerful mushroom include boosting the immune system, helping combat fatigue and depression, and it may help with blood sugar control.

Alpha-Lipoic Acid (ALA)

Alpha-lipoic acid is a powerful antioxidant compound.

In research, ALA supplementation has been found to reduce inflammatory markers and positively affect liver enzymes in obese people with nonalcoholic fatty liver disease.

The compound is naturally found in all of our human cells, and you can use it as a supplement because we only produce small amounts naturally.

Alpha-lipoic acid may help with weight loss in several ways.

Animal studies show it can reduce the activity of something called AMPK.

When the AMPK in your brain’s hypothalamus is more active, it may increase hunger.

When you suppress AMPK activity, you’ll feel less hungry and might also burn fewer calories when you’re at rest.

In animal studies, ALA has been shown to lower blood sugar levels by up to 64% and lower heart disease risk factors.


There are certain supplements that can help improve liver health, reduce fatty liver and perhaps heal the liver if damage is already occurring.

Some of the supplements that have potential liver health benefits include milk thistle, fish oil, choline, vitamin E, reishi mushroom, and curcumin. 

What Causes a Fatty Liver in a Woman—Final Thoughts

What causes a fatty liver in a woman?

Many things that cause a fatty liver in a woman are the same as for men.

There is fatty liver related to alcohol and more commonly related to lifestyle factors.

For example, a diet high in unhealthy fats and processed foods, obesity, diabetes, and a sedentary lifestyle can all contribute to fatty liver.

Certain medications can as well.

Then, there are things specific to women that can cause fatty liver.

Post-menopausal women are more likely to experience fatty liver because they don’t have the protective effects of estrogen.

Women with PCOS are also at high risk of developing fatty liver because of various factors, including metabolic disease, obesity, and hormonal imbalances.

Some pregnant women may develop a fatty liver-related condition, although it’s very rare.

Women with low thyroid function are at greater risk as well.

Unmanaged fatty liver can lead to serious complications and even liver failure.

You can do things to stop or reverse the damage, including weight loss, changing your diet, and trying supplements that are shown to help liver health.

If you have questions, speak to your healthcare provider.

Frequently Asked Questions About Fatty Liver:


What Is Fatty Liver?

Fatty liver, also known as hepatic steatosis, is a condition in which excess fat accumulates in the liver, making up more than 5-10% of the liver’s weight.

There are two main types: non-alcoholic fatty liver (NAFL) and alcoholic fatty liver disease (AFLD).

What Causes Fatty Liver?

Various factors, including obesity, insulin resistance, metabolic syndrome, excessive alcohol consumption, rapid weight loss, certain medications, and underlying medical conditions can cause fatty liver.

It can also result from a combination of these factors.

Are There Symptoms of Fatty Liver?

Fatty liver is often asymptomatic, especially in its early stages.

However, in more advanced cases, some people may experience fatigue, discomfort, or pain in the upper right abdomen and unexplained weight loss.

How Is Fatty Liver Diagnosed?

Fatty liver is typically diagnosed through imaging tests, such as ultrasound, CT scans, or MRI.

Blood tests may also help assess liver function, while a liver biopsy can confirm the diagnosis.

What Are the Risk Factors for Fatty Liver?

Risk factors include obesity, type 2 diabetes, insulin resistance, metabolic syndrome, high triglyceride levels, excessive alcohol consumption, and rapid weight loss. Genetics and certain medical conditions may also play a role.

Can Fatty Liver Be Reversed?

Fatty liver is often reversible, particularly in its early stages. Lifestyle modifications, including a balanced diet, weight management, regular exercise, and, in some cases, medication, can help improve liver health.

What Complications Can Arise From Fatty Liver?

Untreated or advanced fatty liver can lead to more severe liver conditions, such as nonalcoholic steatohepatitis (NASH), cirrhosis, liver fibrosis, and an increased risk of liver cancer.

Is There a Specific Diet for Fatty Liver?

A diet for fatty liver typically involves reducing saturated and trans fats, added sugars, and processed foods. It focuses on consuming more fruits, vegetables, whole grains, lean proteins, and healthy fats.

Portion control and calorie management may be recommended for weight loss.

What Role Does Alcohol Play in Fatty Liver?

Excessive alcohol consumption is a significant risk factor for alcoholic fatty liver disease (AFLD). Reducing or eliminating alcohol consumption is crucial for the management of AFLD.

Can Medications Help Treat Fatty Liver? 

While no specific medications are approved for fatty liver, certain drugs and supplements are being studied for their potential in managing the condition. Medication recommendations should come from a healthcare provider.

How Can I Prevent Fatty Liver?

Fatty liver can often be prevented by maintaining a healthy weight, engaging in regular physical activity, managing blood sugar and lipid levels, and avoiding excessive alcohol consumption. A balanced diet and avoiding rapid weight loss are also key.

Frequently Asked Questions About Fatty Liver in Women


What Causes Fatty Liver in Women?

Various factors, including obesity, insulin resistance, metabolic syndrome, and excessive alcohol consumption, can cause fatty liver in women.

Hormonal changes, such as those occurring during menopause or polycystic ovary syndrome (PCOS), may also contribute to fatty liver.

What Are the Risk Factors for Fatty Liver in Women?

Risk factors for fatty liver in women include obesity, type 2 diabetes, insulin resistance, metabolic syndrome, high triglyceride levels, rapid weight loss, and polycystic ovary syndrome (PCOS).

Postmenopausal women may also be at increased risk.

Can Pregnancy Lead to Fatty Liver in Women?

In some cases, pregnancy can contribute to a temporary condition known as gestational fatty liver, especially in women with gestational diabetes.

It usually resolves after pregnancy but requires medical attention.

What Are the Symptoms of Fatty Liver in Women?

Fatty liver is often asymptomatic, but when symptoms occur, they can include fatigue, discomfort or pain in the upper right abdomen and unexplained weight loss.

Can Hormonal Changes During Menopause Affect Fatty Liver in Women?

Yes, hormonal changes during menopause can lead to weight gain and redistribution of fat, potentially increasing the risk of fatty liver.

Hormone replacement therapy may influence liver health, and discussions with healthcare providers are recommended.

Can PCOS Contribute to Fatty Liver in Women?

Polycystic ovary syndrome (PCOS) is associated with insulin resistance and hormonal imbalances, which can contribute to fatty liver.

Managing PCOS through lifestyle changes and medications may help mitigate this risk.

How Is Fatty Liver Diagnosed in Women?

Fatty liver is typically diagnosed through imaging tests, such as ultrasound, CT scans, or MRI, and sometimes confirmed through a liver biopsy. Blood tests may also help assess liver function and rule out other liver conditions.

Is Fatty Liver Reversible in Women?

Fatty liver is often reversible, especially in its early stages.

Lifestyle modifications, including a balanced diet, weight management, regular exercise, and alcohol moderation, can help improve liver health.

What Are the Complications of Fatty Liver in Women?

Untreated or advanced fatty liver can lead to more severe liver conditions, including nonalcoholic steatohepatitis (NASH), cirrhosis, and an increased risk of liver cancer.

Can Medications Help Treat Fatty Liver in Women?

There are no specific medications approved for the treatment of fatty liver.

The primary approach is lifestyle modification, including dietary changes and exercise.

Healthcare providers may consider medication options in specific cases.

Can Fatty Liver Affect Women Differently Than Men?

While the basic mechanisms of fatty liver are similar in both genders, women may experience additional risk factors such as hormonal fluctuations during menopause and conditions like PCOS.

Individual responses to treatment and disease progression can also differ.

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