In an essay in the March issue of Vogue
titled "The Painful Truth," Dunham wrote that she has "never had a single doubt about having children."
"As a child, I would stuff my shirt with a pile of hot laundry and march around the living room beaming," she wrote. "Later, wearing a prosthetic belly for my television show, I stroke it subconsciously with such natural ease that my best friend has to tell me I am creeping her out."
Yet as much as she yearns for the experience, Dunham said she also had to face her health challenges.
"I can feel it, deeply specific yet unverified, despite so many tests and so much medical dialogue," the actress wrote. "I just sense that the uterus I have been given is defective."
According to the National Institutes of Health
endometriosis is "a condition in which the tissue that normally lines the uterus grows outside the uterus."
Symptoms can include pelvic pain, heavy bleeding during periods and fertility issues.
Dunham wrote that she tried to deal with her excruciating pain from August to November using several methods, including yoga and acupuncture.
Ultimately the 31-year-old decided she wanted to have the surgery, which removed her cervix and uterus.
Given her age, Dunham said, she had to convince her doctors that she really wanted to scuttle her chances of giving birth.
In 2016, Dunham announced she would need to take a break from promoting her hit HBO series "Girls" due to the condition.
In her Vogue essay, which was excerpted by the Endometriosis Foundation of America,
Dunham writes that during her surgery it was discovered there were even more issues than she had suspected.
"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 wrote. "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," she added. "The only beautiful detail is that the organ -- which is meant to be shaped like a light bulb -- was shaped like a heart."
It's been months since her procedure, and Dunham said she has not given up on the idea of motherhood.
"I may have felt choiceless before, but I know I have choices now," she wrote. "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."