Women consistently experience more pain than men across 11 body parts

A large global study spanning 118 countries, published in Nature Medicine, has found that women consistently report more pain than men across 11 bodily sites, including the back, head, face, knees, chest, abdomen and hips. The study also found that, across sexes, the sharpest increases in self-reported pain tend to occur before age 55. These findings may inform a new approach to chronic pain prevention and management throughout the lifespan. 

Shuchita Garg, MD, an associate professor of clinical medicine at the University of Cincinnati College of Medicine, Division of Chronic Pain, within the Department of Anesthesia, and the medical director of the UC Medical Center Pain Clinic, who was not involved in this study, commented on the findings for Medical News Today (MNT).

“This study is a major contribution to the field and challenges some of the existing data,” Garg told us. However, she also cautioned about interpreting the methodology.

“Since most of the data are cross-sectional, they show the age patterns within populations rather than the changes that take place in individuals,” she explained. “Moreover, the estimates refer to point or period prevalence and not to chronicity, meaning that this study deals generally with pain and not just with chronic pain.”

Since the study highlights the consistently higher prevalence of pain in women, it also raises the question of why.

Garg said, “The reasons why women have a higher prevalence of pain are complicated and include biological, hormonal and psychosocial elements, the greatest differences being found in the case of facial and abdominal pain, headaches, as well as in instances of severe symptoms.”

“The differences are greatest in the case of migraine, temporomandibular and visceral pain — conditions which correspond with the reproductive years. It is believed that pubertal development and sex hormones cause the difference between adolescent boys and girls,” she explained.

Garg also highlighted differences in immune pathways, noting that neuropathic pain has been linked to the activity of specialized immune cells called microglia in males and to T-cell — a type of white blood cell — activity in females. However, she also stressed that these findings are based largely on preclinical research in animal models.

“Conditions that differ by sex — such as dysmenorrhea, endometriosis and pelvic pain — contribute directly to the size of the abdominal area,” she explained. “The pain in question is nociplastic [a form of dull, deep, persistent pain], and the type of pain amplification seen in fibromyalgia is more frequently observed in women, which is consistent with the severity and the extent of the pain.”

Finally, Garg hypothesized that “the role of psychosocial factors and access to care includes the possibility that higher rates of depression, anxiety, trauma exposure, caregiving burden, and delays in diagnosis and treatment may be involved.”

Garg suggested that “efforts to prevent pain should be directed at adults in their 20s and 40s, and pain management must be tailored to the individual — this should begin with a thorough investigation for possible treatable causes, promote physical activity, take into account psychological therapies and look at modifying risk factors.”

Read Garg's expert advice in MNT for people experiencing chronic pain.

Featured image at top: A woman grabs her neck/shoulder area in pain. Photo/iStock/Sean Anthony Eddy.