Women report higher rates of pain than men across every major bodily site, according to a landmark global epidemiological study published in Nature Medicine. Spanning data from 6 million people across 118 countries between 1990 and 2025, the research underscores a persistent gender pain gap in clinical diagnosis and treatment.
Women Report Higher Pain Prevalence Globally
- The Gender Pain Gap is Global: Women consistently report higher pain prevalence than men across all 11 measured anatomical sites, particularly in headache, facial, and abdominal regions.
- Midlife Vulnerability: Across both sexes, pain increases most steeply before age 55, highlighting working-age adulthood as a critical window for early intervention.
- Socioeconomic Disparities: Regions with lower Human Development Index (HDI) scores exhibit substantially higher late-life bodily pain, with low back pain nearly doubling in older cohorts.
Global Scale of the Gender Pain Gap
The research, characterized by investigators as one of the largest harmonization efforts in pain epidemiology to date, tracked self-reported data from individuals aged five to over one hundred. The analysis reveals that women’s self-reported pain was universally higher across all 11 tracked anatomical locations: the head, face, neck or shoulder, foot or ankle, hand or wrist, elbow, chest, back, stomach or abdomen, hip, and knee.
While approximately 40% of all participants reported back pain globally, facial pain emerged as the least common at 2%. However, conditions such as headaches, abdominal distress, and facial pain demonstrated a distinct lifecycle phenotype, peaking earlier in life before declining. In contrast, musculoskeletal pain exhibited a progressive, age-dependent accumulation.
Professor Andrew Horne, director of the Centre for Reproductive Health at the University of Edinburgh, noted that the findings provide strong quantitative backing to long-standing clinical observations. “Pain also rises most steeply before age 55, during women’s working, caring and reproductive years. It is strong evidence that the gender pain gap is real, consistent and global. Yet women’s pain is still too often dismissed, underresearched and undertreated,” Horne stated.
Prof Rebeccah Slater, professor of Paediatric Neuroscience at the University of Oxford, emphasized the clinical paradox inherent in these findings. “The troubling paradox is that women experience more pain, yet their pain is also more likely to be dismissed, diagnosed late or undertreated,” Slater observed.
Pain Prevalence Accelerates Before Age 55
Complementing these findings, the study highlighted the critical temporal dimensions uncovered. Rather than climbing in a linear fashion throughout the human lifespan, pain prevalence accelerates most sharply prior to age 55. High-intensity pain typically peaks around age 50, whereas generalized pain reaches its zenith near age 70.
Upper body musculoskeletal complaints—including the neck, shoulders, and elbows—peak during midlife and subsequently decline. Meanwhile, lower body pain involving weight-bearing joints like the back, hips, and knees continues to mount across the lifespan due to cumulative mechanical and degenerative load.
| Pain Phenotype | Peak Lifespan Trajectory | Primary Contributing Factors |
|---|---|---|
| Headache, Facial, & Abdominal Pain | Early to mid-adulthood, declining later | |
| Upper Body Musculoskeletal Pain | Midlife, declining in older age | |
| Lower Body Musculoskeletal Pain | Continual increase across lifespan | Cumulative mechanical and degenerative load at weight-bearing sites |
| High-Intensity & Generalized Pain | Peak at age 50 (high-intensity) to 70 (generalized) |
The global distribution of pain is further dictated by structural and economic determinants. Modifiable risk factors—specifically smoking, obesity, and low household incomes—account for 18.3% of the global pain burden overall, though regional attribution varies widely. In eastern Europe, these factors account for 27.1% of pain, compared to 12.6% in sub-Saharan Africa. Individuals residing in regions with lower Human Development Index scores experience substantially higher late-life bodily pain, featuring low back pain rates nearly twice those observed in higher-development settings.
Cross-Sectional Data Limits Causal Developmental Mapping
Despite the unprecedented scope of the dataset, investigators noted methodological limitations. Because the data relies primarily on cross-sectional observations—collecting information at a single point across different age groups rather than executing longitudinal tracking of the same individuals over time—causal developmental pathways remain to be fully mapped. Uneven healthcare access in lower-resourced regions may skew self-reporting rates, as current diagnostic frameworks frequently fail to capture populations outside formal clinical settings.
