What is a hernia?

But that's exactly what they are (def not lovely tho)-little bulges that occur when an internal organ pushes through the wall of muscle or tissue surrounding it, says Mary Ann Hopkins, M.D., associate professor of surgery at NYU Langone Health, a surgeon who specializes in treating hernias.

Hernias can be super hard to diagnose in women, Hopkins says-they’re small and you often can’t even see the telltale bump that identifies them.

But left untreated, certain hernias can lead to discomfort, pain, and more dangerous conditions like intestinal blockages and even gangrene. Here’s what you need to know to ID the issue.

What Exactly Is a Hernia?

Like we said: Hernias occur when your an internal organ busts through its protective layer of tissue and muscle.

“There are a number of types of hernias, but the most common occur in fairly predictable areas," says Hopkins:

Your groin (an inguinal hernia)
The top of your inner thigh (a femoral hernia)
Your abdomen (a hiatal hernia)
And between your navel and sternum (an epigastric hernia)

Hernias can also occur at the site of a surgical incision or near your bellybutton (that's called an umbilical hernia).

If you have a hernia in your abdomen or groin, you might notice a lump or bulge that can be pushed back in, or that might disappear when you’re lying down. But because women typically experience internal hernias, you might just experience consistent pain that has no other explanation.

How Common Are Hernias?

Very: Hernia repair is one of the most common surgical operations worldwide, according to JAMA Surgery. And inguinal hernias are by far the most common issue, making up 75 to 80 percent of hernia cases, that same journal reports. Approximately 27 percent of men and 3 percent of women will develop a groin hernia at some time in their life, according to the New England Journal of Medicine.

But Hopkins says she’s seeing more and more epigastric hernias in young, thin, otherwise completely healthy women who regularly do yoga and Pilates. “Epigastric hernias are usually congenital, you're born with them. But I think the arching that goes on in yoga and Pilates puts a fair amount of pressure on the abdominal wall, which can lead to a hernia,” she says. “But epigastric hernias are not dangerous. They’re usually very tiny.”

What Causes A Hernia?

“There’s no one culprit to blame for hernias,” says Hopkins. “They can be hereditary, or age-related-your tissues get looser when you’re older.” But hernias are generally caused by muscle weakness and strain, and there are things that can put you more at risk.

Smoking (which can cause a chronic cough), chronic constipation, being overweight or obese, and even lifting really heavy weights can all put strain on the abdominal region. And pregnancy, which puts pressure on the abdomen, can be a major cause of hernias in women.

What Are the Common Symptoms?

There’s a pretty large spectrum of symptoms when it comes to hernias, and it’s entirely possible to have one that’s asymptomatic too. “Most patients, though, describe the main symptom as an awareness or a discomfort that may be worse at the end of the day, after they’ve been standing for a long time or straining a lot,” says Hopkins.

They can occasionally progress: “With an inguinal or femoral hernia, sometimes women will get a burning sensation that can go down to the labia, or discomfort or even pain or burning in the upper inner thigh,” says Hopkins.

The more concerning symptoms occur when you have something called a strangulated hernia. “That's when the intestine goes into the hernia-whether that's a femoral hernia or inguinal hernia, and ends up getting stuck there,” she explains.

Over a couple of hours, the symptoms can progress to extreme pain, potentially with nausea and vomiting. “Typically, an incarcerated or a strangulated hernia is so painful, you'll go to the emergency room almost immediately,” says Hopkins.

How to Treat a Hernia

Once you get a hole in your muscle or tissue that allows an internal organ to push through, that hole will not seal up on its own. “You can't exercise or strengthen your muscles or tighten your muscles to have them go away,” says Hopkins.

People who are asymptomatic or who have minimal symptoms may just have to engage in “watchful waiting." But once you become symptomatic, “the only option at that point in time is surgical repair, either with sutures or mesh, which will depend on both the location and the size,” says Hopkins.

Can You Prevent Hernias?

“The only thing you can really do is mitigate your risk factors, says Hopkins. “So if you smoke, stop smoking so you don't cough. If you get constipated and are really straining to have a bowel movement, make sure that you take a stool softener so that you're not pushing. If you do pretty heavy duty weight lifting, scale back. If you’re really into yoga, make modifications to arching your back.”

What It’s Like to Live With a Hernia

A hernia can range from just unsightly to downright painful. These women opened up on Reddit about what it’s like to deal with one:

“I found a very small (less than 1cm small) hernia on myself after a [CrossFit] WOD with a bunch of sit-ups [in May 2016]. Before I felt the lump, it kind of felt like a stitch in my side that wouldn't go away. I kind of poked around and felt the lump and was able to push it back in with a similar ‘weird feeling.’ I had it repaired in June of 2016. They didn't do mesh because it was so small and closed it with one stitch. I spent two months off with another two months building weight back up.” -jellybeann88

“I had an umbilical hernia during my last pregnancy. I had a surgical repair, no mesh. I am able to do whatever I want … with no pain. Mine, while small, allowed a small piece of the omentum [a fold of peritoneum connecting the stomach with other abdominal organs] through the hole that got stuck and required surgery. I'd get it addressed if you can, if you indeed have one. I know the squishy feeling of pushing on a hernia. Yuck.” -lifeinak

“I ... had an inguinal hernia repaired this past March. I really didn't want to exercise at all in the beginning anyway, so lots of movies were watched and books were read. The two-week mark was also when I began power walking as running was still restricted, but by then, I was bored as hell so a brisk walk outdoors was nice. It wasn't until week four that I was able to run again comfortably, but I was unable to run for almost an entire year before surgery, so what was another four weeks? I now run on a regular basis and boy did I miss it! I do not regret the surgery one bit!” -freedomflower