Background: Although the exact pathogenetic mechanism of PSVD is not fully understood but a possible key element is formation of microthrombi in the small portal branches causing presinusoidal portal hypertension.
Before menopause, women are reasonably protected against venous thrombosis by their circulating estrogens; nevertheless, this protection ends after menopause.
On the other hand hormonal therapy (oral contraceptives and postmenopausal replacement therapy) increases the risk of venous thromboembolism and whether it may impact PSVD development is unknown.