Anogenital distance and Gynaecological diseases: A narrative review

Anogenital distance (AGD) (i.e. the distance measured from the anus to the genital tubercle) is an androgen-dependent, dimorphic feature, which is dependent on the in-utero hormonal environment. Human studies have shown alterations in the AGD associated with reproductive health in adult individuals, both males and females. In particular, recent studies have investigated whether differences in AGD length could be associated with gynaecological diseases, such as endometriosis and polycystic ovary syndrome (PCOS), as in these conditions prenatal hormonal exposure could represent a risk factor for developing the disease later in life. In this narrative review, we aimed to review the most updated scientific evidence on the relation between AGD and the presence of endometriosis and PCOS. Studies suggest that a shorter AGD seems to be related to the presence of endometriosis, whereas a longer AGD seems to be associated with an increased risk of PCOS. In light of these findings, we discuss how AGD measurement in adult women could represent a novel, simple, and easily reproducible biomarker of endometriosis and PCOS. However, scientific evidence is limited, and further well-designed studies are needed to corroborate current findings.