A landmark global study published in Nature Medicine has revealed that women consistently experience higher levels of bodily pain than men across all eleven major anatomical areas. Researchers analyzed data from more than six million people across 118 countries spanning from 1990 to 2025.
The research represents one of the largest harmonization efforts in pain epidemiology to date. Data collection drew upon 902 population-based data sources, incorporating participants ranging from five years of age to over one hundred, with women comprising 55 percent of the total cohort.
Where Pain Strikes Hardest Across Eleven Anatomical Sites
Investigators examined self-reported pain across eleven specific regions: the head, face, neck or shoulder, foot or ankle, hand or wrist, elbow, chest, back, stomach or abdomen, hip, and knee. Women reported higher pain prevalence than men at every single site. The disparities proved especially stark for headaches, facial pain, and abdominal complaints. Women faced an 83 percent higher likelihood of reporting facial pain, 74 percent higher odds of suffering headaches, and a 60 percent increase in stomach or abdominal pain compared to male participants.
Among all surveyed individuals, back pain emerged as the most widespread physical complaint, affecting approximately 40 percent of participants. Conversely, facial pain proved the least common, registered by only 2 percent of respondents. Across both sexes, pain levels rose most steeply before individuals reached age 55, pointing to working-age adulthood as a critical window for the accumulation of lifetime pain burden.
Lifespan Trajectories and the Peak of Disabling Pain
The study demonstrated that pain does not follow a single uniform trajectory over time. Instead, researchers identified distinct patterns depending on the physical phenotype. Conditions such as headaches, facial pain, and abdominal discomfort peaked earlier in life before declining. Musculoskeletal complaints showed different progressions. Musculoskeletal sites including back, hip and knee showed progressive nonlinear increases through adulthood, with the most rapid gains between ages 20 and 55 years and peaking at or beyond age 75,
the authors observed.
While the overall likelihood of experiencing any bodily pain climbs steadily with age, the most disabling forms followed an inverted-U trajectory, reaching peak intensity around age 50 for high-intensity pain and around age 70 for generalized pain, before eventually declining in later decades.
Low Development and Lifestyle Factors Increase Pain Prevalence
Geographic and developmental factors heavily influenced pain distribution. Populations living in regions with lower Human Development Index scores experienced substantially higher rates of bodily pain later in life, with low back pain nearly twice as common among older adults in those areas compared to higher-development regions. By age 80, overall pain prevalence ran roughly 31 percentage points higher in lower-development countries.
Modifiable health and lifestyle factors played a measurable role. Smoking, obesity, and low household income accounted for 18.3 percent of the global pain burden. That proportion varied widely by geography, ranging from 12.6 percent in sub-Saharan Africa to 27.1 percent in eastern Europe.
Expert Responses to the Persistent Gender Pain Gap
Andrew Horne, director of the Center for Reproductive Health at the University of Edinburgh in the United Kingdom, emphasized the timing of the surge during core life stages as strong evidence that the gender pain gap is real, consistent and global.
The troubling paradox is that women experience more pain, yet their pain is also more likely to be dismissed, diagnosed late or undertreated. This enormous study shows that the higher burden of pain in women is remarkably consistent across the body and in a remarkably diverse global population.
Professor Rebeccah Slater, professor of paediatric neuroscience at the University of Oxford
Researchers emphasized that addressing these disparities requires systemic changes in clinical practice. Recommended measures include routinely analyzing data by sex, properly funding research into biological and social causes, and developing targeted, personalized treatments for female patients while taking self-reported pain seriously in medical settings.
