Active Women and Hernia Risk: It’s a Thing -The Toast

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I called him Henry. Henry was much like a houseguest who had overstayed his welcome. While he was no trouble to begin with — and in fact, I barely noticed him at all — after 12 to 18 months, our relationship was beginning to strain. He popped in and out whenever he wanted; he didn’t exactly cause any trouble but I always knew he was there, taking up valuable real estate and eventually, I was going to have to get rid of him.

Recently, the time came to do just that.

Turns out, it’s comparatively much easier to get rid of a long-term houseguest than it is to remove an inguinal hernia. Yes, I named my hernia Henry, and yes, it took 18 months before I bothered doing anything about it. I am apparently terrible at looking after myself.

The thing is, the hernia itself wasn’t really ever painful. An inguinal hernia is basically just a lump of fat or intestines that decides to break through a weak layer in the abdominal wall. It ends up looking like a weird, soft lump on your groin that can easily be pushed back in — or at least, mine could — and it didn’t exactly stop me from living an active life. I still went to gym classes two or three times a week, jogged, played sport, and skied or hiked on the weekend. There is an excellent chance that this active lifestyle is what caused Henry to show up in the first place.

But because inguinal hernias (there are many many other kinds of hernias) are generally considered more of a men’s health issue than women’s, it took awhile for me to figure out what was even wrong. In the last few months, Henry started to show himself more, and I felt a dull sense of discomfort every time he popped out. Because of the general region of my discomfort, googling symptoms (never a good idea) made it seem as though I had anything from ovarian cysts to cancer, until I finally spoke to some people IRL who suggested it might be a hernia.

By the time I finally saw a doctor and had an ultrasound to confirm the hernia, the doctor recommended I have surgery as soon as possible. Apparently Henry wasn’t just a benign (if annoying) friend. He was never going to go away on his own, and could actually “strangulate” my small intestines — that’s when the hernia can’t be pushed back in, and can result in a trip to the emergency room.

Long story short — I had the surgery. I figured it was better to do while I was young (-ish) and healthy. Also, my surgeon told me that it was better to repair before pregnancy, as the pressure could make the hernia even bigger. While I wasn’t planning on getting knocked up any time soon, all the signs pointed to the fact that this was something that I should probably deal with.

The surgery itself was pretty straightforward, although still fairly terrifying for someone who has never so much as had wisdom teeth removed. And I really wasn’t prepared for how much pain would be involved in recovery. The actions of sitting, walking, rolling over, or really, doing absolutely anything vaguely related to my core was painful even when I was pumped full of codeine. The general anaesthetic made me dizzy and lightheaded, but eating was also annoying because I had a sore throat and lacked appetite. As someone who has always been healthy, it was a shock to realize this fairly minor surgery had a lot of repercussions — including a warning to avoid strenuous exercise for six weeks.

More than the discomfort, though, I was amazed at how little information seemed to be available for cis women with inguinal hernias. While certainly the stereotype of old men and hospital patients is fairly accurate (men are nearly 25 times more likely than women to develop inguinal hernias), 3% of women will develop inguinal hernias in their lifetime. I can’t help but wonder if those statistics are still in date — with the rise of “fitspo” on Instagram and the popularity of high-intensity workouts or weights-based training programs like Crossfit, it’s not a stretch to assume that number of female patients will rise.

Essentially, anything that causes an increase in pressure in the abdomen can cause a hernia — like lifting heavy objects or persistent coughing. But because of cis men’s anatomy (i.e. balls), hernias are more common and the pain is generally more acute earlier on, leading to faster diagnosis. For cis women, the symptoms are similar to other women’s health problems, such as ovarian cysts, which means we’re more likely to put up with discomfort or pain for years, exacerbating symptoms by activities such as exercising, lifting children, or having sex.

Being aware of how you lift, and the risks associated with over-straining in workouts is essential to avoiding hernias. At the same time, not being embarrassed of symptoms, and checking out anything that might be unusual down there is important too.

Perhaps due to the lack of information out there, people tended to react with disbelief or embarrassment when I told them I needed time off for a hernia repair. “What exactly is that?” they’d ask, while eyeing my groin and clearly picturing some kind of hysterectomy. Men generally blushed and muttered something about a speedy recovery, before hastily exiting.

I can understand — the words “groin”, “lump”, and “surgery” don’t exactly conjure up a nice image when you’re chatting around the water cooler. But it’s this kind of lack of knowledge about hernias that can be dangerous. If hernias are relatively common (repairs are one of the most common types of general surgery operations, with 28 per 100,000 in the U.S), and apparently a hidden health risk for active men and women, why aren’t we talking about it?

Post surgery, I was fine. A little sore and a big baby when it came to painkillers, sure, but fine. But many women out there who may be lifting weights, carrying kids, or generally living an active lifestyle may experience pain or discomfort without realising what’s wrong — or be too embarrassed to take the next step to fix the problem.

Margaret is an Aussie freelance writer and editor living in beautiful Vancouver, B.C. She has worked in a variety of journalism, marketing, and digital media roles in Canada and Australia.

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It ends up looking like a weird, soft lump on your groin that can easily be pushed back in — or at least, mine could — and it didn’t exactly stop me from living an active life. I still went to gym classes two or three times a week, jogged, played sport, and skied or hiked on the weekend.
4 replies · active 467 weeks ago
Me right now:

MASAYOSHI!

(also, thanks for writing this piece!)
I didn't write it--please send all much-deserved love and credit to Margaret!
I feel like this is a slight betrayal. I'm trying to take care of you, Body, why would you do this?!?
Thanks for posting this! I'm so glad you're doing better, too. A fond farewell to Henry, may his afterlife be a pleasant one.

I have had many many patients over the years who come to me worried they have cancer and when I tell them they have an inguinal hernia, the response is invariably "but... women can't have that."

Aside from exercise-related causes, the other huge cause of increased pressure inside the abdomen of people-with-uteruses is... pregnancy and birth. Most of my hernia patients are middle-aged and have given birth before. Their hernias have grown slowly, slowly, over many years. But I have another patient with a hernia now, and plans for surgery soon, who is 25. (She's also given birth vaginally four times.)
1 reply · active 467 weeks ago
Thanks for the feedback! Really interesting to hear about your patients and the effects of pregnancy. I was 28 when I first realized something was wrong... makes me very glad to have had the operation before getting pregnant!
I had that when I was a kid for years and years, until finally, at age 12, my mom decided I go to a doctor to get that lump examined.
I didn't know it's that uncommon in women. I might have a genetic predisposition since my dad had the same thing and I was so little when I got it. But no one paid any attention to it. It would pop in and out all the time.
I recovered after being prohibited to even lift my schoolbag for 3 months and now I am trying to lift weights to get stronger.
But I lifted 20 kilos the other day and my hernia scar felt funny. Maybe I shouldn't suck it up and ignore the weird sensation.

I am glad you are better and I hope Henry never returns again.
This is great information, and I'm glad you're fully recovered! Though I'm sure you won't miss Henry, he was valuable in his own way (I'm trying to think of a silver lining/abdominal lining joke but nothing's coming to me...).
1 reply · active 467 weeks ago
He taught you to trust your gut feelings?
I had a pretty amazing anatomy professor who used to explain the development/anatomy of the testicles and their susceptibility to hernias by layering several sheets of plastic wrap to represent fascia and muscle layers and shoving her face into them to represent... well, the ball, I suppose. It was good times.
9 replies · active 467 weeks ago
It makes you wonder why something so important is completely... defenseless. I feel like I've read that it has something to do with regulating sperm temperature? Perhaps we need to rethink which is the "delicate" sex.
Sperm can't survive at body heat, so balls hang closer or farther from the body to regulate their temperature.
apricots's avatar

apricots · 467 weeks ago

I don't understand this at all, why would humans evolve so that that something we produce in our bodies can't survive at body temperature? Seems like a design flaw.
Maybe so the sperm can survive for longer outside the body / in transit between bodies?
But they're delivered in a very warm, internal way!
My partner has a difficult time telling when they're cold and hates wearing clothes, so I've learned to eyeball their balls so I know when to remind them to put a robe on. It's much more fun than them checking me for purple toes before ordering me to wear socks.
I once read something that argued basically: men are only the stronger sex if you define strength by deadlifting ability. If you define strength by the ability to withstand a gentle knee to the groin, you'll get a different result
Or the ability to push a small watermelon out of your genitals.
I had to have hernia repair when I was 19, forty years ago. And I heard from the doctors at the time that it was weird that I had one because it was a "man's thing, not a woman's thing." Apparently not much has changed in that time and reading your experiences was like a trip down memory lane. Glad you took care of it sooner rather than later. They can be very innocuous until your intestine becomes trapped in the hernia and then it can be very nasty.
I had TWO hernias as a kid! Well, one, but it re-split about two years after the surgery. I was about 5 and 7 for my surgeries. I actually had my first hernia very young (my mom noticed it when changing my diaper) but because I didn't really know how to make it happen (i.e., not enough physical awareness to know how to flex my abs), she couldn't produce evidence at the doctor's for years
My sister had a hernia that she maybe got while being born (which I guess would put a lot of pressure on a tiny baby body!) and would pop out and cause her pain. My parent's (well, let's be honest, my mom's) fix was to put her in a hot bath. This went on for 23 years.

I'm still mad at my parents for dismissing their children's pain as discomfort that can be cure by time and teeth-gritting. See also my seasonal allergies that were so bad I would wake up and not be able to open my eyes because they were crusted shut. No medicine for me! And I still had to mow the lawn.
6 replies · active 467 weeks ago
Also intense debate can eat my shorts. I want to comment more but itakes me about 5 tries to login and my comment disappears and I get mad.
Note to self: start saying "eat my shorts" more often. Ehehehehehe
In my head its the sweaty shorts I've peeled off after a big workout.
Bike shorts with a sopping chamois.
That happens to me on my school network, it's killing me and its why I've not been commenting on link roundups as much as I'd like. I did get a weird warning today, saying that my "nonce instance" was missing?
this...is just too much. I can't even say how much this article affects me. I have been slowly facing the idea that I have a hernia from my traumatic fall in 2009. I have had 3 doctors look at me and say it's nothing, and the only person who keeps insisting it's real is my friend/co karate student who is a P.A. It only shows up when I plank--and only when I do a forearm plank. I've literally had one doctor say, "Oh, there's some separation there. It'll close up on it's own". I haven't even tried to see a doctor since because she made me feel so completely stupid and useless. (and I've not had health insurance or the chance to lose that many weeks of my actual life, so what's the point, anyway). And it's the last remnant of that horrible accident year and I can't face it. I've been trying to and just gave up again, and this article appears. Seriously a punch in the gut.
2 replies · active 467 weeks ago
I'm so sorry to hear about your accident. I hope the lump isn't anything serious. If it is a hernia, like one other poster said, they are usually pretty innocent until there's a complication so it's worth asking a doctor again. It might sound silly, but it could be worth doing the plank to show them! I had to cough to get mine to show for my ultrasound, even though of course the rest of the time it popped out without warning...
Oh, it's a hernia. But no doctor I've seen cares, so I stopped trying to get them to listen. I don't have the money, anyway, this is the US. I'm still paying the med bills from 8 years ago--if I'd have declared bankruptcy then I'd be in the clear now. So actually fixing something is pretty much not going to happen, because I don't have the energy for that fight now. It would be nice, but it's not happening. I am however pretty angry when I think about it, so I just try to ignore it. Except I'm having to do fewer and fewer of the things I like (no silks, climbing, now yoga, some of my karate classes) because of it. Which sucks. I don't know, I'm just whining now.
i have an inguinal hernia. i blame yoga. i suspected it was a hernia, went to the urgency care center to get it verified and the doctor there had no clue. i basically had to tell him it was probably a hernia.

then i made an appointment with a surgeon to get it looked at. the guy was so ready to cut me open, he practically wanted to schedule the surgery for right then and there. that made me uncomfortable, as well as his complete cluelessness when i asked him about whether or not i should continue exercising (i weight lift). he just looked baffled at the question of exercise in general.

so, i made an appointment with a different surgeon for a second opinion. this guy told me that the chances of it becoming strangulated were very slim and advised waiting until the hernia actually caused pain before getting it repaired because after surgery, i would forever experience some discomfort from the scar tissue and whatnot. so, why do it now when the hernia is not bothering me? also, when i asked if i needed to curtail my weight lifting or any other activities, he said 'no'. i could continue doing whatever i'd been doing. i liked this guy better, ofc, because a) he wasn't confused by the idea of me exercising and b) he gave me the answer i wanted to hear. clearly.

it's been over 2 years at this point. oddly, any time i feel discomfort (rarely), it's never where my Henry is. it's usually several inches above the lump and just feels like a little pull. and i've noticed he gets bigger in the week leading up to my period then almost magically recedes once it starts. or if i've been eating way too much.

just thought i'd share since, as you've stated, info for women with inguinal hernias is scarce on the interwebs.
1 reply · active 467 weeks ago
Thequeenmum's avatar

Thequeenmum · 467 weeks ago

FWIW, I had a very similar experience with a small umbilical hernia. The hernia is still so small that it would have to be enlarged during the surgery to fit the surgical mesh inside.
I'm a high anxiety "fix it now!" type of person, and the surgeon was willing to fix it. My voice of reason was my friend, a surgical nurse, who said that fixing it now would cause far more problems than it was actually causing me (there is currently no pain, no strangulation, I'm still able to exercise, etc). So I'm happily working out still, ignoring it for the most part, and I'll take care of it when it becomes a problem.
In early December, I noticed a small bulge in my mid-abdomen and mentioned it to my primary doc. She said she wanted a surgeon to take a look. "Oh," I said, "I also have this odd lump lower down, but my previous doctor said it was probably a lipoma." [a fatty cyst under the skin]
"Yup, that looks like a lipoma. But I want a surgeon to look at this other one."

At the surgeon's office:
"I want to schedule an MRI to look at that bulge."
"Okay. By the way, I also have this lump lower down that my doctor thought was probably a lipoma..."
"Yeah, that's common."

Two or weeks later, the day before Christmas Eve, I'm making cookies, not worried about the scheduled MRI, when I start realizing I feel kind of crappy. I go lie down to rest for a minute, and look at my abdomen - and notice a golf ball-sized lump in my groin. It's not going anywhere. I call the surgeon's on-call doctor, and she tells me to get to an ER.

So, yes. That "lipoma" was now an incarcerated (one step down from strangulated) inguinal hernia, and I had emergency hernia surgery at midnight the night before Christmas Eve. On the bright side, I'm apparently in an elite group - I like to think of us as the top 3% of women!

The bottom line I took from the experience was that when I feel like something is just not quite right, I should probably be a little more pushy about making doctors look at it. On the other hand, the MRI they did right before the surgery showed that the other, original bulge doesn't need attention. Or at least not yet.
RocketJSquirrel's avatar

RocketJSquirrel · 467 weeks ago

OK, two things . . . One, go get any new lumps checked immediately and by a licensed health care professional. Do not mess around with that shit. Go get it checked.

Second, I had a double inguinal hernia repair as an infant. I had always been told that it was very rare for a female to have a hernia. After reading all these hernia sufferers' comments, I guess I'm not as special as I was lead to believe. :-(
My Henry showed up around 2005...5 yrs after my first c-section. I finally brought it up in 2007 and my very surprised doctor told me it was a hernia and soon after I saw a surgeon who was also surprised I had this. I was soon in surgery. The doctor came in after and said I actually had a very small one on the other side too so I had a bowtie mesh done.
Did you have an open repair or laparoscopic repair? Mesh or no mesh?
1 reply · active 433 weeks ago
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