Having polycystic ovary syndrome puts you at higher risk of developing fatty liver disease. Lifestyle strategies and prescription medication can decrease your risk.

Polycystic ovary syndrome (PCOS) is primarily thought of as a reproductive system disorder. But researchers have come to understand that it can affect multiple organs, including your liver.

Although experts are not certain of the main cause, they have found strong links between PCOS and nonalcoholic fatty liver disease (NAFLD). For example, a large 2020 study found that people with PCOS are four times more likely to develop NAFLD than people without PCOS.

This article examines the connections between PCOS and fatty liver disease, including how PCOS may cause NAFLD, whether PCOS can cause liver damage, and what the best options are for treating NAFLD caused by PCOS.

Fast facts about polycystic ovary syndrome

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A possible connection between PCOS and NAFLD was reported in 2005. Since then, numerous studies have found clear associations between PCOS and NAFLD.

The incidence of NAFLD is notably higher in women who have PCOS. Additionally, NAFLD is often more severe in those with PCOS.

Language matters

You’ll notice that the language used to share stats and other data points in this article is pretty binary. Although we typically avoid language like this, specificity is key when reporting on research participants and clinical findings.

Unfortunately, the studies and surveys referenced in this article didn’t report data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.

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Can PCOS cause NAFLD?

A small 2019 study involving 60 women with PCOS found that 38.3% of the participants had NAFLD.

PCOS and NAFLD also share some risk factors, including:

These similarities may explain the link between the two conditions. However, researchers are not sure how PCOS might cause or increase the risk of NAFLD.

Researchers are also considering certain genes that may be associated with both PCOS and NAFLD.

Can PCOS cause liver damage?

One of the possible complications of NAFLD is inflammation of the liver, which can lead to liver fibrosis (liver scarring). NAFLD can also cause permanent scarring of the liver (cirrhosis), which can lead to liver cancer.

Researchers are still trying to understand how and why PCOS could lead to worse liver damage among people with NAFLD. A 2017 study suggests that NAFLD tends to be more severe in people who have PCOS. And women with PCOS may have an increased risk of liver fibrosis and steatosis (buildup of fat in the liver).

Besides PCOS, the following risk factors can also increase your risk of developing NAFLD:

Common symptoms of NAFLD

One of the tricky aspects of NAFLD is that it usually causes few or no symptoms. This is true even in more serious cases of NAFLD, including cirrhosis. People who do have symptoms may experience pain in their upper right abdominal area or exhaustion.

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As of now, there is no agreed-upon approach for treating NAFLD in people with PCOS. But the most recent research has found that NAFLD can be managed with healthy lifestyle strategies and medications.

Lifestyle strategies that may be helpful include dietary changes and exercise to promote weight loss and target some of the metabolic conditions associated with PCOS, such as insulin resistance, diabetes, and high cholesterol.

A diet low in sugar and high in whole foods and complex carbohydrates, along with regular aerobic exercise, may be beneficial.

Some prescription medications can also help treat PCOS-associated conditions such as insulin resistance and hirsutism. These medications include:

In addition, certain nutritional supplements may be helpful, such as omega-3 fatty acids and vitamin E.

Please discuss any possible medications, supplements, or dietary changes with a healthcare professional who is familiar with your health background and can make specific recommendations.

Is fatty liver disease reversible?

Fatty liver is thought to be reversible in most cases, and it responds well to lifestyle changes. The most significant change that seems to reverse it is weight loss.

Weight loss can decrease liver inflammation, fat in the liver, and even scarring (fibrosis) of the liver. For example, a loss of 3–5% of your body weight can decrease liver fat, and a loss of 7–10% can decrease inflammation and scarring.

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Having PCOS increases your risk of developing fatty liver disease. But prevention strategies can help reduce your risk.

Sticking to a healthy diet, getting regular exercise, losing weight, and taking certain prescription medications can reduce your risk of developing fatty liver disease if you have PCOS.

Talk with a healthcare professional if you have PCOS and are concerned about your personal risk of developing fatty liver disease.