Increase of serum estradiol in cirrhotic men treated by transjugular intrahepatic portosystemic stent shunt

Background/Aims: Liver cirrhosis is frequently associated with sexual dysfunction and hormonal abnormalities, To evaluate the effect of portosystemic shunting on sex steroid serum concentrations, a prospective study was performed in cirrhotic patients treated consecutively and electively by transjugular intrahepatic portosystemic stent shunt (TIPS). Methods: In 27 patients with liver cirrhosis we measured serum levels of testosterone (T), sexual hormone binding globulin (SHBG), luteinizing hormone, follicle-stimulating hormone, dehydroepiandrosterone sulfate, androstenedione (A), estradiol (E-2), 17-OH-progesterone and the T/SHBG ratio before and 3 months after TIPS, Results: In men (n = 17) 3 months after TIPS, A and E-2 significantly increased, with mean serum levels rising from 4.4 +/- 2.5 to 5.6 +/- 2.9 ng/ml (P = 0.04) and from 27 +/- 9 to 40 +/- 19 pg/ml (P = 0.003), respectively. In contrast to A the increase of E-2 persisted at 9 and 15 months after TIPS, Erectile dysfunction increased from 30% before TIPS to 70% after TIPS, In women (n = 10) A and E-2 levels did not change significantly after TIPS. Conclusions: TIPS aggravated hormonal dysbalance of ses steroids in favor of estrogens (hyperestrogenism) in men, (C) 2001 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved.