Inguinal and Femoral Hernia in Women: Why Careful Evaluation Matters

Inguinal hernia is more common in men. In women, however, groin hernias require careful assessment because the relative rate of femoral hernia is higher than in men.

Why extra care?

Femoral hernias sit in a narrow channel and carry a higher risk of strangulation. Labelling every female groin swelling as an inguinal hernia can miss the diagnosis; examination and, when needed, ultrasound help.

Symptoms

• Bulge just below the groin crease, toward the upper inner thigh
• More prominent on standing, smaller when lying down
• Occasional pulling or pressure
• Discomfort with walking, lifting or coughing

Differential diagnosis

Groin and upper thigh swellings in women may reflect inguinal hernia, femoral hernia, lymph nodes, saphenous varix, lipoma, cyst or rarely gynaecologic causes.

Pregnancy and hernia

Pregnancy can unmask weaknesses. Non-urgent hernia surgery is usually deferred until after delivery unless there is a risk of strangulation.

Treatment

Because of strangulation risk, a diagnosed femoral hernia is generally recommended for surgical repair. Open or laparoscopic approaches may be used depending on the case.