MON-205 Estrogen Deficiency Leading To Inguinal Ovarian Hernia In Women

Abstract Disclosure: S. Verma: None. S. Hermida: None. P. Godspower: None. C. Dos Santos: None. D. Alame: None. L. Yousif: None. F. Shifaly: None. A. Perera: None. A. Dominguez-Bali: None. Inguinal ovarian hernia are most commonly seen in pediatric population or reproductive age females, the cases of inguinal ovarian hernia in postmenopausal women are exceedingly rare. This abstract explores the pathophysiological link between estrogen deficiency and the development of inguinal ovarian hernia in post-menopausal women. The structural integrity of pelvic connective tissue and musculature depends heavily on estrogen. As the level of estrogen declines with age, the pelvic floor weakens, muscle atrophies, and there is decreased uterosacral ligament resilience, as supported by studies in Bone, British Journal of Surgery, and Menopause. Such changes in tissues predisposes postmenopausal women, or women who have low estrogen to herniation by weakening the supportive structures around the inguinal canal. A case of a 69-year-old woman presenting with a left-sided tender groin mass was reviewed alongside 17 prior cases of adult ovarian hernias. CT scans and MRI imaging confirmed an ovary within the hernial sac, and surgery successfully repositioned the structure. There was no evidence of mullerian anomalies further supporting an acquired rather than congenital etiology. This case underlines the importance of recognizing estrogen deficiency induced musculoskeletal weakening as a modifiable factor for herniation in postmenopausal women or women with low estrogen. Imaging and diagnosis are crucial to avoid complications such as strangulation. Education and awareness of this mechanism can improve detection and management in post menopausal patients. This disorder could be an unknown described part of what has been recently published as the musculoskeletal syndrome of menopause. Presentation: Monday, July 14, 2025