Why Are Femoral Hernias More Common in Women?

Femoral hernias are uncommon overall, but they occur more often in women than in men. One reason is anatomy: the female pelvis is generally wider, which affects the space around the femoral canal where this type of hernia develops. Age-related tissue changes, pregnancy, childbirth, and other factors that increase abdominal pressure may also contribute.

Although femoral hernias are rare, they deserve prompt medical evaluation. The femoral canal is a relatively narrow space, which increases the chance that tissue can become trapped within the hernia.

What Is a Femoral Hernia?

A femoral hernia occurs when abdominal tissue, sometimes including a portion of the intestine, pushes through a weak area and enters the femoral canal.

The femoral canal is located in the upper inner thigh near the groin, below the inguinal ligament. A femoral hernia may appear as a small lump in the groin or upper thigh, although some are difficult to see or feel.

Femoral hernias are different from inguinal hernias, even though both occur in the groin region.

Why Are Femoral Hernias More Common in Women?

The difference is largely related to female pelvic and groin anatomy.

Women generally have a wider pelvis, which can create a larger space around the femoral canal. This anatomical difference is one reason femoral hernias occur more frequently in women. The NHS specifically identifies the wider shape of the female pelvis as a factor in their increased frequency among women.

Other factors may also contribute to weakness or increased pressure in this area.

Pregnancy and Childbirth

Pregnancy increases pressure inside the abdomen and stretches abdominal and pelvic tissues.

Pregnancy does not automatically cause a femoral hernia, but repeated or increased abdominal pressure may contribute when there is already an anatomical weakness.

Age-Related Tissue Changes

Femoral hernias are particularly associated with older women. NCBI patient guidance notes that they are most common in women over age 65.

As tissues weaken with age, areas of the abdominal and groin wall may become more susceptible to herniation.

Increased Abdominal Pressure

Conditions and activities that repeatedly increase pressure inside the abdomen may also contribute to hernia formation.

These can include:

• Chronic coughing
• Constipation and repeated straining
• Heavy lifting
• Pregnancy
• Obesity

These factors do not necessarily cause a femoral hernia on their own. Hernias typically result from a combination of an anatomical weak area and pressure placed on that area.

What Are the Symptoms of a Femoral Hernia in Women?

Some femoral hernias cause few or no symptoms initially.

When symptoms occur, they may include:

• A small lump in the groin or upper inner thigh
• Groin discomfort or aching
• Pain during lifting or straining
• Tenderness around the groin
• Sudden or worsening groin pain
• A bulge that becomes more noticeable while standing, coughing, or straining

Femoral hernias may also cause groin pain without an obvious bulge, which can make them harder to recognize.

Where Does a Femoral Hernia Appear in Women?

A femoral hernia generally appears below the inguinal ligament, near the crease between the lower abdomen and upper thigh.

This location is an important distinction between a femoral and inguinal hernia.

An inguinal hernia generally occurs higher in the groin, while a femoral hernia develops lower, closer to the upper thigh.

However, the difference may be difficult for a patient to identify without an examination.

Femoral Hernia vs. Inguinal Hernia in Women: What Is the Difference?

Femoral and inguinal hernias are both groin hernias, but they develop through different anatomical spaces.

Because the two types can occur close together and produce similar symptoms, physical examination and imaging may be necessary to distinguish them.

Learn more about inguinal hernias.

Why Can Femoral Hernias Be More Serious?

Femoral hernias develop through a relatively narrow opening.

This narrow space can make it easier for tissue within the hernia to become trapped. Femoral hernias therefore have a higher risk of incarceration and strangulation than many other hernia types.

An incarcerated hernia occurs when the tissue becomes trapped and cannot return to its normal position.

A strangulated hernia occurs when blood flow to the trapped tissue becomes compromised. This is a medical emergency.

Learn more about incarcerated hernias and strangulated hernia symptoms.

Are Femoral Hernias Harder to Diagnose in Women?

They can be.

Femoral hernias may be small, located deep within the groin, or cause pain without a clearly visible bulge. NCBI patient guidance notes that these hernias may initially be difficult to notice because a visible lump is not always present.

Groin pain in women can also have many other causes, including:

• Muscle or tendon injuries
• Hip conditions
• Enlarged lymph nodes
• Inguinal hernia
• Other soft tissue conditions

For this reason, persistent or unexplained groin pain should not automatically be assumed to be a muscle strain.

How Is a Femoral Hernia Diagnosed?

Diagnosis usually begins with a medical history and physical examination.

A healthcare provider may examine the groin and upper thigh while the patient is standing or lying down. The patient may also be asked to cough or strain to make a small hernia easier to detect.

When the diagnosis is uncertain, imaging may be recommended.

Possible imaging studies include:

• Ultrasound
• CT scan
• MRI in selected cases

Imaging can help identify a femoral hernia and distinguish it from other causes of groin pain or swelling.

Do Femoral Hernias in Women Need Surgery?

Femoral hernias are generally treated with surgical repair because of their comparatively high risk of becoming incarcerated or strangulated. Cleveland Clinic identifies surgery as the treatment for femoral hernias, and StatPearls notes their increased risk of incarceration and strangulation because of the narrow hernia neck.

The recommended timing and surgical approach depend on factors such as:

• Symptoms
• Hernia size and location
• Whether the hernia is reducible
• Whether tissue has become trapped
• Previous abdominal or groin surgery
• Overall health

A surgeon can determine whether an open, laparoscopic, or robotic-assisted approach is appropriate for the individual patient.

Learn more about femoral hernia treatment and surgery.

When Should a Woman See a Doctor for a Groin Lump?

A new groin or upper-thigh lump should be evaluated, particularly when it is painful, persistent, or becoming larger.

Consider scheduling an evaluation for:

• A new lump in the groin or upper thigh
• Persistent unexplained groin pain
• Pain that worsens during coughing, lifting, or straining
• A lump that repeatedly appears and disappears
• Increasing tenderness around a known hernia

Because femoral hernias can sometimes be difficult to see, persistent groin pain may also deserve evaluation even when there is no obvious bulge.

When Is a Femoral Hernia an Emergency?

Seek immediate medical attention if a known or suspected femoral hernia causes:

• Sudden or severe groin or abdominal pain
• Rapidly worsening pain
• A very tender or firm bulge
• Persistent nausea or vomiting
• Rapidly increasing swelling
• Redness or darkening of the skin around the hernia

These symptoms can occur when tissue becomes trapped or loses adequate blood supply. Severe worsening pain, nausea, vomiting, and skin color changes are recognized warning signs of a strangulated hernia.

Femoral Hernia Surgery for Women in the East Bay

Hernia Innovations provides evaluation and surgical treatment for femoral, inguinal, and other groin hernias throughout the East Bay.

Our board-certified surgeons evaluate the location and type of hernia, symptoms, medical history, imaging findings, and individual risk factors to determine the appropriate treatment plan.

When surgery is recommended, treatment may include open, laparoscopic, or robotic-assisted hernia repair depending on the individual patient and hernia.

Call (925) 940-1025 or request an appointment online.

Frequently Asked Questions About Femoral Hernias in Women

Why do women get femoral hernias more often than men?

Female pelvic anatomy is one important reason. Women generally have a wider pelvis, which affects the anatomy around the femoral canal and is associated with a greater likelihood of femoral hernia development. Pregnancy, age-related tissue changes, and increased abdominal pressure may also contribute.

Where is a femoral hernia located in a woman?

A femoral hernia usually develops near the upper inner thigh or lower groin, below the inguinal ligament. This is generally lower than the location of an inguinal hernia.

What does a femoral hernia feel like in a woman?

A femoral hernia may cause a lump, aching, tenderness, or pain in the groin or upper thigh. Some femoral hernias cause pain without an obvious visible bulge.

Can women get inguinal hernias too?

Yes. Women can develop both inguinal and femoral hernias. Although inguinal hernias are much more common in men, they also occur in women. Distinguishing between the two types may require a physical examination or imaging.

Are femoral hernias dangerous?

Femoral hernias have a comparatively high risk of incarceration and strangulation because tissue passes through a narrow opening. Surgical evaluation is generally recommended after diagnosis.

Do femoral hernias always cause a lump?

No. Some femoral hernias are difficult to see or feel and may initially cause unexplained groin pain rather than an obvious lump.

Does a femoral hernia need surgery?

Femoral hernias are generally treated surgically because of their increased risk of becoming trapped or strangulated. The timing and surgical approach depend on the patient's symptoms, anatomy, overall health, and whether complications are present.