Women report more pain across most stages of life. Researchers connect the gap to physiology, paid work and the unequal share of family care.
Data from 6,125,459 people in 118 countries and territories show how widely pain differs by sex. The participants ranged in age from 5 to over 100 years. Researchers from Instituto de Salud Carlos III and three Spanish universities found that women reported pain more often across most stages of life.
The study used self-reported pain data collected between 1990 and 2025. Nature Medicine published the research under DOI 10.1038/s41591-026-04696-w. The analysis covered eleven body areas: the head, face, neck, chest, stomach, back, elbow, hand, hip, knee and foot.
The gap is real.
Women reported pain more often in those areas during different periods of life. The largest differences appeared in facial, head and abdominal pain.
Women reported facial pain 83% more often than men, headache 74% more often and abdominal pain 60% more often.
Marta Miret from Universidad Autónoma de Madrid described the difference as multifactorial. Biology is part of the picture. The study points to menstrual migraine, endometriosis and rheumatoid arthritis.
Social conditions matter too. Women often combine paid work with a larger share of household care. That can leave less time to seek help or rest when symptoms begin.
That matters.
Pain can become persistent when people keep putting it off while work and family duties continue, according to the researchers' explanation. Men also tend to report pain less often than women. A higher number of female reports therefore does not prove that men feel less pain.
The study relied substantially on symptoms reported by participants rather than on diagnoses alone. That method captures people who rarely seek medical care. It also reflects differences in willingness and opportunity to report pain.
Smoking, obesity and low household income together were associated with 18.3% of the global burden of pain. The corresponding estimate reached 27.1% in Eastern Europe, highlighting the role of potentially preventable social and health factors.
Age alone does not explain the pattern. Seven of the eleven body regions reached their highest pain levels during middle adulthood, often before the age of 55.
Headache and abdominal pain peaked earlier. Pain in the back, hip and knee kept rising with age.
The pattern is not linear.
Development levels changed the picture as well. Among people over 65, pain linked to old age was more common in countries with low levels of development. Pain among young people was broadly similar across countries at different development levels.
Economic and social conditions were also linked to pain. The study identified obesity and addiction to alcohol and tobacco as modifiable factors. Prevention can target conditions that people and institutions can change.
The authors did not reduce the issue to personal choices. Their findings connect individual health with workload, care duties and the time available for treatment. Household income, smoking and obesity should be considered alongside clinical risk factors in pain-prevention strategies, according to the estimates.
The figures vary sharply by body area. Reported prevalence ranged from roughly 2% for facial pain to about 40% for back pain.
One dataset shows the wider pattern.
Across 118 countries and eleven body regions, the gender gap appeared throughout the life course. It was not limited to one diagnosis or one age group. The findings support a view of pain as a condition that often reaches its highest prevalence during working and reproductive years, not only in old age.
Women’s pain cannot be assessed properly without looking at physiology and unpaid care work. Social roles can affect when people report symptoms and whether they receive treatment. Ignoring that burden risks treating a repeated health pattern as a series of isolated complaints.
