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

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.