A global study published in Nature Medicine analyzing data from over 6,125,459 participants across 118 countries reveals that women consistently report higher pain prevalence than men across all 11 examined anatomical sites, with researchers pointing to complex biological, hormonal, and immunological factors.
Researchers examining population-based data collected between 1990 and 2025 found stark disparities in how physical discomfort manifests across sexes across 902 data sources. Women demonstrated an 83% higher relative prevalence of facial pain, a 74% higher prevalence of headaches, and a 60% higher prevalence of stomach or abdominal pain compared to men.
Back pain emerged as the most commonly reported complaint overall, affecting roughly 40% of the study population. Meanwhile, facial pain proved the least common, registered by about 2% of participants according to health data. Across sexes, self-reported pain increased most rapidly before the age of 55, challenging the long-standing assumption that aches and discomfort simply accumulate steadily in later life.
Biological Drivers and Immune Pathways Behind Sex Disparities
The physiological mechanism driving these differences extends deep into cellular biology. Research published in Science Immunology identified that pain resolves more slowly in female subjects than in males due to distinct activity levels among immune cells responsible for turning pain off. The analysis also found evidence of a similar pattern in human patients recovering from traumatic injuries, with lead researcher Dr Geoffroy Laumet from Michigan State University stating that the differences have a biological basis in the immune system rather than being psychological.
Vernon Williams, MD, a sports neurologist and founding director, along with other specialists, notes that early and middle adulthood are periods when exposures contributing to pain begin to accumulate through physical workload, injuries, weight gain, metabolic disease, stress, and repetitive strain.
Clinical Recognition and the Historical Pain Gap
Beyond cellular pathways, clinical encounters remain shaped by a legacy of medical oversight. Historically, medicine has treated women’s pain differently than that of men, leaving healthcare providers underequipped to diagnose conditions that disproportionately affect women such as endometriosis, chronic pelvic pain, migraines, and fibromyalgia.
Despite this, women’s pain has historically been under-recognised, misunderstood, or inadequately treated. In some cases, their symptoms have been attributed primarily to psychological factors without sufficient clinical evaluation or appropriate investigations.
Emergency department data analyzed from a 2024 study published in the Proceedings of the National Academy of Sciences examining more than 21,000 emergency department records across the United States and Israel further demonstrates that women were less likely to receive pain-relieving medications than men, even after researchers accounted for factors including how much pain patients reported. Furthermore, nurses were less likely to record women’s pain scores, women spent about 30 minutes longer in the emergency department, and a University of Cambridge study involving 6,600 patients found that 43% of females reported having their autoimmune symptoms misattributed to psychiatric causes, compared to 33% of males.
Socioeconomic Risk Factors and Prevention Strategies Across the Lifespan
Lifestyle and socioeconomic elements compound the global pain burden. Factors including smoking, obesity, and lower household income together account for 18.3% of global pain across all anatomical sites, though this figure varied from 12.6% in sub-Saharan Africa to 27.1% in eastern Europe. People residing in countries with lower Human Development Index scores experience a substantially higher late-life prevalence of any bodily pain than those in the highest, with low back pain approaching twice the prevalence at the oldest ages.
Amanda Schild, a women’s health nurse practitioner at Sanford Health, advises that if patients feel their provider is not listening, they should seek a second opinion. Dr. Anand encourages patients to discuss non-opioid and non-pharmacologic options with their doctor as part of a comprehensive approach when medication is needed, noting that the best strategy remains prevention and preservation of function by maintaining a healthy weight, strengthening muscles supporting joints, and avoiding smoking.
The goal of pain management is function.
Readers should consult qualified healthcare professionals to discuss personalized evaluations, diagnostic investigations, and individualized multimodal treatment plans rather than relying on generalized assumptions or waiting for symptoms to resolve without clinical oversight.
