Actress, director, writer and activist Lena Dunham has revealed in a personal essay that she has undergone a total hysterectomy.

A total hysterectomy is the removal of the womb and cervix (leaving the fallopian tubes and ovaries intact) according to the NHS and, in her case, is a radical attempt to reduce the star's chronic pain.

Dunham has been open about her struggles with endometriosis, including a 2015 essay which documents her life with the disease. According to the NHS, endometriosis 'is a common condition where tissue that behaves like the lining of the womb (endometrium) is found in other parts of the body.'

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The 31 year-old has suffered from the painful disease for years, in an essay for Vogue she wrote that there were 'complex surgeries measuring in the double digits.'

She also endured chronic pain which she attempted to thwart with, 'pelvic floor therapy, massage therapy, pain therapy, colour therapy [and] acupuncture.'

In April 2017, she believed her journey was finally over after yet another surgery, yet only a month later she was rushed to hospital after the Met Gala.

This lead to the actress cancelling her Lenny tour. She explained at the time, 'I'm in the greatest amount of physical pain that I have ever experienced. After being told I was endometriosis-free after my last procedure, more disease was found in deeper spots that required immediate surgery and now physical therapy.'

Now she has revealed the true extent of her medical problems. In her essay she explained that endometriosis was only only one aspect, and detailed other problems with her reproductive organs. For example, '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.'

She continues, '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.'

The writer, who has also recently broken up with her boyfriend of five years Jack Antanoff and came under fire for being part of the Time's Up movement, ultimately feels hopeful about her medical decision.

She wrote, 'I may have felt choiceless before, but I know I have choices now. 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.

Hopefully her journey to recovery is smooth and she gets the support she needs.

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Daisy Murray
Digital Fashion Editor

Daisy Murray is the Digital Fashion Editor at ELLE UK, spotlighting emerging designers, sustainable shopping, and celebrity style. Since joining in 2016 as an editorial intern, Daisy has run the gamut of fashion journalism - interviewing Molly Goddard backstage at London Fashion Week, investigating the power of androgynous dressing and celebrating the joys of vintage shopping.