A "THOROUGH" examination would have determined Caster Semenya's gender, a gynaecologist has said.

Herman Netshidzivhani said there were at least three ways to determine gender, including the testing of blood for dominant hormones, physical examination and an ultrasound to detect reproductive organs.

Netshidzivhani said a blood test would determine the ratio of hormones that dictate a person's sex. Human beings have both testosterone and oestrogen but in varying quantities. A man has more testosterone, which determines masculine traits such as a deep voice and muscle bulk. A woman will have more oestrogen, which promotes the development of reproductive structures in the body.

An ultrasound would have detected whether she had internal reproductive organs such as Fallopian tubes, ovaries and a womb. A physical examination would have detected anomalies in her genitals such as a "shallow vagina" and an enlarged clitoris, said Netshidzivhani.