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The link between ovarian cysts and endometriosis

Ally Hirschlag is a producer/actor/writer who lives in Brooklyn, NY and buys way too many toys for her cats. She contributes to several publications, including Bustle, and The Nerve, and enjoys writing about all things woman. In her spar...

Endometriosis is hard to diagnose and even harder to live with

Recently Lena Dunham, creator and star of the hit HBO show Girls, was hospitalized for a ruptured ovarian cyst. This was likely due to a bad turn in her endometriosis — a condition the actress/writer/producer has had for most of her life.

Dunham has been refreshingly open about her struggle with the disease as a way of showing fellow sufferers that they shouldn't be ashamed of it. In fact, back in February, she used her decision to take a break from press work for the new season to explain how the disease is taking its toll on her.

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Dunham explains that endometriosis is a "chronic condition that affects approximately 1 in 10 women's reproductive health," but there's a lot more to it than that. Endometriosis is one of the most elusive diseases that affects women, especially because it's so difficult to diagnose.

As such, I consulted Dr. Sherry Ross, an OB-GYN at Providence Saint John’s Health Center in Santa Monica, California, to get a better understanding of how it works.

The simple definition of endometriosis is a condition in which the tissue that normally lines the uterus is found outside the uterus. "These 'endometrial implants,' as they are referred to, can be found on the ovaries, fallopian tubes, bowels, bladder and anywhere else in the pelvis," Dr. Ross said. While symptoms vary somewhat from person to person, they're usually related to your monthly cycle. Whereas normal uterine lining sheds, causing you to bleed from your vaginal opening every month, someone with endometriosis will have bleeding occur wherever that extrauterine lining happens to be growing. So, instead of leaving your body, that shed uterine lining will build up into scar tissue, swell and sometimes cause acute pain during your time of the month.

More: Lena Dunham's outspoken opinions can now be found in your inbox

The ruptured cyst Dunham experienced was simply an enlarged endometrial implant that formed on her ovary. Women who suffer from endometriosis often get these types of ovarian cysts, otherwise known as ovarian endometrioma, but they don't always rupture. And even when they do, they doesn't usually require hospitalization. Dunham's cyst might have been particularly large, needing surgery to remove the scar tissue that resulted from the rupture.

Endometriosis is often genetic, so if your mother, sister or aunt has it, you have a higher chance of having it. Particularly long periods and severe childhood acne have also been linked to the disease's development. Unfortunately, little can be done to prevent the onset of endometriosis, but some believe that reducing inflammation in the body can lower risk or lessen symptoms. Dr. Ross said, "Many believe that keeping your estrogen levels low can help reduce your risk. The birth control pill, regular exercise, avoiding excessive alcohol and caffeine all help keep estrogen levels low in your body and help reduce your risk."

There is no cure for endometriosis. Once you're diagnosed, it's all about treating the symptoms. Patients are often prescribed pain medications and birth control to lessen the severity of pain during their periods. If the symptoms are really severe, sometimes laparoscopic surgery to remove the scar tissue is recommended.

More: What OB-GYNs want women to know about endometriosis

While it is difficult to diagnose the disease (even for a specialist), women are becoming more apt at pinpointing their symptoms thanks to online resources. However, the diagnosis is just a small part of the battle. Living with endometriosis is difficult and can lead to other complications (like Dunham's cyst). Thus, Dr. Ross says, "It is incredibly important to find a health care provider who is comfortable and competent in treating endometriosis and who can guide your treatment based on your personal needs." This is especially true if you're trying to get pregnant as endometriosis can negatively affect your fertility. According to Dr. Ross, 40 percent of women with infertility also have endometriosis.

The one silver lining is that the symptoms should dissipate once you go through menopause and no longer shed your uterine lining monthly.

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