Following years of chronic pain and numerous surgeries, Lena Dunham says she has undergone a total hysterectomy in the hopes of finally ending her years-long struggle with endometriosis.

Dunham has spoken openly in the past about her experiences with endometriosis which occurs when endometrial tissue, which normally lines the inside of the uterus, grows in and on other organs. She shared the news of her hysterectomy in the March 2018 edition of Vogue. The Endometriosis Foundation of America published excerpts of the article on its website Tuesday.

The 31-year-old Girls creator said shed made the difficult decision to undergo the hysterectomy, which involves the removal of the uterus and cervix, following years of complex surgeries measuring in the double digits and alternative treatments including pelvic floor therapy, massage therapy, acupuncture and yoga.

Dunham said her surgeons found several other issues with her reproductive organs while they were performing the procedure.

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 said. My ovary has settled in on the muscles around the sacral nerves in my back that allow us to walk. Lets 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.

Dunham has been hospitalized multiple times in recent years for endometriosis. Last April, she said she was endometriosis-free after undergoing surgery to move her ovaries away from her rectal wall. Weeks later, however, she suffered complications from the procedure and had to be rushed to the hospital following a red carpet appearance at the 2017 Met Gala.

Those complications forced her to cancel her Lenny Letter: America IRL tour. At the time she said she was 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, Dunham wrote in a note to fans on the Lenny Letter website.