Back in March, Lena Dunham revealed that after dealing with endometriosis for years, she'd undergone a total hysterectomy (removal of the uterus and cervix) to help treat her chronic pain due to the condition. Now, in an intense Instagram post, Dunham shared that this week she had her left ovary removed as well.
Dunham posted about the procedure on Instagram in a post that featured a photo of her lying in what appears to be a hospital bed. “Yesterday I had a two hour surgery to remove my left ovary, which was encased in scar tissue & fibrosis, attached to my bowel and pressing on nerves that made it kinda hard to walk/pee/vamp,” she wrote in the caption. “Over the last month it got worse and worse until I was simply a burrito posing as a human.”
“My mother took this picture after I spent 9 hours in the post op recovery area with v low blood pressure, the nurses were diligently monitoring. I was so out of it that I thought I looked sensually moody a la Charlotte Rampling (turns out it was more of a constipation vibe)," she continued.
The procedure to remove an ovary, called an oophorectomy, isn't common among young women. But there are a few reasons why it might be necessary.
The ovaries are the small organs that sit on either side of the uterus. They contain eggs and make hormones that regulate your menstrual cycle. In many cases, an oophorectomy may be combined with another procedure, such as a hysterectomy, the Mayo Clinic explains. But if just one ovary is removed, the other continues to make hormones, which prevents you from going into an early menopause, Lauren Streicher, M.D., a professor of clinical obstetrics and gynecology at Northwestern University Feinberg School of Medicine, tells SELF.
Patients who need to have one or both ovaries removed may have endometriosis, ovarian cancer, noncancerous ovarian tumors or cysts, an ovarian torsion (a condition in which the ovary twists), or an abscess in the area, the Mayo Clinic explains. People who have an increased risk for breast or ovarian cancer may also undergo the procedure in order to reduce the risk of those conditions actually developing.
Although we obviously don't know the specifics of Dunham's case, we know that she's previously dealt with endometriosis and underwent her hysterectomy earlier this year. Treatment for endometriosis, a condition in which the type of tissue normally found inside the uterus grows outside of it, often starts with over-the-counter pain relievers and hormonal birth control. Surgery is only used if those less extreme methods aren't successful, and there are different types of surgery available.
Removing an ovary won't necessarily "cure" someone of endometriosis, but it might relieve some of the painful symptoms, Charles Ascher-Walsh, M.D., director of gynecology and urogynecology at Icahn School of Medicine at Mount Sinai, tells SELF. Especially if a patient only feels pain on one side of their pelvis or abdomen, removing the ovary on that side could help alleviate that if other treatment options haven't helped. “But if the pain is bilateral or moves around, you wouldn’t necessarily take an ovary out for that,” Dr. Ascher-Walsh says.
In the Instagram post, Dunham mentioned that her ovary was “encased in scar tissue & fibrosis” and was attached to her bowel. It’s hard to know exactly why this might happen, but it could be due to a combination of her endometriosis and prior surgery, Dr. Streicher says. Both endometriosis and previous surgeries can cause scar tissue to develop in the area, and endometriosis can also add inflammation.
Dunham went on to say that her ovary was also "pressing on nerves" and made it hard to walk and go to the bathroom, which, unfortunately is a real thing. Which nerves are being pressed makes a difference in the symptoms a woman might experience, Dr. Streicher says. But Stephanie V. Blank, M.D., director of gynecologic oncology for the Mount Sinai Health System, tells SELF it could cause “terrible pain.”
Depending on the type of surgery you have, it may take between two and six weeks to fully heal.
“In someone who does not have endometriosis and hasn’t had prior surgery, this is usually a very straightforward procedure,” Dr. Streicher says. But extra scar tissue and inflammation “can make an ovary get completely buried in scar tissue and attached to other structures, making the surgery very complex and difficult to do.”
The surgery can either be done via a laparotomy (in which the surgeon makes one long incision in your lower abdomen to access your ovaries) or with minimally invasive laparoscopic surgery, (the surgeon only makes three or four small incisions in your abdomen in this case).
You shouldn't have any vaginal bleeding post-op, and you'll usually just feel "a little soreness around the incisions, and some internal pain in the pelvic region," she says. "Patients are able to walk around and carry on with their daily function pretty soon, they just may do it a little slower for the first week or so."
But it is "very normal" for a patient to have low blood pressure after surgery, especially when they've been under general anesthesia because those medications may temporarily lower blood pressure, Dr. Shepherd says. However, it usually goes back to normal about 24 hours post-op.
The recovery process with laparoscopic surgery usually takes one to two weeks, Jessica Shepherd, M.D., a minimally invasive gynecologic surgeon at Baylor University Medical Center at Dallas, tells SELF. But it's usually "quite a bit longer" with a laparotomy because the incision is a lot bigger, Kathy Huang, M.D., director of the NYU Langone Endometriosis Center, tells SELF. It may take up to six weeks to fully heal after a laparotomy, the Mayo Clinic says.
As Dunham heals, she said she's been reflecting on what she's learned from dealing with her medical issues, namely that "health, like most things, isn't linear."
"Things improve and things falter and you start living off only cranberry juice from a sippy cup/sleeping on a glorified heating pad but you’re also happier than you’ve been in years," she wrote in the Instagram caption. She also said she's gotten a lot of feedback from people about what she should do for her health and how her hysterectomy “should” have fixed things.
But although it's tempting to think that one supplement, one new habit, one surgical procedure could completely turn your health around, that's usually not the way it works. The truth is that everyone has good and bad days when it comes to their health. So, if you're feeling off, especially after a medical procedure, it's important to talk to your doctor about what's going on to figure out a long-term plan to get you where you want to be.
"My health not being a given has paid spiritual dividends I could never have predicted and it’s opened me up in wild ways and it’s given me a mission," Dunham wrote, "to advocate for those of us who live at the cross section of physical and physic pain, to remind women that our stories don’t have to look one way, our pain is our gain and oh shit scars and mesh 'panties' are the fucking jam. Join me, won’t you?"