Introduction: Gabapentin has potential analgesic benefits in patients with neuropathic pain, such as post-herpetic neuralgia and diabetic peripheral neuropathy neuropathic pain. However, its efficacy in women with chronic pelvic pain (CPP) remains contradictory. In the present study, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to ascertain the efficacy of this treatment. Methods: We systematically reviewed RCTs published in PubMed, Embase, the Cochrane Library, Web of Science, and Google Scholar databases, up to July 2021. These articles compared gabapentin with placebo or any other active treatment for CPP in women, with 'the change in pain scores from the baseline during the first 3 and 6 months of treatment' taken as the primary outcome. We considered reductions equivalent to 1.0 cm for primary outcomes to be clinically important. Results: Four studies, comprising 469 participants, were included in our meta-analysis. Results revealed that the gabapentin group had significantly higher change in pain intensity scores from baseline to 3 months [weighted mean difference (WMD) -0.61 cm; 95% confidence interval (CI) -0.97 to -0.25; I 2 = 0%; p = 0.0009] and 6 months (WMD -1.38 cm; 95% CI -1.89 to -0.88; I 2 = 0%; p \ 0.00001), relative to the control group. The difference of 6-month pooled result was more clinically important. Results from analysis of secondary outcomes showed that gabapentin had no beneficial efficacy during the first 3 months of treatment. Although gabapentin treatment was associated with a higher risk of dizziness and somnolence, no statistically significant differences were observed with regards to the total incidence of adverse events. Conclusions: Overall, gabapentin could be a potential treatment option for CPP in women. However, as a pilot study, further studies are needed to explore the longer-term benefits and definite safety of this therapy in the future.Xiu-Mei Fan and Yi-Feng Ren contributed equally as co-first authors.

Although several clinical studies have evaluated gabapentin for the treatment of chronic pelvic pain in women, efficacy and safety of this therapy remains controversial.The published meta-analysis evaluated efficacy and safety of gabapentin for treatment of chronic pelvic pain in women, and the results revealed that gabapentin has potential analgesic effects in this group of patients. This is a response article to: Letter to the Editor regarding ''Gabapentin has Longer-Term Efficacy for the Treatment of Chronic Pelvic Pain in Women: A Systematic Review and Pilot Metaanalysis''. Dear Editor, Thank you for informing us about the letter discussing the results of ''Gabapentin has Longer-Term Efficacy for the Treatment of Chronic Pelvic Pain in Women: A Systematic Review and Pilot Meta-analysis'' [1]. Meanwhile, Yi-Feng Ren and Xiu-Mei Fan contributed equally to this work as co-first authors.