Moreover, the decline in blood testosterone level and increase in estrogen level via the action of the aromatase enzyme in older participants is another potential reason for increasing the prevalence of hernia among older participants where lower abdominal muscles are sensitive to the body’s estrogen hormone and tend to express a very high level of estrogen receptor; and thus, the increase in the estrogen level could lead to atrophy and fibrosis of lower abdominal muscles which results in increasing the occurrence in older participants, especially among males [16]. Here, ESR1 is linked to Hernia.