Reason for hepatic involvement in oral contraceptives is ?

Ans. is 'a' i.e., Estrogen Hepatotoxicity with oral contraceptive pills While early formulations of OCPs were associated with frequent serum enzyme elevations, current formulations and hormonal replacement therapy have not been linked to ALT or alkaline phosphatase elevations at rates any higher than occur with placebo. Estrogens in OCPs can cause mild inhibition of bilirubin excretion leading to jaundice in patients with inherited forms of bilirubin metabolism such as the Dubin Johnson syndrome. It can induce a clinically apparent cholestatic liver injury which typically arises during the first few cycles of therapy, and rarely after the six months. It has also been linked to hepatic tumors, both benign and malignant.