Some researchers from Milan, Italy [it had to be from Italy] say that women with the most severe form of endometriosis are also the most attractive.

Their study involved three groups of 100 women–one group with rectovaginal endometriosis (RVE), the worst kind; a second group with peritoneal/ovarian endometriosis (POE), which is milder; and a third group who had no evidence of endometriosis.

Attractiveness was judged on a scale of 1 to 5 by raters blinded to the diagnoses of the women.

They found that 31/100 with RVE were attractive or very attractive compared to only 8/100 of the POE group and 9/100 in the No Endometriosis group. The difference was significant with p < 0.001.

Further proof of the attractiveness of the RVE women was that they first engaged in sexual intercourse at a significantly earlier age than those in the less attractive groups.

Ages of women in the three groups were similar at 32. Morphologic characteristics of the women, such as hair and eye color, BMI and waist-to-hip ratio, were similar for the three groups but RVE cohort had a significantly higher breast-to-underbreast ratio (a scientific term for large breasts).

The authors postulated that higher estrogen levels are linked with attractiveness and might also be responsible for the development of endometriosis.

The paper was published ahead of print in the journal Fertility and Sterility.

Some issues come to mind after reading this paper.

As they would have to be, the sexual histories of the subjects were self-reported. This sort of thing is always open to skepticism.

Four doctors, two men and two women, judged the subjects’ attractiveness. Is a panel of only four doctors sufficient to rate attractiveness? Who knows? In fairness, the inter-rater reliability of the four judges was good.

The criteria for attractiveness were not stated, so evidently “Beauty is in the eye of the beholder.”

Since the group without endometriosis served as a control, it represents a sample of all women of Milan. Is it possible that only 9% of women in Milan, the fashion capital of Italy [some say the world], are rather attractive or very attractive?

As usual, the media reported these findings uncritically. Along with its article, a site called Medical Daily posted a sort of NSFW photograph of celebrity Padma Lakshmi, who is very attractive and has endometriosis, severity unstated. She is not a resident of Milan but did some modeling there in the past. Also, she was once married to author Salman Rushdie, who has a son named Milan from a previous marriage.

The Medical Daily headline “Why Women Diagnosed With Rare Gynecological Condition Are “Unusually Attractive” is misleading because the condition is not rare, ‘rather attractive’ is not ‘unusually attractive,’ and the study only speculates but does not explain why the women are attractive.

Cosmopolitan handled the story with typical restraint using the title “This Painful Condition Makes You Attractive,” which of course is a complete misinterpretation of the results. The short write up is accompanied by some scathing comments from endometriosis sufferers wondering why research is focused on how women look rather than curing the disease.

There is one good thing about research like this. It keeps me occupied.

Skeptical Scalpel is a recently retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times. For the last two years, he has been blogging at and tweeting as @SkepticScalpel. His blog averages 800 page views per day, and he has over 4700 followers on Twitter.