A review of the factors historically thought to contribute to the feminization of men with Laennec's cirrhosis is presented. Objective scientific data is presented both in support of and in rejection of such factors when available. Recent hypotheses about the significance of an altered estrogen to androgen (E/T) ratio as being important in the pathogenesis of feminization also are discussed. Finally, a hypothesis which incorporates the findings of hypogonadism and cirrhosis with portal-systemic shunting is presented as a pathogenic mechanism for the feminization of men with alcohol-induced Laennec's cirrhosis.