Abstract
Estrogens are secreted mainly by the gonads and to a very small extent by the adrenals. In addition, they are formed to an important degree from peripheral conversion of adrenal and gonadal androgens, mainly androstenedione and testosterone, to estrogens. They circulate in both unconjugated and conjugated form in the blood with the unconjugated estrogens either free (minimal amounts) or bound to proteins, mainly to albumin and to the specific sex-hormone-binding globulin (SHBG), which shows a great affinity for estradiol, but even greater for testosterone.The estrogens are metabolized mainly in the liver, but other organs also contribute. Regarding liver disease . . .