The effect of oral
testosterone treatment (200 mg tid) on liver morphology was examined in a double-blind, placebo controlled study including men with
alcoholic cirrhosis (n = 126). Liver biopsies obtained before randomization showed micronodular
cirrhosis in 119 patients (94%),
alcoholic hepatitis in 64 (51%), and
fatty liver in 104 (83%). These and other morphological findings did not differ significantly in the patients randomized to
testosterone (n = 76) and to placebo (n = 50) (skewed randomization 3:2). Follow-up liver specimens (biopsies or autopsies) obtained after a median
treatment duration of 30 months demonstrated a significant (p less than 0.01) increase in the prevalence of macronodular
cirrhosis (from 6 to 51%) and a significant (p less than 0.01) decrease in the prevalence of
alcoholic hepatitis (to 21%) and of
fatty liver (to 52%).
Testosterone treatment did not significantly influence the prevalence of these changes. Further,
testosterone treatment had no significant effect on the prevalence of other morphological changes, including vascular and malignant changes. However, in the
testosterone-treated group one patient developed diffuse sinusoidal dilation and one patient showed Budd-
Chiari's syndrome. The degree of
fatty liver and of
alcoholic hepatitis in follow-up liver specimens were significantly (p less than 0.002) higher among patients who consumed
ethanol during follow-up than in patients who abstained (76 versus 22% and 30 versus 6%). In conclusion, this study does not establish any indication or any
contraindication in terms of hepatic histopathology with the possible exception of hepatic
venous thrombosis for the use of oral
testosterone treatment in men with
alcoholic cirrhosis.