Groin hernias occur when tissue pushes through a weakness in the lower abdominal wall. The two main types are inguinal and femoral hernias. Both can affect women, but femoral hernias account for a greater proportion of groin hernias in women than in men and may be harder to recognise. Accurate diagnosis matters because the recommended management and risk of complications can differ.
Inguinal versus femoral hernia
An inguinal hernia develops through the inguinal canal and usually creates a swelling above the groin crease. A femoral hernia passes through the femoral canal and tends to appear lower, near the upper inner thigh. The position may be subtle, especially when the hernia is small. Fat or bowel may enter the defect, and symptoms can range from no discomfort to significant pain.
Symptoms and risk factors
Common symptoms include a groin lump, aching, pressure or burning that becomes worse with standing, coughing or lifting. Some women experience pain without an obvious lump. Pregnancy, ageing, connective-tissue weakness, chronic coughing, constipation and activities that repeatedly increase abdominal pressure may contribute, although a hernia can develop without a clear cause.
Diagnosis
Assessment includes a medical history and examination while standing and lying down. The surgeon may ask you to cough or strain gently. Ultrasound can help when a lump is not clearly visible or another condition is possible. Further imaging may be considered in complex or recurrent cases. Persistent groin symptoms should not be attributed automatically to the hip, muscle or pelvis without considering a hernia.
Treatment
A confirmed symptomatic groin hernia is commonly treated with surgery. Repair may be performed through an open incision or using keyhole techniques, often with mesh reinforcement. The choice depends on hernia type, previous surgery, general health and surgeon assessment. Because femoral hernias have a greater tendency to trap tissue, specialist advice should not be delayed.
Possible complications
A hernia can become incarcerated, obstructed or strangulated. Sudden severe pain, vomiting or a firm irreducible lump requires emergency care. Surgical risks include bleeding, infection, fluid collection, urinary retention, persistent pain or numbness, mesh complications, damage to nearby structures and recurrence.
Frequently asked questions
Are groin hernias common in women? They are less common than in men, but women are proportionally more likely to have a femoral hernia.
Can a femoral hernia be mistaken for an inguinal hernia? Yes. Examination and imaging may be needed because the location can be difficult to distinguish.
Can groin hernias be monitored? Management is individual, but suspected femoral hernias generally require timely surgical assessment.