The largest study to date on sex differences in pain, published in Nature Medicine, finds that women report pain more often than men at every one of 11 body sites. The analysis spans 118 countries and territories and 6,125,459 participants aged 5 to over 100, harmonizing 902 data sources from 138 study programs covering surveys from 1990 to 2025. The Guardian and Medical Xpress report it as the most complete dataset ever assembled on the question.
The 11 sites are the head, face, neck/shoulder, foot/ankle, hand/wrist, elbow, chest, back, stomach/abdomen, hip, and knee, with risk ratios (women vs. men) ranging from 1.08 to 1.83. The widest gaps are facial pain (1.83x), headache (1.74x), and stomach/abdominal pain (1.60x). Overall, the risk ratio for reporting pain anywhere in the body is 1.16, for high-intensity pain 1.52, and for generalized pain 1.50. But the 1.83 figure needs absolute context: facial pain prevalence is only about 2% overall, while back pain reaches 40%.
Pain reporting rises most sharply before age 55, and 7 of the 11 sites follow an inverted-U curve (rising then falling). Headache peaks around age 34, abdominal pain around 23. Pain intensity peaks near age 48 at about 5.0 for women versus 4.6 for men on a 10-point scale. The authors caution that most data were collected at a single time point, so the curves show differences between age groups, not how the same people's pain changes as they age.
The study also finds a development-level split: from age 40, curves diverge between lower- and higher-HDI countries. By age 80-plus, older adults in lower-HDI countries report any bodily pain at rates about 31 percentage points higher, and low back pain at nearly twice the rate. Strikingly, known risk factors like smoking, obesity, and low income explain less of the burden there, suggesting uncaptured influences.
The study is descriptive — it does not explain the biology behind the gap. Mechanistic clues come from elsewhere: Michigan State University research published in Science Immunology in February found that the monocyte cytokine interleukin-10, linked to testosterone levels, may help explain why chronic pain persists longer in women. Alongside the paper, the team launched an open Global Lifespan Pain Benchmarking Tool where researchers and the public can look up pain reference curves by age group and region.