Sarkar M, et al. - Secondary amenorrhea in reproductive-aged women and feminization of cirrhotic men indicates that cirrhosis is related to hormonal dysregulation, so researchers analyzed a cohort of post-menopausal women with chronic hepatitis C virus (HCV) infection to compare sex hormone levels by cirrhosis presence and across Child-Turcotte-Pugh (CTP) class. Findings revealed a progressive decline in sex hormone binding globulin (SHBG) and follicle stimulating hormone (FSH) levels in cirrhotic compared to non-cirrhotic women with HCV infection. Cirrhotic women display a steady decline in these levels in correlation to disease severity. As low SHBG and FSH is associated with cardio-metabolic disease, they suggest investigating the clinical implications of hormonal changes by cirrhosis severity in HCV-infected women.