Women's Health Update

Women's Health Update from the Lifestages Center for Women is a quarterly newsletter for you and your family. Your physician uses this newsletter to provide updates on a regular basis. We hope you find the information timely, helpful and convenient.

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Spring 2019

Surprise! That Chronic Pelvic Pain Might Be a Hernia

When women have chronic pain in their pelvis, doctors naturally suspect it’s related to reproductive organs. But sometimes women (and their doctors) are surprised to discover the pain stems from a hernia instead.

“Being healthy, maintaining a healthy weight, not smoking and lifting correctly with your legs might help you avoid a hernia, but in the end, there’s not a lot you can do to prevent one,” says Michelle DeGroat, MD.

Hernias occur when one of the muscles around your stomach or pelvis develops a weak spot. Tissue or an organ pushes through the weak spot, creating pain and sometimes a noticeable bulge.

James de Caestecker, DO, Gem City Surgical Associates and Hernia Center, explains how hernias occur. Click play to watch the video or read the transcript.

What is a hernia?

A hernia is a defect in the abdominal wall. The abdominal walls may have a multiple layers, the skin and soft tissues, underneath the soft tissues, there is the core muscle the musculature of the abdomen. And there is an opening or defect in the core muscles of your abdomen where any part of the intra-abdominal contents including the fat, the intestines can migrate out through that opening and you will see a bulge that causes pain but that’s the hernia it’s when your intra-abdominal contents starts migrating outside that abdominal wall and that’s called a hernia.


Hernias are common and most often occur in the stomach area. There are several types: 

  • Congenital diaphragmatic hernia: A birth defect that needs surgery to repair 
  • Femoral hernia: A bulge in the upper thigh just below the groin 
  • Hiatal hernia: A small opening in the diaphragm allowing the upper part of the stomach to move into the chest 
  • Incisional hernia: Occurs through a scar 
  • Inguinal hernia: The most common type, occurs in the groin, more common in men than in women 
  • Umbilical hernia: Happens around the belly button 

What Causes a Hernia? 

Hernias can be due to a birth defect or a weakened area around a scar or previous incision. They sometimes develop after straining the muscles in your stomach or groin while lifting heavy objects. “Being healthy, maintaining a healthy weight, not smoking and lifting correctly with your legs might help you avoid a hernia, but in the end, there’s not a lot you can do to prevent one,” says Michelle DeGroat, MD, with Gem City Surgical Associates and Hernia Center.  

How Are Hernias Diagnosed?

Chronic Pelvic Pain small

Hernias can be difficult to diagnose. They often have no symptoms. Or if they cause chronic pain in the pelvic area, in women the pain is often thought to be related to the reproductive organs. If your doctor doesn’t consider a hernia as a possible cause of your pain, it can lead to a long and frustrating delay in diagnosis. Some hernias create a noticeable bulge. But others are deeper and hard to see, even on an ultrasound.  

Hard-to-find hernias are often diagnosed by a surgeon based on: 

  • Your answers to questions about when and where the pain occurs 
  • Results of a laparoscopic procedure that involves putting a camera into an incision near the navel and looking for possible causes 

“I have had patients who have gone from doctor to doctor to doctor. They have suffered with the pain of a hernia for three to four years and it has progressed to a point where it affects their lifestyle,” says Dr. de Caestecker. “I put a scope into many of these individuals, find a hernia, fix it, and they are extremely happy. The pain is gone and their quality of life has improved.” 

How are Hernias Treated?

Hernias won’t heal on their own. They almost always require surgery. Your surgeon will repair the weak spot either by stitching it or by placing a mesh over the weak spot. You’ll likely go home the same day and resume normal fairly soon after the surgery.

James E. de Caestecker, DO, FACS

James E. de Caestecker, DO, FACS

Gem City Surgeons

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