In An Emotional Essay, Lena Dunham Opens Up About Having A Hysterectomy At 31

"I may have felt choiceless before, but I know I have choices now."

Lena Dunham is known for sharing her honest thoughts on everything from body image to anxiety. This week, in an emotional essay for Vogue magazine, the Girls creator and author is once again opening up, this time about her decision to have a hysterectomy at age 31 to deal with endometriosis pain.

According to the Endometriosis Foundation of America, the condition affects approximately 176 million women worldwide, including 1 in 10 women in the United States. It occurs when the uterine lining (endometrium) grows outside of the uterus, and can cause severe pain. 

Dunham has shared her endometriosis struggle with fans in the past, by showing off her scars on Instagram and teaming up with Ellen DeGeneres to surprise a nurse she befriended during a 10-day hospital stay. In Vogue, she reveals that the hysterectomy was her ninth surgical procedure in a decade-long battle with the condition.

In the essay, Dunham shares her lifelong desire to have children, and to be pregnant — and how wearing a fake belly on her TV show made her "look forward" to a real-life pregnancy. "But I know something else, too," she writes, "and I know it as intensely as I know I want a baby: that something is wrong with my uterus."

Dunham says her pain became "unbearable" last August, and she tried to deal with it until November, trying things like pelvic-floor therapy and acupuncture. "Finally I ask my doctor if my uterus needs to come out," Dunham writes. "She says, 'Let's wait and see.'"

"Two days later (which has always been my definition of 'wait and see'; I am not a patient girl) I check myself into the hospital and announce I am not leaving until they stop this pain or take my uterus. No, really, take her," she continues, going on to describe the 1,000-word essay she wrote during her time in the hospital to convince the doctors that she was sure about her decision.

Dunham goes into detail about her 12-day hospital stay prior to the procedure, and her attempts to remain humorous even as she was heading into the operating room. "I want to cry so badly, but I know it's not welcome here," she writes. "My sobbing could easily be seen as doubt and reverse it all. I am already mourning, but I am not in doubt."

Dunham explains how, after the surgery, she learned the extent of her problems: 

In addition to endometrial disease, an odd humplike protrusion, and a septum running down the middle, I have had retrograde bleeding, a.k.a. my period running in reverse, so that my stomach is full of blood. My ovary has settled in on the muscles around the sacral nerves in my back that allow us to walk. Let's please not even talk about my uterine lining. The only beautiful detail is that the organ—which is meant to be shaped like a lightbulb—was shaped like a heart.

Although she has a limp from a pinched nerve in her pelvis, Dunham says she is "healing like a champ," and is hopeful about options besides pregnancy. "I may have felt choiceless before, but I know I have choices now," she writes, saying that she will soon look into "whether my ovaries, which remain someplace inside me in that vast cavern of organs and scar tissue, have eggs," and is also considering adoption.

"But I wanted that stomach," she admits in closing. "I wanted to know what nine months of complete togetherness could feel like. I was meant for the job, but I didn't pass the interview. And that's OK. It really is. I might not believe it now, but I will soon enough."

You can read Dunham's full essay on the Vogue website.

Cover image: Sky Cinema / Shutterstock.com

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