what causes fatty liver a woman

What Causes a Fatty Liver In a Woman?

Last modified on February 2nd, 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 for 7-30% of people, the condition progresses and worsens.

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 is more common, called nonalcoholic fatty liver disease or NAFLD. 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 you’re 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 menstrual female reproductive cycles.

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 of 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 yellowing.


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 the accumulation of hepatic fat, which could lead to fibrosis in some women.

what causes a fatty liver in a woman
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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 significantly help your liver health.
  • 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 conditions affecting the liver, kidneys, and gallbladder. There’s a flavonoid in milk thistle called silymarin that 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. If you don’t get enough choline in your diet, you might consider a supplement. 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

There’s recent research to show 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 lowers 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 health care provider.

What Causes Fatty Liver in a Woman FAQs

Some of the primary causes of fatty liver disease, specifically in women, include:

  • Obesity
  • Being post-menopausal
  • Having PCOS

For both men and women, causes of fatty liver include obesity, insulin resistance, high blood sugar, and high levels of fat in the blood. Risk factors can include metabolic syndrome, high cholesterol, type 2 diabetes, underactive thyroid, and an underactive pituitary gland.

Three primary signs of a fatty liver include:

  • Pain or discomfort in the upper right part of the abdomen
  • Fatigue
  • Weakness

The goal isn’t to get a fatty liver out. Instead, the goal is to stop the damage or reverse it. You can start to reverse a fatty liver by changing your diet, losing weight, getting more exercise, and trying certain supplements and vitamins.

Fatty liver can be reversed, and some say it can be cured. If you take action as soon as you find out you have fatty liver, you can begin the reversal process. The liver has a great ability to heal itself. The biggest thing to do as soon as possible is to lose at least 10% of your body weight and keep it off. Even if you can only lose as little as 3% of your body weight, you will be taking steps to stop and ultimately reverse fatty liver.

Females with fatty liver often don’t have symptoms until the disease progresses. If you experience symptoms, they may include abdominal pain or a feeling of fullness in the upper right side of your stomach. Other symptoms include nausea, weight loss, and appetite.

If there’s a lot of damage or cirrhosis, symptoms can include edema when the legs and abdomen swell, extreme tiredness, and jaundice, which is yellowing of the whites of the eyes and the skin.

Fatty liver can be reversed with lifestyle changes, including weight loss.

Around 30% of people with nonalcoholic fatty liver disease develop an inflamed liver or nonalcoholic steatohepatitis (NASH) and scarring. Twenty percent of people with scarring and NASH can develop end-stage cirrhosis. End-stage cirrhosis can lead to liver failure and cancer.

Having NAFLD may reduce the life expectancy of a woman by around 4.2 years.

For some people, fatty liver will reverse, and for others, it progresses to serious inflammation and liver cellular damage.

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