Women with congenital adrenal hyperplasia (CAH), which results in elevated androgen levels before birth, have lower, more masculinized 2D:4D on average. Other possible physiological effects include an enlarged clitoris and shallow vagina. Males with CAH have more smaller (more masculine) digit ratios than control males, suggesting that prenatal androgens affect digit ratios. Amniocentesis samples show that prenatal levels of testosterone are in the high-normal range in males with CAH, while levels of the weaker androgen androstenedione are several fold higher than in control males. These measures indicate that males with CAH are exposed to greater prenatal concentrations of total androgens than are control males.