February 15, 2018 at 07:34 AM EST

Lena Dunham is opening up about the emotional process of undergoing a total hysterectomy at 31 — and how it affected her relationship with then-boyfriend Jack Antonoff.

In a harrowing essay published in the March issue of Vogue, the former Girls star chronicles the process from start to finish, explaining that she made the decision in the hopes of ending her crippling endometriosis-related pain. After “desperately” trying to manage a “new level of pain” from August to November, Dunham says she finally checked her into the hospital and refused to leave “until they stop this pain or take my uterus.”

“My family just wants to see me happy again,” she recalls. “They are, for the first time after all my shenanigans, truly scared, and my father checks my breath as I sleep, leaning close to my chest. I apologize weakly for what they are witnessing — someone who hurts too much to express themselves, who can’t help but be a nuisance at best and a terror at worst.”

Though Antonoff, 33, was also supportive, Dunham says the situation wasn’t easy on the couple.

“My beautiful partner, who has seen me through so much pain with compassion and care, has to be away for work, and I can feel us growing slowly apart, since life is so determined to display its full complexity right now,” she says. “I am surly and distant. I offer nothing.”

“He reminds me again and again that I am still a woman and still alive,” she continues. “But I also know that soon — for so many reasons that have nothing to do with my uterus — we’ll slip away from each other and I will face everything I am losing in impossibly tiny step.”

Reps for Dunham and Antonoff confirmed to PEOPLE in January that the couple had split after over five years together, with a source sharing that the breakup was “amicable.” The two met in 2012 after being set up on a blind date by Antonoff’s sister Rachel and comedian Mike Birbiglia.

Days later, Dunham briefly addressed the breakup during a livestream on Instagram, revealing that she was still wearing a ring that Antonoff had given her.

“I’ll always wear it because love is a really cool, powerful, eternal thing,” she said. “It doesn’t have to be defined the way that we, in Western culture, define it as beginnings and ends.”

“Things can be, ‘You know what, you’re a drop of water, and then you reenter the ocean,’ ” she continued. “Anyway, I really love you all. I’m really thankful for the support. I’m really thankful for the love.”

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