Lena Dunham, the creator, writer and star of the HBO series "Girls," recently announced that she was taking time off from work due to endometriosis. In this chronic condition, the uterine lining grows abnormally — either outside of the uterus or on other organs or muscles in the abdomen. It is estimated that roughly 5 million women of reproductive age in the United States have the condition.
Dunham, 29, shared the message on her Facebook page, noting that she is "going through a rough patch" with the illness, which can cause extremely painful menstrual cramps along with pain in the abdomen and during intercourse, bowel movements and urination. Endometriosis is also marked by heavy menstrual periods, and bleeding or spotting between cycles as well as gastrointestinal issues including diarrhea, constipation and nausea.
Although any woman can develop endometriosis, those at greater risk are Caucasian women, women giving birth for the first time after age 30, women with an abnormal uterus and women with a first-degree relative with the condition.
"Without having examined Ms. Dunham, I would say that she may be experiencing debilitating mid-cycle pain or very painful periods as a result of endometriosis," says Dr. Jack Hsiao, an OBGYN affiliated with Sharp Memorial Hospital and Sharp Mary Birch Hospital for Women & Newborns. "She may be taking time off to allow some medical therapy to take better effect, or possibly for some minimally invasive surgery to address or excise endometriosis, which may have been found during a prior surgery."
Dr. Hsiao took a moment to answer a few questions about endometriosis, its symptoms and treatment.
How does a young woman like Ms. Dunham know whether menstrual pain is simply normal cramping or something more serious like endometriosis?
It's likely she had prior surgery or some kind of evaluation to confirm the diagnosis of endometriosis. Typically in young patients such as Ms. Dunham, the primary reasons for her to seek treatment or evaluation for this condition would be painful, debilitating periods; progressively worsening pelvic pain with or without her periods; irregular periods; or infertility issues.
Can endometriosis affect a woman's fertility?
This condition, depending on its severity, can have a negative impact on fertility, especially if it causes structural changes to the reproductive organs. Fortunately, consultation with a reproductive endocrinologist often can find solutions around most obstacles that can result from being diagnosed with endometriosis.
How is endometriosis treated?
In severe cases, surgery can help when in the care of a surgeon experienced in dealing with difficult cases of endometriosis. Often times, excision of endometriotic implants — or patches — may be required for pain relief and to preserve fertility. Laparoscopy (surgery using a thin, lighted tube through a small incision) and robotic-assisted surgery can give the surgeon better visualization, and allow for more delicate and precise movements during surgery to reduce the risk of accidental injury to other nearby pelvic organs.
Sharp also offers robotic-assisted surgery for the removal of uterine fibroids.
Dr. Hsiao explains that mild cases of endometriosis might be treated with hormonal birth control to regulate periods and reduce bleeding and pain. He recommends that you speak with your doctor about severe pain experienced during menstrual cycles, and any concerns you may have about endometriosis and how it can affect fertility.