TEMPO.CO, Jakarta - Dr. Kanaga Lakshmi K, a senior consultant in obstetrics and gynecology at MGM Malar, Chennai, India, explained that women can experience a more rapid increase in liver fat after menopause, especially after the age of 45.
“After 45, many women enter perimenopause or menopause, where estrogen levels decline significantly. So, estrogen plays a very crucial protective role in how fat is distributed and metabolised,” Kanaga told the Hindustan Times on Monday, April 6, 2026.
Kanaga explained that this situation can affect estrogen in a woman’s body, extending beyond the reproductive system and also regulating fat distribution.
When estrogen levels decline, fat shifts from peripheral areas, such as the hips and thighs, to the visceral areas around the abdomen and internal organs.
This shift in fat can trigger a chain reaction, disrupting blood sugar control and overall metabolism.
“Insulin resistance increases, and this in turn promotes fat deposition in the liver. This is why the risk of fatty liver rises sharply in women during perimenopause and after menopause,” said Dr. K. Kanaga.
She continued, explaining that what's even more concerning is that fatty liver disease is often asymptomatic in its early stages.
The main reason fatty liver disease develops without symptoms is because the changes are often subtle. In fact, women may not even experience significant weight gain.
As a result, attention tends to be focused on visible fat, while internal fat in the liver is overlooked, delaying diagnosis and potentially leading to complications.
“Before menopause, women are relatively protected compared to men due to estrogen,” she said.
Kanaga highlighted the importance of estrogen in a woman's body. After menopause, women lose this protective effect, which increases fat accumulation in the liver and other visceral areas, making them more susceptible to metabolic problems than men.
The gynecologist revealed a worrying fact: “After menopause, the risk not only catches up but can even surpass men, increasing vulnerability to metabolic complications and cardiovascular disease.”
While there are no specific warning signs, several indicators can help detect fatty liver disease early. Dr. Kanaga explained that these indicators include increased waist circumference despite stable weight, persistent fatigue, mild elevations in liver enzymes, and associated conditions such as a history of PCOS, diabetes, or high cholesterol.
It's important to understand that fatty liver disease isn't just a liver condition; it's a major metabolic red flag. The doctor warns that it increases the risk of type 2 diabetes, heart disease, and stroke.
He recommends focusing on a balanced, protein-rich diet, regular strength training, and aerobic exercise, not just walking. Therefore, maintaining a healthy weight, prioritizing sleep, managing stress, and getting regular checkups when risk factors arise can help reverse this condition.