Clinical significance of estrogens in chronic aggressive hepatitis

For a long time, it has been assumed that stagnation of active estrogens in the blood gives rise to liver injury and causes a severe inflammatory process in the liver as well as affecting the clinical course of chronic aggressive hepatitis in women. During reproductive years, estrogen production, as gaged by the values of urinary excretion, follows a cyclic pattern. As the menopause is approached, urinary excretion of estrogens gradually diminishes and the cyclic fluctuation becomes more shallow. The titer continues to fall progressively in the post-menopausal years although some estrogen may be found even in aged women. Even though it must be assumed that estrogens are rarely produced in bilaterally ovariectomized women, chronic aggressive hepatitis is rather frequently encountered in practice in women after ovariectomy. To find a solution to the question of whether stagnation of active estrogen in the blood actually gives rise to liver injury, estrogen levels in the blood must be estimated in these patients. It will be desirable to estimate not the metabolites of estrogens in the urine but the estrogens or estrogenic substances themselves in the blood. The authors have estimated estrogens in the blood by means of radioimmunoassay and revealed a decrease in quantity of the estrogen values in the blood. Therefore, it can be stressed that the lack of estrogens in the blood must be taken into consideration because it has been pointed out that estrogens exert some form of liver-protecting influence against infection as well as the protracting factors of hepatitis.