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Updated: Dec 17, 2025

Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse POP Quantification System
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Anogenital Distance in Healthy Infants: Method-, Age- and Sex-related Reference Ranges

Margit Bistrup Fischer1,2, Marie Lindhardt Ljubicic1,2, Casper P Hagen1,2

  • 1Deptartment of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

The Journal of Clinical Endocrinology and Metabolism
|June 24, 2020
PubMed

Insights

Anogenital distance (AGD) reference ranges were established for infants, showing AGD increases up to six months. These findings aid clinical evaluation of prenatal androgen action and epidemiological research.

Area of Science:

  • Pediatric endocrinology
  • Human anatomy
  • Public health

Background:

  • Anogenital distance (AGD) is increasingly used in clinical and epidemiological studies.
  • There is a scarcity of sex-specific reference data and longitudinal data on AGD in children.

Purpose of the Study:

  • To establish age-, sex-, and method-related reference ranges for AGD in healthy children aged 0-24 months.
  • To assess age-related changes in AGD.
  • To evaluate two common AGD measurement methods.

Main Methods:

  • Compiled data from 3705 healthy children (0-24 months) across 4 international centers.
  • Collected 7295 AGD measurements, including ano-scrotal, ano-penile, and ano-clitoral distances.
  • Analyzed AGD in relation to body size indices (BMI, length, etc.) and assessed measurement reproducibility.

Main Results:

  • Age-specific reference ranges for AGD were created.
  • AGD increased from birth to 6 months, then plateaued.
  • AGD/BMI changes were minor in the first year (0-6% in boys, 0-11% in girls).

Conclusions:

  • Established AGD reference ranges are valuable for epidemiological research and clinical evaluation of prenatal androgen action.
  • AGD increase in the first year is age-related, while AGD/BMI remains stable.
  • The TIDES and Cambridge measurement methods demonstrated equal reproducibility.
Abstract

Keywords:
anogenital distancedisorders of sexual developmentendocrine disrupting chemicalsreference ranges

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