The liver and estrogen metabolism; report of cases.

THE ASSOCIATION of certain endocrine abnormalities, particularly those of estrogen metabolism, with fairly severe liver disease is common and well known. Some of the clinical signs and symptoms of such association are, in the male, gynecomastia, softening of the testes, loss of axillary hair, impotence, and decreased libido, and, in the female, menstrual disturbances, breast changes and symptoms, and acne. Infertility may occur in both sexes. Some patients with these endocrine abnormalities have clinically evident liver disease; some give a history of having had jaundice in the past but show no other evidence of impaired liver function, and others exhibit no apparent cause in the history or findings for their endocrine or estrogen disturbance. We have become more aware in recent years of the existence of impaired liver function in persons who have been and are otherwise in apparently good health. It is well known that hepatitis with appreciable liver