When actress, model, and reality star Denise Richards came into my office, she had been suffering from chronic pelvic pain for years. Doctor after doctor had given her the same advice: ignore it.
It’s just a hernia.
By the time Richards consulted me, she was experiencing more than just a hernia. It was four: two inguinal hernias and two femoral hernias, all needing immediate repair.
Richards’ situation is far from unique.
In case after case, the story is the same: patients show up to my clinic perplexed by an invisible pain that has been ignored, dismissed, and misdiagnosed.
Hernias are one of the most common diagnoses made by general surgeons. They’re also one of the most misunderstood. What the public doesn’t understand is that hernias are dangerous or potentially fatal if not treated.
June was National Hernia Awareness Month, and it is the perfect time to seek evaluation for a hernia, especially if you are experiencing pain in the pelvis, groin, or abdomen, with or without bulging. Hernias are common: half of all men and a tenth of women will develop one during their lifetime. Certain risk factors, such as family history or chronic cough, constipation, nicotine use, obesity, and prior abdominal surgery, can greatly increase your likelihood of developing a hernia.
Most but not all hernias exist with a bulging through the abdominal or groin muscles. Hernia symptoms can include dull, burning, sharp pain, or discomfort at the hernia. They may give you bloating, nausea, an urgency to urinate, back pain or send pain down the inner thigh. In females, inguinal hernias can cause vaginal pain, worsening pain during menstruation, or pain with intercourse. In males, inguinal hernias can cause testicular pain or pain with sexual function.
Hernias are rarer—but significantly more dangerous—when they present in women. Women are ten times more likely than men to develop femoral hernias, which, if ignored, carry a mortality rate of 5 percent. Women experiencing symptoms of a hernia should immediately seek a medical consultation.
Unfortunately, even this can present challenges: Many women experience dismissal and disbelief of their symptoms by medical professionals.
In my Beverly Hills practice, I’ve seen that hernias commonly go undiagnosed. Some patients, and even doctors, incorrectly believe that only men get hernias. Pain in women can be misdiagnosed as a muscle strain, pelvic problems, endometriosis, ovarian cysts, or fibroids. Too many women are told it is all in their heads, and they must live with it. To add to this, my research shows that up to 3 of 4 radiologic studies evaluating their pain will be misinterpreted.
Much of our understanding of hernias is derived from five major international clinical trials. Out of more than 3,000 patients involved in those trials, only 17 were women. Without the proper research or public awareness, hernias will continue to silently burden women and men alike.
All people can benefit from reducing their hernia risk factors. This includes managing weight and exercising to strengthen their core. A common misconception is that you should stop lifting weights or be less active if you have a hernia, but regular exercise can help prevent hernia development, minimize hernia symptoms, and may even reduce the size of your hernia.
A hernia belt, also called a hernia truss or abdominal binder, can reduce the discomfort of a hernia. Hernia belts are useful for those who engage in activities that require a lot of standing, bending, or straining.
However, these solutions are only temporary. Many hernias will eventually require surgery. I recommend getting at least two surgical opinions, including one with a hernia specialist, before committing to an operation. Not every hernia requires surgery, and not every patient is a good candidate for surgical repair.
Fortunately, we have a wide range of surgical approaches for hernia repair. Technological advancements have made hernia repair surgery safer and more effective than ever. A hernia surgery specialist can help you find the solution that best fits you.
If you have unexplained or chronic abdominal, groin, or pelvic pain, speak to your doctor about getting screened for hernias. Like Denise Richards, it could be the first step toward a pain-free life.
Shirin Towfigh is a surgeon and hernia specialist.
