Groin hernias (inguinal hernias) are extremely common and have a lifetime incidence of 10% in men. They are five times more common in men than in women.
Inguinal hernias are classified as direct or indirect, depending on where the intraabdominal contents pass through the abdominal wall. Indirect hernias protrude lateral to the epigastric vessels (i.e., in close association with the spermatic cord cords) and direct inguinal hernias protrude through the floor of the inguinal canal.
Femoral hernias do occur in both men and women but are more frequent in women (but still relatively rare.)
Even experienced examiners have difficulty differentiating direct from indirect inguinal hernias on exam. The best test method to detect a hernia is having the examiner place their forefinger into the inguinal canal and evaluating for a bulge when the patient coughs.