After struggling with endometriosis since she was in her teens, Lena Dunham is now free of the painful gynecological disorder.
In the latest issue of her Lenny Letter newsletter, the Girls creator and star explains that she woke up last weekend feeling off—"knees-buckling, back-aching, dry-heaving-at-the-idea-of-breakfast off"—and ended up in the hospital for her fifth surgery in a year.
Endometriosis occurs when the endometrium, the issue that normally lines the uterus, grows outside the uterus and elsewhere in the pelvis. It it can lead to unusually heavy bleeding, severe cramps, and pelvic pain during periods. In Dunham's case, one of her ovaries had become stuck to her pelvic floor, near her rectum. The 30-year-old had been trying recently to ease her symptoms with nonsurgical measures, including yoga, therapy, and a healthy diet. "But last weekend the pain could no longer be denied," she writes.
Luckily, her operation was a success, and the actress awoke to good news: "When I emerged, cotton-mouthed, [my doctor] told me something I hadn’t expected to hear, maybe ever: there was no endometriosis left," she says. "Between my surgeries and hormonal intervention, I was disease-free."
So what does that actually mean? It is difficult to use the term "disease-free" to describe endometriosis, says Charles J. Ascher-Walsh, MD, director of gynecology and urogynecology at Mount Sinai Hospital in New York City.
The goal of surgery is typically to remove rogue uterine tissue that's triggering symptoms like pelvic pain, he explains. "It's often not possible to identify all the endometriosis—and that's why it's a very tricky thing to say 'disease-free.'"
There are doctors who claim they "cure" people of the disease, Dr. Ascher-Walsh says. "But my experience has been that that's most often not the case."
What's more, there is always a chance the disease will appear again—which is a point Dunham makes in Lenny Letter: "That doesn’t mean [my endometriosis] can never return, but for now, once my sutures have been removed and my bruises have changed from blue to yellow to green to gone, I will be healthy," she writes.
Another problem with the term "disease-free": It's possible to have the disease and not exhibit any symptoms. Dr. Ascher-Walsh has operated on patients for unrelated reasons and discovered endometriosis during surgery. "The amount of actual disease in the pelvis doesn't always correlate to the amount of symptoms a person has," he says. "What makes a person feel disease-free is a lack of symptoms."
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Whether or not Dunham is technically disease-free, the important thing is that she's no longer in pain. "I've had patients who I've operated on who felt like the symptoms never came back in a significant way again," Dr. Ascher-Walsh says. "In their minds they felt like they were cured."