Anogenital Distance and Endometriosis: Results of a Case–Control Study
Open accessAbstract
AGD is the distance measured from the anus to the genital tubercle. Recent evidence suggests that a shorter AGD, a sensitive biomarker of the prenatal hormonal environment, could be associated with higher endometriosis risk. However, studies investigating AGD in affected women are scanty. We have set up a case-control study recruiting nulliparous women (aged 18-40 years) with endometriosis between 2017 and 2018. Cases were 90 women with a surgical or with a current nonsurgical diagnosis of endometriosis (n = 45 deep infiltrating endometriosis (DIE), and n = 45 ovarian endometrioma (OMA)). Controls were 45 asymptomatic women referring for periodical gynaecological care and without a previous diagnosis of endometriosis. They were matched to cases for age and BMI. For each woman, two measures were obtained using a digital calliper: AGD AC, from the clitoral surface to the upper verge of the anus, and AGD AF, from the posterior fourchette to the upper verge of the anus. Each distance was derived from the mean of six measurements acquired from two different gynaecologists. The mean ± SD AGD AC in women with DIE, OMA and without a diagnosis of endometriosis was 76.0 ± 12.1, 76.1 ± 11.1 and 77.8 ± 11.4 mm, respectively (p = 0.55). The mean ± SD AGD AF in women with DIE, OMA and without a diagnosis of endometriosis was 22.8 ± 5.0, 21.7 ± 9.0 and 23.7 ± 7.8 mm, respectively (p = 0.38). Our study failed to find an association between AGD and the presence of endometriosis. AGD does not seem to represent a reliable indicator of the presence of endometriosis to be used in clinical practice.
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A recent study found a lack of significant difference in AGD between women with endometriosis and controls.
“By contrast, a recent study20 found a lack of significant difference, perhaps in part because sample sizes were relatively small.”
From Prenatal Origins of Endometriosis Pathology and Pain: Reviewing the Evidence of a Role for Low Testosterone (2023) · cites this paper as [20]
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- Authors
- Buggio, L., Somigliana, E., Sergenti, G., Ottolini, F., Dridi, D., & Vercellini, P.
- Affiliations
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- University of Milan (IT)
- Corresponding author
- Buggio, Laura
- ORCID
- Venue
- Reproductive Sciences
- Published
- 2022-07-11
- Volume
- 29
- Issue
- 12
- Pages
- 3508-3515
- ISSN
- 1933-7191 (ISSN-L)
- 1933-7205
- OpenAlex
- W4285006146
- Cited by
- 8
- References
- 45
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 3
- FWCI
- 1.47
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Reproductive Sciences (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
- Keywords
- anogenital distance, endometriosis, deep infiltrating endometriosis, endometrioma, biomarkers, nulliparous women
- MeSH terms
- Anal Canal, Endometriosis, Female, Genitalia, Female, Humans, Pregnancy, Biomarkers, Case-Control Studies
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