Yes, women can and do get hernias. While hernias are more common in men, women have a 3% to 6% lifetime risk of developing a groin hernia, and they account for about 10% of all hernia repair surgeries in the United States. Women also develop umbilical hernias, incisional hernias after surgery, and several rarer types linked to their anatomy. The bigger issue isn’t whether women get hernias, but that their hernias are frequently missed or misdiagnosed.
Why Hernias Look Different in Women
A hernia happens when tissue, usually part of the intestine or abdominal lining, pushes through a weak spot in the surrounding muscle or connective tissue. In men, the classic sign is a visible bulge in the groin. Women often don’t get that bulge. Instead, they’re significantly more likely to have what’s called an occult or hidden hernia, one that causes pain but doesn’t produce any visible lump.
A 2024 study found that patients with hidden hernias were significantly more likely to be female, younger, and have a higher BMI. These women had more pain before diagnosis and endured it for longer. On physical exam, they were twice as likely to have tenderness over the inguinal canal (the passage in the lower abdomen near the groin) compared to patients with visible hernias. The good news: once these hidden hernias were identified and repaired, 83% of patients were cured of their pain.
Types of Hernias That Affect Women
Women can develop most of the same hernia types as men, but certain varieties are far more common in female patients.
Femoral Hernias
Femoral hernias occur in the upper thigh, just below the groin crease, where blood vessels pass from the abdomen into the leg. Women are dramatically more likely to develop them. In a large study of Medicare patients, 14.6% of women who had groin hernia repair had a femoral hernia, compared to just 1% of men. The wider shape of the female pelvis creates a larger opening for tissue to push through.
Inguinal Hernias
Inguinal hernias, which occur in the groin area, are the most common type overall. While men get them far more frequently, women develop them too. The challenge is that women’s inguinal hernias are more likely to be the hidden, non-bulging type described above, which makes them harder to spot on a standard physical exam.
Umbilical Hernias
Umbilical hernias develop at or near the belly button, where abdominal tissue pushes through a weakness in the abdominal wall. Pregnancy increases this risk. The reported incidence of umbilical hernias during pregnancy is about 0.08%, which sounds small but is notable given how many pregnancies occur each year. A related condition called diastasis recti, where the two sides of the abdominal muscles separate, affects 30% to 70% of pregnant women and persists in about 60% of cases after delivery. While diastasis recti isn’t a hernia itself, it weakens the abdominal wall and significantly increases the chance of hernia recurrence after repair.
Incisional Hernias After C-Section
Any abdominal surgery can leave a weak point in the muscle wall, and cesarean deliveries are no exception. A large registry study found that about 2 in every 1,000 women who had a C-section needed hernia repair within 10 years. Most of these hernias appeared early: the majority of repairs happened within the first three years, with a median time of about 16 months after delivery.
Obturator Hernias
This rare but dangerous type primarily affects women between the ages of 70 and 90. An obturator hernia pushes through a small opening in the pelvic bone. Symptoms include lower abdominal pain, nausea, vomiting, and a distinctive pain that starts in the groin and travels to the inner thigh. Doctors test for it by rotating the hip to see if this movement triggers inner thigh pain. Obturator hernias carry a high risk of becoming strangulated, meaning blood supply to the trapped tissue gets cut off, which is a surgical emergency.
Why Women’s Hernias Are Often Misdiagnosed
Hernias in women are frequently mistaken for gynecological problems. Because the pain centers on the pelvis and groin, women often see a gynecologist first, where the focus naturally turns to conditions like ovarian cysts, endometriosis, or pelvic inflammatory disease. The hernia itself falls outside the typical scope of that visit.
Some hernia types mimic other conditions almost perfectly. Sciatic hernias, where tissue pushes through an opening near the sciatic nerve, cause classic sciatica symptoms, pain radiating down the leg, but MRI scans of the spine come back normal. Nerve entrapment in the groin produces nearly identical pain patterns to an inguinal hernia. This overlap means women can cycle through multiple specialists and treatments before anyone considers a hernia as the source.
The result of all this diagnostic confusion is prolonged suffering. Research has shown that women with occult hernias are more likely to use pain medications, including opioids, for longer periods before getting a correct diagnosis and definitive treatment.
How Hernias Are Diagnosed in Women
Physical examination alone catches hernias about 75% of the time. That’s adequate for large, visible hernias but unreliable for the smaller, hidden ones that women are more likely to have. Ultrasound raises detection rates to about 93% sensitivity, though it produces more false positives. MRI is the most accurate option, with roughly 95% sensitivity and 96% specificity, meaning it’s excellent at both finding hernias that exist and ruling out ones that don’t.
If you have unexplained groin or pelvic pain, especially pain that worsens with coughing, straining, or standing for long periods, and no visible bulge is present, imaging can be the key to getting a diagnosis. MRI is particularly useful when the clinical picture is unclear.
Treatment and Recovery
Hernia repair is the standard treatment for hernias that cause symptoms. Two main approaches exist: open surgery, which uses a larger incision directly over the hernia, and laparoscopic surgery, which uses several small incisions and a camera to guide the repair.
Recovery timelines depend on the approach. After laparoscopic repair, most people can resume normal daily activities within three to four days and return to work in one to two weeks. Open repair takes a bit longer, with normal activities resuming around six to seven days and a return to work typically in four to six weeks. Both approaches require avoiding heavy lifting (nothing over 10 pounds) and vigorous exercise until your surgeon clears you at a follow-up visit.
For women with diastasis recti who need umbilical hernia repair, mesh-based repairs are generally preferred over simple suture repairs. The weakened, stretched tissue around the separation makes the hernia more likely to come back if it’s closed with stitches alone.
Risk Factors Specific to Women
Several factors raise a woman’s hernia risk beyond what applies to both sexes (obesity, chronic coughing, heavy lifting, constipation). Pregnancy stretches and weakens the abdominal wall, with each pregnancy adding cumulative strain. Cesarean delivery creates an incision site that remains a potential weak point. The wider female pelvis creates a larger femoral canal, which explains the sharp gender difference in femoral hernias. Age and low body weight are additional risk factors for obturator hernias, which almost exclusively affect thin, elderly women whose pelvic openings have lost protective fat padding.
If you have persistent groin, pelvic, or lower abdominal pain that hasn’t been explained by gynecological evaluation, a hernia is worth investigating, particularly if the pain worsens with physical exertion or straining. The fact that no bulge is visible does not rule out a hernia in women.