For the 31-year-old actress, having her uterus and cervix removed was the only cure for her painful endometriosis—even if it means she can never carry a baby. 

By Melanie Mannarino
Updated February 14, 2018
Noam Galai/Getty Images

In the March issue of Vogue, Lena Dunham reveals that she underwent a hysterectomy—surgery to remove her uterus and cervix—at the age of 31, to cure the painfully debilitating endometriosis she’d struggled with for a decade. If you follow the “Girls” creator and star on social media, you know it’s something that has bothered her for years, resulting in nine surgeries and numerous hospital stays.

In the essay she wrote, Dunham recounts the events leading up to her decision: “The pain becomes unbearable. I am delirious with it, and the doctors can’t really explain….I go to pelvic-floor therapy, massage therapy, pain therapy, color therapy, accupuncture, yoga, and a brief yet horrifying foray into vaginal massive from a stranger…. Finally I ask my doctor if my uterus needs to come out.”

It's a decision that was right for Dunham, but is it right for everyone?

What is Endometriosis?

According to the Endometriosis Foundation of America, endometriosis is a condition where the lining of the uterus grows outside the uterus—in places like the fallopian tubes, ovaries, or any of the spaces between the bladder, uterus/vagina, and rectum. Though it’s less common, endometrial tissue can also be found on the bladder, bowel, intestines, appendix, or rectum.

Symptoms can include extremely painful and heavy periods, pain during sex, pain while going to the bathroom, and infertility, according to the Mayo Clinic. The condition affects women age 25-35, and while symptoms can temporarily disappear during pregnancy, they end permanently with menopause.

Does a Hysterectomy Cure Endometriosis?

In her Vogue essay, Dunham shares how doctors were reluctant to remove her uterus and cervix, given her age. Once a woman has a hysterectomy, she can no longer carry a baby. “They don’t contemplate this request lightly, doctors,” she writes. “I know that a hysterectomy isn’t the right choice for everyone…that it’s not a guarantee that this pain will disappear.” But it’s the choice she makes.

Hysterectomy is the most extreme treatment for endometriosis—and, as the procedure removes the uterus and also triggers menopause, it is the most effective. Other, more commonly prescribed treatments only manage symptoms of endometriosis, according to the Mayo Clinic. These include OTC medications to ease pain, hormone therapy to better regulate the growth of the uterine lining, and surgery to remove built-up endometrial growth.

Though she is no longer able to carry a child, Dunham remains positive about her future as a mother. “Soon I’ll start exploring whether my ovaries, which remain someplace inside me in that vast cavern of organs and scar tissue, have eggs.” she writes. “Adoption is a thrilling truth I’ll pursue with all my might.”