why do you get inc estrogen in cirrhosis

[MudPhud20XX]

Is it b/c of the decreased synthesis of SHBG? Liver dysfunction leading to low SHBG synthesis--> Low SHBG conc --> Increases free estrogen --> causes spider nevi, gynecomastia, testicular trophy???

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[Jabbed]

Is it b/c of the decreased synthesis of SHBG? Liver dysfunction leading to low SHBG synthesis--> Low SHBG conc --> Increases free estrogen --> causes spider nevi, gynecomastia, testicular trophy???

Cirrhosis
Total estrogen: ↑
Free estrogen: ↑
Bound estrogen: ↓

SHBG does decrease, which does result in ↑ free estrogen, but it's important to note that the liver is important in metabolizing estrogen itself. i.e., liver dysfunction → ↓metabolism of estrogen → ↑total estrogen