Is endometriosis maintain by sexual selection?

Endometriosis is a disease characterized by the presence of endometrial tissue outside the uterus, causing chronic inflammation. It affects more than one in ten person who menstruate and significantly impacts quality of life due to dysmenorrhea and potentially severe and debilitating pain. Its causes remain poorly understood, and existing treatments are non-curative and generally ineffective in alleviating symptoms. Additionally, it involves infertility in one out of three person who menstruate. The goal of this project is to understand how endometriosis may have evolved and why it still exists today. The hypothesis we are putting forward here comes from the theory of Crespi and Dinsdale (2023) that the underlying mechanism that maintain this disease among people who menstruate even if it causes infertility, is sexual selection. Evidence that people who suffer from endometriosis are more competitive than other regarding sexual selection is lacking, however. In this study we will evaluate differences between a group of people who suffer from endometriosis (ENDO+) and a group who does not for characteristics that may play an important role in sexual selection and mate choice: self-rated attractiveness (based on face, body and voice), self-reported length of menstrual cycle, facial femininity and voice femininity.