Femoral Hernias Are More Common in Women
Femoral hernias represent the most common hernia type with a female predominance, though umbilical hernias are the most frequently encountered hernia specifically during pregnancy.
General Hernia Epidemiology in Women
The provided evidence focuses primarily on hernias occurring during pregnancy rather than general hernia epidemiology in women. However, based on the pregnancy-specific data and general medical knowledge:
Umbilical Hernias in Pregnancy
- Umbilical hernias are the most common hernia type encountered during pregnancy, with an incidence of 0.08% among pregnancies 1, 2
- These hernias are more common in women than men overall 2
- Pregnancy causes or unmasks umbilical hernias due to progressively raised intra-abdominal pressure 2, 3
- Among pregnant patients requiring umbilical hernia repair, 58% present with incarceration or strangulation 1
Inguinal Hernias in Pregnancy
- Inguinal hernias represented 58% of groin and umbilical hernias presenting during pregnancy in one surgical series 4
- The female anatomy has a stronger posterior wall of the inguinal canal compared to males, with the gubernaculum persisting as the ovarian round ligament 5
- The right side predominates (86%) when inguinal hernias occur during pregnancy 4
Clinical Context
Important caveat: While the evidence provided focuses on pregnancy-related hernias, in the general female population (outside pregnancy), femoral hernias have the highest female-to-male ratio of any hernia type, though they remain less common than inguinal hernias in absolute numbers. Femoral hernias occur 4-10 times more frequently in women than men due to the wider female pelvis and larger femoral canal.
Pregnancy-Specific Considerations
- Groin and umbilical hernias are rare in adult women outside pregnancy 4
- Neither incarceration nor strangulation occurred in any patient before or after delivery in one series of 12 patients managed expectantly 4
- Diastasis recti is very frequent in pregnancy and may persist postpartum, increasing recurrence risk especially after suture repairs 2