Lena Dunham has revealed she underwent a total hysterectomy after enduring a decade of endometriosis-related pain.
The 31-year-old actress has been open in the past about her struggle with endometriosis, a disorder which causes tissue that normally lines the uterus to grow outside of it.
In the March issue of Vogue, Dunham revealed she opted to remove her cervix and uterus in an attempt to end years of chronic pain associated with the disease.
While hysterectomies are a standard method to deal with uterine conditions, the procedure can come with serious risks especially for people under the age of 35.
Lena Dunham, 31, said she removed her cervix and uterus in an attempt to end years of chronic pain associated with the disease
‘[Hysterectomies] should never be the first resort [to deal with endometriosis],’ Dr. Lauren Streicher, author of The Essential Guide to Hysterectomy, told Daily Mail Online.
Endometriosis, a condition that affects approximately 176 million women around the world, occurs when the tissue that normally lines the uterus grows somewhere else.
The displaced tissue continues to act as it normally would — it thickens, breaks down and bleeds with each menstrual cycle, according to Mayo Clinic. Since this tissue has no way to exit the body, it becomes trapped.
This can cause painful periods, excessive bleeding, infertility and pain during bowel movements or urination.
The pain from the condition can even interfere with sex.
‘Endometriosis can cause chronic, debilitating pain that takes over your life,’ said Dr Streicher.
Dunham, who kept her ovaries after the procedure, said her decision came after ‘years of complex surgeries measuring in the double digits’ and trying alternative treatments such as ‘pelvic floor therapy, massage therapy, pain therapy, color therapy, acupuncture and yoga’.
Hysterectomies are standard to treat uterine conditions, but research shows it has risks
However, just removing the cervix and uterus doesn’t cure endometriosis.
‘If you just remove the uterus and don’t do anything about the endometriosis outside of the uterus, you haven’t cured the disease,’ Dr Tatnai Burnett, minimally invasive gynecologic surgeon at Mayo Clinic, told Daily Mail Online.
In fact, the uterus may not even be the cause of Dunham’s pain.
He said the pain factor may come from a combination of factors including fibrosis, or the creation of scar tissue, and inflammation from the body dealing with endometrial tissue in an unusual location.
Dr Burnett said there are patients who suffer from endometriosis and don’t have a uterus.
The fact that Dunham still has her ovaries means the endometriosis pain could come back.
‘Unless they take out the ovaries you’re not curing endometriosis,’ Dr Streicher said. ‘If the ovaries are left there, [she may] continue to have pain and [the ovaries] may need to be removed at a later date.’
This is because the estrogen the ovaries produce can stimulate any remaining endometriosis and cause pain to persist, according to Mayo Clinic.
But oophorectomy, the removal of ovaries, can trigger premature menopause in younger women, thus increasing their risk of osteoporosis and cardiovascular disease.
Although Dunham didn’t remove her ovaries, she could still undergo premature menopause.
‘When we leave ovaries in women still undergo menopause at least one to two years earlier,’ Dr Burnett said.
‘It will have some kind of effect on ovary function even when you leave the ovaries in,’ he said.
Furthermore, a recent study by Mayo Clinic found hysterectomies come with serious long-term risks for women under the age of 35.
Researchers found younger women who’d had a hysterectomy – without ovary removal – had a 4.6 fold increase of congestive heart failure and a 2.5-fold increased risk of coronary artery disease.
In general – including women over 35 – the operation increased the risk of obesity by 18 percent, coronary artery disease by 33 percent, lipid abnormalities by 14 percent and high blood pressure by 13 percent.
There are other risks associated with the procedure, including a higher risk of bleeding ‘because you’re removing a major organ,’ Dr Burnett said.
There’s also a risk of infection and damaging surrounding organs like the bowel and bladder.
Treatment for endometriosis usually involves medications or surgery.
Doctors often prescribe hormone medication to slow endometrial tissue growth and prevent new implants of endometrial tissue.
Surgeries are also performed to remove as much endometriosis as possible while preserving the uterus and ovaries. However, Dr Streicher said it’s difficult for doctors to get all of the tissue because the tissue can be microscopic.