Reviewer’s report
Title: 
Premenstrual dysphoric disorder is associated with the longer length from
clitoris to urethra
Version: 
1 
Date: 
23 Jan 2021
Reviewer's report:
- I think the authors are stating that imbalances, excessive or possibly inadequate
(not sure which) prenatal sex hormones are a potential causative factor for
PMDD. If this is the case then this idea needs to be clearly stated in the 2nd
paragraph of the introduction and there needs to be strong cited literature to
support this. Secondly I think the authors are trying to say that 2D:4D analysis
has been found to be related to prenatal sex hormones and possibly PMDD. If
this is the case the authors need to definitively say this. Finally, the authors
introduce AGD as a marker of prenatal sex hormones. As such they are
proposing that they need to study the relationship between 2D:4D, AGD and
PMDD. None of this is clear and it took me several times of reading and re-
reading the introduction to try to glean this information. 
- The entire introduction needs to be rewritten so that the objective and rationale
of the study is clear.
- Page 5 Line 28 - please replace the word "pacing"
- Page 5 Line 24:49; I appreciate the changes made by the authors. However, the
inclusion of animal studies in the paragraph introducing 2D:4D theories does not
make sense in its current form. It seems as if there are 3 different main ideas in
this single pathway and none of them are linked. 
I am not sure what the link is to
PCOS, unless the authors are just using the prenatal hormone theory?
- Page 5 Line 51: It seems as if there is a word missing after dimorphic
- Methods: Please change the part on no pregnancy lasting longer than 12
months. Do the authors mean 40 weeks, 42 weeks? What did they confirm.
Biological human pregnancies do not last 12 months...ever.
- Methods: Was the use of an injectable contraception (such as depo-provera) or
certain classes of intrauterine devices also exclusion factors?
- Methods: Did the women sign a consent form and was this an ethical approved
board study?
- Page 6 line 30: Please change "both hands" to "either hand"
- Did any of the study participants have a history of uterine fibroids or abnormal
uterine bleeding?
- It might be better to put the criterion of PMDD in a table either as a regular
table or as a supplement. It is currently confusing and hard to follow in the
current format.
- Page 6: Beginning on line 58 through line 2 of page 7, the authors can delete
these lines. They can simply state, "Anthropometric data was collected at study
enrollment" and then move into the AGD and CUMD measurements.
- Regarding the following statement, "In order to improve accuracy, two
examiners performed...." 1st of all I am shocked that was approved by an ethical
board. Secondly it is offensive in its current form. Would it be accurate to state
the following, "Measurements were collected in triplicate by two two
independent examiners".
- In the results add the units of measurement (i.e. kg/m2, cm, etc.)
- Was there an association between any of the measurements and the patients
current hormone levels?
- The discussion needs a lot of work
- The authors need to proofread this manuscript for grammar. There are several
instances of missing words or words in the wrong tense
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Is the study design appropriate to answer the research question (including the use
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