Polycystic ovary syndrome is common and strongly associated with insulin resistance and steatotic liver disease, often at a younger age and lower BMI than clinicians expect.
In a young woman with raised transaminases or steatosis on ultrasound, ask about menstrual irregularity, hirsutism and acne, and consider PCOS. The reverse also applies: women with PCOS merit metabolic screening, including liver assessment with a non-invasive fibrosis score.
Weight-focused lifestyle change helps both conditions and is the first step.
- Ask about menstrual history in young women with steatosis
- Screen women with PCOS for metabolic liver disease
- Use a non-invasive fibrosis score such as FIB-4 for triage
- Lifestyle and weight change remain the first step for both conditions
Why it matters
MASLD in young women is easily put down to weight alone, missing a treatable endocrine driver.
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