📸: @obstetricnurse

Lena Dunham wrote an essay for the March issue of Vogue detailing her choice to have a hysterectomy at 31. It was a brave move on her part– there is no doubt she knew the risk involved to reveal such a vulnerable detail of her life. We have always been huge fans at Pitusa of her brilliant show GIRLS and her fearlessness when it comes to her art. She’s never been afraid to talk about her body, so it makes sense that she opened up about this. It’s a heartbreaking trial to have to face and that she decided to speak out will certainly result in millions of women feeling less alone. Because, despite the fact that it’s 2018, there is still a stigma attached to hysterectomy. In Dunham’s case it was a choice she made, but many times it’s performed because there is no other option. Somehow there is a sense that having a hysterectomy is a failure – and something to be ashamed of or swept under the rug. And frankly, it’s sexist. As a society, there should be no shame in discussing these things openly. It’s a large part of the reason so little is known about many female medical conditions.

 

Dunham has had a decade-long battle with one such condition: endometriosis – an inflammatory condition that currently affects approximately 5 million women in the US. It’s difficult to know the exact number because it is so misunderstood. Many women may have symptoms but have not been diagnosed. There is no known cause of the often debilitating and very painful condition – and therefore not a huge amount can be done to ameliorate symptoms beyond lifestyle changes and hormone therapy–and there’s no guarantee that those will work. There are suggestions like regularly exercising, eating a low-sugar and high protein diet. Dunham tried a myriad of things to get her body to co-exist peacefully with her endometriosis, she writes in the essay: “From August to November I try desperately to manage this new level of pain. I try so hard it becomes a second job. I go to pelvic-floor therapy, massage therapy, pain therapy, color therapy, acupuncture, yoga, and a brief yet horrifying foray into vaginal massage from a stranger.”

 

The media loves to have a field day with anything Dunham comes out with – for some reason, she has become a punching bag for an unforgiving press (and Twitter trolls). And since it was Dunham’s choice to have a hysterectomy, her essay was met with some derision. There are some who contend that having a hysterectomy doesn’t cure endometriosis. But that’s not the point: Dunham didn’t have to tell us about her choice – and that’s just it, it was her choice, and it was the right one for her body. To look at the symptoms and know that Dunham lived 10 years with this condition, it’s admirable that someone who lived in such a great amount of pain did everything she could to take care of herself and decided enough was enough. According to the National Women’s Health Network symptoms include: “pain before and during periods, pain during or after sexual activity, fatigue, infertility, and heavy bleeding. Other symptoms that may occur with periods include painful bowel movements, lower back pain, and diarrhea and/or constipation or other intestinal upsets.” At this moment, facing the loss of not only her uterus, a vital organ, but also the option to carry her own child Dunham doesn’t deserve think-pieces about how she possibly made the wrong choice (didn’t she get enough of those when GIRLS was still airing?) – she deserves compassionate understanding.

 

The idea that every single woman wants to have a child is simply false (and again, sexist). Of course, there are a great number of women who want to be a mother and it can be a devastating loss when you’re told that you are infertile or that you will most likely have a miscarriage or that your only option is surrogacy or adoption. It’s a loss like any other, and there is a necessary grieving process that accompanies it. Dunham writes: “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. But I wanted that stomach. I wanted to know what nine months of complete togetherness could feel like.”

 

Even with the emotional truth of facing losing one’s uterus: the fact that there are doctors who will not listen or even argue when women ask to have their uterus taken out due to debilitating pain shows how far we have to go in this area. Dunham herself had to jump through a considerable share of her own hoops to convince her medical team that she wanted to have a hysterectomy. That we as a society question a woman’s choice when it comes to reproductive health starkly illustrates we have a long way to go until we trust women. We owe our women more, and the medical community would do well to start listening when women say they are in pain: and believing them.

 

Lena Dunham made a choice for her body, and chose to share about it because that’s what she does—she’s a storyteller. People sit up and pay attention when she puts something out into the world. So although everyone’s body is different and of course, a hysterectomy is not the right choice for everyone – it’s a beautiful impulse to share one’s vulnerability in the hopes that others feel less alone. It’s a conversation worth having and we hope it’s one that will continue to shake its stigma so more women have the agency to advocate for their reproductive health. It’s important to remember that not everyone has a voice as loud as Dunham’s, nor do they have the resources to take care of themselves. The more we educate ourselves on our options, the more power we have collectively.

 

To find out more about endometriosis and hysterectomy you can visit the Endometriosis Foundation of America and the ACOG.