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What Is A Total Hysterectomy? Lena Dunham Had The Procedure Done For Her Endometriosis

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Fans who’ve followed along with Lena Dunham through her struggle with endometriosis know the suffering she’s endured through debilitating symptoms, like weeks-long vaginal bleeding, chronic exhaustion, and knife-to-the-uterus painful cramping. A warrior through it all, Lena Dunham has now had a total hysterectomy to treat her endometriosis, and she's shared her experience through an emotional, albeit gorgeously written editorial for Vogue that details what a total hysterectomy is, when she had the procedure done, and how the 31-year-old is coming to terms with such a life-changing decision.

Before getting into the actual procedure, let’s backtrack for a second to identify what, exactly, endometriosis is. MedicineNet defines the condition as the “abnormal growth of cells (endometrial cells) similar to those that form the inside of the uterus” that grow outside the uterus, usually “on other organs of the pelvis.”

While most women with endometriosis won’t show any symptoms, some, like Dunham, experience side effects like severe menstrual cramping, discomfort during sex, painful urination or bowel movements, and, in some cases, infertility. A diagnosis is made through surgery, and once a diagnosis is made, the endometriosis is classified as one of four stages from "minimal" to "severe," based on where the cells are located and the severity of their growth.

Having a hysterectomy is one way to treat, not cure, endometriosis.

According to the Endometriosis Foundation of America, one in 10 women in the United States will suffer from the condition, while a heartbreaking 176 million women worldwide are currently struggling.

The first signs of endometriosis usually occur when a young woman experiences her first menstrual cycle (as early as 11 years old), according to the Endometriosis Foundation of America. Though experts have yet to figure out the root cause of the disease, surgical treatments and medication are available to ease the pain — one of them being a hysterectomy.

According to the Office on Women's Health, every year, about 500,000 women in the United States have a hysterectomy, which is a procedure that involves a doctor surgically removing the woman's cervix and uterus, aka where a baby develops during pregnancy. By removing a woman’s uterus, she is no longer able to become pregnant, and she will stop experiencing a menstrual cycle.

It's important to note that, while Dunham’s decision to remove her uterus will likely ease her endometrial pain, it will not cure her of the condition entirely. University of Michigan Medicine reports that, generally, 85 out of 100 women who have the surgery do not experience pain after the fact. However, there is always that small chance that the pain can resurface. The only way to definitely cure endometriosis once and for all is to remove both ovaries by having a procedure called an oophorectomy.

The recovery process after having a hysterectomy is long, and you'll feel your body start to change.

It's been a few months since Dunham's surgery, and "despite some small complications," she wrote in her Vogue editorial, physically, she's "healing like a champ," but her emotional attachment to the surgery and loss of her uterus is something she's still working through. She wrote,

I have a limp, the result of a pinched nerve in my pelvis, but I rock it like the new Balenciaga boots I bought myself as a push present. My mind, my spirit, are another story.
Because I had to work so hard to have my pain acknowledged, there was no time to feel fear or grief. To say goodbye. I made a choice that never was a choice for me, yet mourning feels like a luxury I don’t have.

Although I cannot imagine what this might be like for Dunham, I hope she finds even the slightest bit of comfort in the fact that what she's feeling is a normal reaction women have after the surgery. From what I understand, the recovery process is not solely physical; it's emotional, as well.

According to Healthline, when you undergo a full hysterectomy, you no longer have a menstrual cycle, Pap smears might not be necessary (though you should absolutely speak to your physician to make sure of this), your sex drive should be on the up and up, and if you do decide to take out your ovaries, menopause will follow the procedure.

What's more, it's likely that you will experience some sort of emotional reaction, Healthline reports. A hysterectomy is such a personal, difficult decision for a woman to make, because you are taking away a very feminine part of your biological makeup.

This is especially true for Dunham, who said she always wanted to be a mother and experience all the ins and outs of pregnancy. Luckily, she explained, there are options for her if and when she decides she wants to become a mother.

Because her body still has ovaries, she said, eggs are still produced, so there are options for a surrogate. Adoption is also still possible, of course, and it's an option she described as a "thrilling truth" that she eventually plans on pursuing. Still, she wrote that she mourns the fact that she will be unable to carry her own child, though she is beginning to come to terms with her decision:

I wanted that stomach. 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. And all that will be left is my story and my scars, which are already faded enough that they’re hard to find.

Like anything else, you have to make the right decision for your body, and though I can only begin to imagine what Dunham must be experiencing right now, I can send her love and well wishes during her recovery.