Lena Dunham has called on the friends, family and acquaintances of endometriosis sufferers to stop asking whether or not they can have children.

In an essay for US Glamour, Dunham – who first wrote about her endometriosis diagnosis in 2015 – says that she has experienced “virtual strangers asking whether I’m fertile, if I plan to freeze my eggs, and how I feel about adoption”.

Around one in 10 women of reproductive age are estimated to suffer from ‘endo’, a chronic medical condition where the lining of the womb grows in other parts of the body, such as the fallopian tubes, ovaries, stomach, bladder or bowel.

Many women with endometriosis experience debilitating pain, including during periods, in their pelvis and lower back, and while having sex or going to the toilet. It can also – but doesn’t always – damage a woman’s ability to have children.

Read more: Why you should be getting checked for endometriosis if you have bad period pains

Dunham says she doesn’t appreciate the way people automatically “leap to fertility concern” when she talks about her endometriosis.

“I talk about my illness to normalise it for other women, not to invite dialogue about every aspect of my private life, including my desires around motherhood,” she writes.

In addition, she points out that “endometriosis is not a fertility death sentence.” And that’s true: according to Endometriosis UK, the condition will not necessarily lead to infertility. While it can result in the formation of scar tissue that makes it more difficult to conceive naturally, women with minimal to mild endometriosis are unlikely to have problems getting pregnant.

Women with severe endometriosis can also get pregnant – although the more extreme the scar tissue, the more difficult it generally is to conceive.

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But as Dunham observes, endometriosis is far from the only reason that a woman may or may not choose or be able to have children.

“Women mother under so many circumstances, in sickness and health, biologically or otherwise – which is why it never fails to shock me how binary this party conversation is,” she writes. “Can she or can’t she? Which is it?”

Not all women want to have children, says Dunham, regardless of whether they have endometriosis or not. And while she herself “has always craved motherhood”, she says her fertility is not something that causes her particular anxiety.

“Am I afraid that I’m a professional impostor and a total bitch? Yes,” she says. “Do I feel like half a woman because my uterus and ovaries have misbehaved so thoroughly? Heck, naw.”

Dunham also addresses women who are experiencing anxiety or distress about their fertility. “I understand,” she says. “You are in wonderful company. You are not your organs.

“Your femininity, your contribution to society, and your status as a bad bitch are already established and not dependent on your ability to bring life into the world.”

So if a friend of yours is diagnosed with endometriosis, says Dunham, don’t immediately ask if she’s thought about her fertility. Instead, she recommends a useful question that a good friend of hers asked her: “How does that make you feel, and how can I help?”

For more advice and information on endometriosis, visit endometriosis-uk.org.

Images: Rex Features