Non-Alcoholic Fatty Liver Disease (NAFLD)

Non-alcoholic fatty liver disease (NAFLD) is the accumulation of excess fat in liver cells in people who drink little to no alcohol, and it occurs in approximately 30-40% of women with PCOS—significantly higher than the general population. NAFLD in PCOS develops through multiple pathways including insulin resistance, elevated androgens, chronic inflammation, and excess visceral fat, and often progresses silently without noticeable symptoms. The condition can advance to more serious liver inflammation (NASH) and scarring if left untreated, making it important for women with PCOS to discuss liver health screening with their healthcare providers, especially those with metabolic syndrome risk factors.