The 31-year-old writer and actress spent years suffering from endometriosis, a disease that affects the lining of the uterus. Dunham's case was so extreme that her uterus and cervix had to be entirely removed — a procedure known as a hysterectomy.
The essay is filled with Dunham's trademark transparency and numb self-examination, sprinkled with medical jargon. She explains how the endometriosis has effected her life, leading her to "years of complex surgeries measuring in the double digits."
Dunham also lists some of the alternative treatments she's experimented with before turning to such a drastic procedure — including "pelvic floor therapy, massage therapy, pain therapy, color therapy, acupuncture" and yoga.
"In addition to endometrial disease, an odd hump-like protrusion and a septum running down the middle, I have retrograde bleeding, a.k.a. my period running in reverse so that my stomach is full of blood," Dunham wrote. "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 light bulb — was shaped like a heart."
While the total hysterectomy has freed Dunham from her long-endured chronic pain, it also means that she can't carry a child, a fact she examined closely in her essay.
"I may have felt choiceless before, but I know I have choices now," she wrote. "Soon I'll start exploring whether my ovaries, which remain someplace inside me in that vast cavern of organs and scar tissue, have eggs. Adoption is a thrilling truth I'll pursue with all my might."
Dunham's confessional essay comes on the heels of HBO's announcement that she's making a new series for the premium network. Titled Camping, the show stars Jennifer Garner in her first TV role since Alias. It was co-created by Dunham and her Girls cohort Jenni Konner.