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When people hear the words “fatty liver,” the first thing that often comes to mind is alcohol.

It’s a common misconception — one that has led many women to believe they’re not at risk, especially if they don’t drink. But here’s the truth: fatty liver disease can affect anyone, and it’s increasingly becoming a concern among women, particularly due to lifestyle factors and hormonal changes that occur at different life stages.

Whether it’s during pregnancy, the postpartum phase, living with polycystic ovary syndrome (PCOS), or entering menopause, women experience natural hormonal shifts that can quietly affect liver health. Combined with the stresses of daily life, sedentary habits, or underlying conditions like diabetes and high cholesterol, these changes can create the perfect storm for fat accumulation in the liver — even in women who don’t consume alcohol at all.

Let’s learn more with Dr. Deborah Chew, our Consultant in Internal Medicine, Gastroenterology & Hepatology at Sunway Medical Centre Velocity, as we uncover the silent ways fatty liver disease can impact women — even those who don’t drink alcohol.
It’s time to break the myth that fatty liver is only an issue for men or heavy drinkers.

What Is Fatty Liver and Why Should Women Care?

Fatty liver disease occurs when excess fat builds up in the liver cells. While a small amount of fat in the liver is normal, too much can lead to inflammation, scarring (also called fibrosis), and eventually more serious liver damage if not addressed early. There are two main types:

• Alcoholic fatty liver disease (AFLD) – caused by heavy alcohol use.
• Non-alcoholic fatty liver disease (NAFLD) – which happens without any alcohol consumption and is driven by metabolic, hormonal, or lifestyle factors.

NAFLD is now recognised as one of the most common causes of chronic liver disease worldwide, and more women — especially in their 30s to 60s — are being diagnosed with it. The worrying part? Many have no symptoms in the early stages. They might feel a little tired or bloated, but usually nothing alarming. That’s why it’s often called a “silent condition.”

Hormones, Lifestyle, and Hidden Risks in Women

Hormonal fluctuations can influence fat distribution in the body, including the liver. Let’s explore how different phases of a woman’s life may increase the risk of NAFLD:

Pregnancy

During pregnancy, the body undergoes drastic metabolic changes. In some women, these changes can temporarily affect liver function and fat storage. Although most cases resolve after delivery, some women may unknowingly retain a higher liver fat content if lifestyle changes aren’t addressed postpartum.

Polycystic Ovary Syndrome (PCOS)

PCOS is a common hormonal disorder that affects up to 1 in 10 women. It is closely linked with insulin resistance and weight gain, both of which increase the likelihood of developing fatty liver. In fact, women with PCOS are more likely to have NAFLD.

Menopause

Oestrogen has a protective effect on the liver. When women go through menopause, oestrogen levels drop, and this hormonal shift may contribute to increased fat storage and inflammation in the liver. Even women who are not overweight may find themselves more vulnerable to fatty liver after menopause.

Silent, But Serious

One of the biggest concerns with NAFLD is how silent it is. Most women will not experience pain or discomfort until the disease has progressed to later stages. In some cases, the liver can become inflamed (a condition called non-alcoholic steatohepatitis or NASH) or even develop scarring (fibrosis). If left untreated for years, this may lead to cirrhosis or liver cancer.

Symptoms, when they do appear, may include:

• Unexplained fatigue
• Mild abdominal discomfort
• Slight bloating or fullness
• Elevated liver enzymes in a routine blood test

But for many, the warning signs come too late — which is why proactive screening is essential.

Prevention Starts with Lifestyle

The good news is that fatty liver is reversible in its early stages. With the right steps, women can reduce fat in the liver, improve liver function, and even avoid complications altogether.

Adopt a liver-friendly diet

• Eat more vegetables, whole grains, and lean protein.
• Cut down on sugary drinks, refined carbs, and processed foods.
• Include healthy fats from sources like nuts, seeds, olive oil, and fish.

Get moving

• Aim for at least 150 minutes of exercise per week.
• Moderate-intensity activities like brisk walking, swimming, dancing, or cycling help reduce liver fat even without major weight loss.

Know your numbers

• Have regular check-ups to monitor blood sugar, cholesterol, and liver function.
• If you have PCOS, diabetes, or have gone through menopause, talk to your doctor about screening for fatty liver even if you feel fine.

A Word from Dr. 

   “Many women don’t realise they are at risk of fatty liver because they associate it only with alcohol or visible symptoms. But the truth is, hormonal shifts and lifestyle factors can play a big role, even in women who don’t drink. The key is early detection and prevention.”

Take Charge of Your Liver Health Today

Fatty liver isn’t just a men’s issue or a result of drinking. For many women, it’s a silent consequence of modern life, hormonal shifts, and metabolic changes that often go unnoticed. Whether you're planning a family, managing PCOS, going through menopause, or simply trying to stay healthy — now is the right time to check in on your liver.

Don't wait for symptoms to appear.
By the time signs show up, the damage may already be done. Early detection and lifestyle changes can make a powerful difference.

Learn More at Our Digestive Care Centre

Fatty liver disease doesn’t wait — and neither should you.
Learn more about our digestive health services at the Digestive Care Centre.
Taking care of your liver today means feeling better, ageing stronger, and reducing your risk of long-term complications down the road.