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Practice Commentary

How should we manage women with unexplained chronic pelvic pain in light of uncertainty about the effectiveness of gabapentin?

BMJ 2017; 358 doi: (Published 21 September 2017) Cite this as: BMJ 2017;358:j3624
  1. James M N Duffy, National Institute for Health Research, doctoral research fellow
  1. Balliol College, University of Oxford, Oxford, UK
  1. Correspondence to: JMN Duffy james.duffy{at}

Chronic pelvic pain affects 2.1% to 24% of the global female population,12 and up to half of the affected women have no obvious pathology.23 The neuromodulator gabapentin can be used to modulate pain, but the evidence for its effectiveness and safety is limited, as discussed by Andrew Horne and colleagues in a related article (doi:10.1136/bmj.j3520). Here, James Duffy explores how we should manage women with unexplained chronic pain in light of this uncertainty.

Treatment of women with chronic pelvic pain is directed towards achievement of higher function with some pain rather than a cure.4 At the initial consultation, explore and document the severity of …

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