A comprehensive analysis of more than six million participants across 118 nations has revealed that women consistently experience greater pain than men at every body site examined. The research, covering the period from 1990 to 2025 and encompassing ages as young as five up to over a century, was published in Nature Medicine. The findings highlight a pronounced gender pain gap that persists worldwide and underscore the need for sex‑specific approaches to pain management and research.
Gender differences in reported pain
The investigation recorded pain at 11 locations: head, face, neck or shoulder, foot or ankle, hand or wrist, elbow, chest, back, stomach or abdomen, hip and knee. Women’s self‑reported discomfort was higher than men’s for all these sites, with the most notable disparities observed in headaches, facial pain and abdominal discomfort. Experts describe the pattern as “real, consistent and global”, noting that women’s pain is frequently dismissed despite the robust evidence.
Pain trajectories through life and key risk sites
For both sexes, pain levels rise sharply before the age of 55, then peak in later decades, with back, hip and knee pain continuing to increase with age. Approximately 40 % of participants reported back pain, while facial pain was the least common at just 2 %. The study also found that individuals in regions with lower Human Development Index scores experienced a higher prevalence of bodily pain in later life, particularly low back pain, which was almost double the rate seen in higher‑development areas. High‑intensity pain peaked around age 50, whereas generalised pain reached its highest point near age 70.
Socioeconomic and lifestyle contributors
The researchers identified lifestyle and economic factors as substantial drivers of the global pain burden. Smoking, obesity and low household income together accounted for 18.3 % of all pain cases, with notable regional variations. Eastern Europe recorded the highest contribution (27.1 %), while sub‑Saharan Africa lagged behind (12.6 %). Oceania showed a relatively low smoking‑related pain rate of 6.6 % compared with 2.5 % in sub‑Saharan Africa. Obesity contributed 11.2 % of pain in Oceania, 2.7 % in central and southern Asia, and 14.6 % in North America. Low income explained around 8 % of pain globally, with the highest rates observed in eastern Europe.
Clinical and research implications
Professor Andrew Horne, director of the Centre for Reproductive Health at the University of Edinburgh, called the work a “landmark study”. He stressed that the steep rise in pain before age 55—coinciding with women’s working, caregiving and reproductive years—demonstrates the urgency of addressing the gender pain gap. “Closing the gap means taking women’s pain seriously in the clinic, routinely analysing data by sex, properly funding research into the biological and social causes, and developing better, more personalised treatments for women,” he said. Professor Rebeccah Slater of the University of Oxford echoed these concerns, noting the paradox that women experience more pain yet their symptoms are more often dismissed or undertreated. The study’s reliance on self‑reported pain, rather than clinical diagnoses, was highlighted as a way to capture populations with limited healthcare access and to inform more equitable monitoring and prevention strategies.
Why it Matters
The gender pain gap revealed by this massive, multinational study has far‑reaching consequences for public health policy, clinical practice and research funding. Recognising that women suffer more pain across the entire body—and that this disparity begins early in adulthood—calls for immediate action: healthcare providers must take women’s pain reports seriously, health systems should integrate sex‑specific data collection, and investigators need increased support to explore the biological and social mechanisms driving these differences. Addressing these inequities will improve quality of life, reduce disability and move toward a more just and effective pain‑care system for all.
