Hernias in Women

Hernias can affect both men and women, but there are some differences in terms of anatomy and potential considerations for women, particularly in relation to pregnancy.

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Anatomic Differences

Inguinal hernias are the most common type of hernia and occur more often in men. One reason is the anatomy of the inguinal canal, through which the spermatic cord passes. During development, the testicle descends through this canal; an opening that persists can contribute to an inguinal hernia.

Women can also develop inguinal hernias. Femoral hernias, which occur through a different opening in the groin, are more common in women than in men.

Rectus Diastasis

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Diagram showing the original position of testes, path of descent, normal position of testes in scrotum, and scrotum.

Pregnancy increases pressure within the abdomen and stretches the abdominal wall, which may contribute to abdominal wall or umbilical hernias. Hormonal changes also allow the tissues to expand during pregnancy. Recovery after delivery varies, and a separation between the rectus abdominis muscles, called rectus diastasis, may persist.

Rectus diastasis and associated hernias in women can cause a number of symptoms including:

  • Pain and discomfort

  • Abdominal bulging

  • Back pain

  • Abdominal and core weakness

  • Bloating, indigestion

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Types of Hernias in Women

Women can have several different types of abdominal wall and groin hernias.

  1. Inguinal Hernia

  2. Femoral Hernia (More common in women)

  3. Umbilical Hernia (More common in pregnancy)

  4. Epigastric hernia

  5. Pelvic, obturator, and perineal hernias

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Symptoms of Hernias in Women

Most often hernias do not have symptoms and present as a bulge. Other symptoms to watch out for include:

  • Pain, discomfort or a burning sensation in the area of the hernia, groin or pelvis (Sometimes pelvic pain without an obvious source may indicate a hernia)

  • Indigestion

  • Swelling

  • Muscle weakness

  • Back pain (can be a sign of an abdominal wall hernia or diastasis)

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Diagnosis and treatment considerations

Hernias and rectus diastasis can be challenging to assess in women because symptoms may overlap with other causes of pelvic or abdominal pain, including endometriosis, ovarian cysts, and pelvic organ prolapse. A careful evaluation helps identify the cause.

Femoral and obturator hernias can trap bowel and may need prompt treatment. Your surgeon will advise on timing based on the hernia and your symptoms.

For abdominal wall hernias, pregnancy plans are part of the discussion. Elective umbilical or epigastric repair may be postponed until after a planned pregnancy when appropriate, because pregnancy can increase the risk of recurrence. Symptoms, hernia size, and the complexity of the case may change that recommendation.

Hernias in Women FAQ

Answers to common questions about hernias, rectus diastasis, and pregnancy.

Do I need mesh for my hernia repair?

Selected smaller umbilical, epigastric, and inguinal hernias may be repaired without mesh. Larger hernias or repairs involving abdominal wall reconstruction may need mesh for support and durability. Your surgeon will discuss the benefits, risks, and options for your case.

When should I have hernia surgery?

Timing depends on your symptoms, the type and size of the hernia, your health, and any pregnancy plans. Some elective repairs can wait until after pregnancy or completion of childbearing, while other hernias need earlier treatment. After delivery, allow time for recovery and discuss the appropriate timing with your surgeon and obstetric clinician rather than relying on a fixed waiting period.

Can I have a future pregnancy after hernia repair?

Discuss future pregnancy plans before choosing a repair. Pregnancy after surgery can place additional strain on the abdominal wall and increase the risk of recurrence. Your surgeon and obstetric clinician can help weigh the timing and repair options.

What are my options for rectus diastasis with a small hernia?

Options may include physical therapy to improve core function, hernia repair with diastasis repair through an abdominal incision, or abdominoplasty (a tummy tuck) when excess skin is also a concern. Abdominoplasty typically involves a longer incision near the bikini line and may combine tissue repair with excess skin removal. The scope, risks, recovery, and cosmetic goals differ; your surgeon will help you compare them.

Do I need tests to diagnose a hernia?

A medical history and physical examination may be enough. Your surgeon may request imaging if the diagnosis is unclear or more detail is needed to plan treatment.

My abdomen still bulges after childbirth. Should I have rectus diastasis repaired?

A postpartum bulge can have several causes, including rectus diastasis or a hernia. Assessment can help distinguish them. Treatment depends on symptoms such as core weakness, abdominal or back discomfort, and limits on daily activity, as well as your goals. Surgery is not always needed. A physical therapist with experience in pelvic health or rectus diastasis may help guide rehabilitation.