Here’s an age-old stereotype: Men are tough and the fairer sex is, well, less so. It sounds antiquated and maybe even sexist—but new science says there may be some truth to the idea that women experience pain more acutely than men do. In fact, women report up to 20 percent higher pain levels than men for the exact same conditions, according to a new study in the Journal of Pain. Researchers analyzed the medical records of more than 11,000 patients, who rated their pain scores on a 0-10 scale (where zero was no pain, and 10 was the worst imaginable). The findings? In every instance—whether patients were examined for hernias, sinus aches or arthritis, to name just a few—women reported feeling more intense pain than men. But does this mean women actually experience more pain, or that we’re just more apt to complain about it? “It’s not because women are wimps,” says pain expert Jacob Teitelbaum, MD, author of Pain Free 1-2-3, “but because they’re wired differently.”  Here, six surprising reasons women feel more pain than men:  

  1. They’re literally wired differently. The neural fibers (called the corpus callosum) that run between the part of the brain that regulates emotion and the part that interprets it are literally bigger in women. This difference in structure is likely why men are more prone to think things through (even unconsciously) before experiencing their feelings of pain, while women’s brains are more geared toward experiencing pain faster, says Teitelbaum. Plus, brain scans show that opposite sides of the brain light up when women experience pain compared to men.
  2. Women have fewer pain blockers. It takes twice as much morphine to squelch pain for females as it does for males, according to studies. Why? Women don’t have as many mu opioid receptors, which act like terminals to usher in feel-good endorphins to reduce pain. 
  3. Hormones make a difference. “Testosterone influences pain, and higher levels mean less pain,” says Dr. Teitelbaum. Women have lower levels of testosterone, which means a mild ache in a man may feel much more acute in a woman. 
  4. Attitude has an influence. Gender stereotypes may cause men to underreport their pain. “Men are expected to be tough while women are taught to express their emotions,” says Dr. Teitelbaum.
  5. There are clues in the blues. “Increased pain is likened to depression and anxiety because it turns your focus inward,” says Dr. Teitelbaum. But looking inward at your unpleasant feelings also means they may get amplified. Since women are at least twice as likely to have anxiety, and are 70% more likely to get depressed than men, they may be more likely to notice their pain, too.
  6. Women tune in more. “Women are better at self monitoring,” says Dr. Teitelbaum, “so they are more apt to be aware of their body’s signals in general.” In other words, they’re more likely to pay attention to their aches and pains—making them more likely to report feeling it in the first place.  More from Prevention: 5 Pain-Relieving Yoga Poses