What is a hernia? hernia in women.

A hernia is protrusion of tissue through the wall of a body cavity in which it is normally contained, most often an opening or weakness in the muscular wall of the abdomen.

A general surgeon who trains other doctors in laparoscopic surgery, explained that in men hernias often involve an obvious outward protrusion. In rare instances, such hernias may entrap a piece of the intestine, causing gangrene and even death.

But while women can sometimes develop a similar hernia, they are more likely to have a hidden, internal kind that entraps abdominal fat and compresses nerves, causing intense pain, despite frequent misdiagnoses, the symptoms of a hernia in women are really not typical of more common gynaecological problems.

The patient recalled that  she had experienced “burning, pinching pain shot down into her groin, leg and back. It was worse with exercise, prolonged standing, lifting, bending, coughing, laughing, going up and down stairs, straining at stool, and during her menstrual period”.

In other words, anything that increases abdominal pressure, sometimes even prolonged sitting, can provoke the pain, which occurs randomly throughout the day.

“Women with young children can’t bend over to pick them up. It affects their marriage because sex hurts too much, and it impairs their ability to work,” she said. “The pain can be severe enough to cause a woman to pass out. It can be so extreme that women are given spinal injections and spinal stimulators as well as multiple pain medications and psychiatric drugs.”

Tiny hernias are the worst. “The smaller the hole, the worse the pain. But in examining a woman, even with an MRI, “you don’t see the hole — you only see the hole when something goes through it.” That may require positioning the patient to provoke the symptoms.

An abdominal exam in the standing position sometimes reveals a subtle bulge. But more often these hernias can be neither seen nor felt, and a correct diagnosis relies mainly on a vaginal examination. The pelvic muscles are often tense and tender, and the patient’s pain can be reproduced by pressure on the internal inguinal area.

When a woman’s hernia is diagnosed and surgically corrected — usually by placing mesh over the hole during a laparoscopic procedure — the pain disappears completely. “It’s so easy to fix,”.

Women are also more likely than men to develop umbilical hernias, in the bellybutton, especially if they are overweight, have had multiple pregnancies or endured very long labour when delivering a baby. A patient said that she first noticed that whenever she laughed, she automatically put her hand on her stomach and could feel an odd bulge. Though she did not have much pain at first, one day she experienced “excruciating pain, as if someone had grabbed hold of my insides and was twisting them”. The surgeon she consulted told her that a piece of fatty abdominal tissue was being caught in the weakened umbilical wall and that without an operation it would only get worse.

Umbilical hernias can also entrap intestines and become life-threatening. But umbilical hernias are easier to recognise than internal hernias in women.

“The bellybutton should be perfectly symmetrical,” the doctor said. “If you look carefully, you can see the asymmetry caused by an umbilical hernia, when a little piece of fat pushes out through a small hole.”