The Most Common Hernia in Women

Inguinal hernia is the most common type of hernia in women. 1

Epidemiology of Hernias in Women

The lifetime risk of developing a groin hernia in women is 3-5.8%, which is significantly lower than in men 1
Women represent only 8.0-11.5% of all operated groin hernias 1
Among hernias in women, inguinal hernias are the most common type, followed by femoral hernias (which constitute 16.7-37% of all groin hernias in women) 1
Bilateral primary indirect inguinal hernias are the most frequent type of bilateral hernias in women, while bilateral primary femoral and direct inguinal hernias are quite rare 2

High age is a significant risk factor for developing groin hernias in women 1
Positive family history increases the risk of inguinal hernia development (OR = 4.3) 3
Chronic constipation is associated with increased risk (OR = 2.5) 3
Protective factors include:
- High levels of current sports activity (OR = 0.2) 3
- Obesity (Quetelet index > 30) appears to be protective (OR = 0.2) 3
Contrary to common belief, smoking, previous appendectomy, other abdominal operations, and multiple deliveries have not been shown to be associated with inguinal hernia development in women 3

Women with inguinal hernias often present with groin pain, which can sometimes be severe 4
Common symptoms include burning, gurgling, or aching sensation in the groin, and a heavy or dragging sensation that worsens toward the end of the day and after prolonged activity 4
Physical examination typically reveals a bulge or impulse in the groin area when the patient coughs or strains 4
Imaging is rarely needed but ultrasonography or MRI may be helpful when the diagnosis is uncertain 4

The rate of emergency procedures for groin hernias in women (14.5-17.0%) is 3-4 times higher than in men, and even higher (40.6%) for femoral hernias 1
Due to this higher risk of complications, watchful waiting is not recommended for women with groin hernias 1
During surgical repair of groin hernia in females, the presence of a femoral hernia should always be excluded 1
If a femoral hernia is detected, it should be repaired using a laparo-endoscopic or open preperitoneal mesh technique 1
Women have a higher rate of chronic postoperative inguinal pain compared to men 1
Groin hernias during pregnancy should not be operated on unless absolutely necessary 1

For hernias in women, and for all bilateral hernias, a laparoscopic or endoscopic procedure is generally preferable to an open procedure 5
Mesh-based repair is generally recommended based on the pathogenesis of the condition 5
Patients treated by laparoscopy/endoscopy develop chronic pain less often than those treated by open surgery 5