The impact of chronic liver disease on the endo- crine system has been of great interest to both endocrinologists and hepatologists, as multiple abnormalities in sex hormone metabolism have been reported. In addition, a number of clinical manifestation of liver disease have been reported to be the result of these, including amenorrhoea, impotency, gynaecomastia, and spider angiomata

There is probably no greater demand on the female endocrine system than the establishment and maintenance of pregnancy. In this regard, the disease autoimmune hepatitis is of particular interest as it predominantly impacts women, and at a relatively younger age, compared with many other forms of chronic liver disease. In addition, these patients often have cirrhosis by the time a diagnosis is made.

The majority of patients respond well to immunosuppressive drugs but most women with autoimmune hepatitis require maintenance immunosuppression …