Use of oral neuromodulators in chronic pelvic painNumber 8 - 2025.

•Chronic pelvic pain is a common and complex condition that significantly affects women's quality of life. •Neuropathic pain and nociplastic pain are important components in the pain picture of these patients and should be considered in clinical treatment. •Oral neuromodulators, antidepressants and anticonvulsants for the control of neuropathic and nociplastic pain should be present in the therapeutic arsenal of the gynecologist who treats patients with chronic pelvic pain. •Pregabalin is the medication with the best pharmacokinetic profile; nortriptyline has the best adverse effects profile; duloxetine is the most widely used and has the lowest risks; and venlafaxine should be used as a second-line inhibitor. •Although the drug classes can be combined to reduce the total doses and minimize side effects, maximizing the analgesic effect, monotherapies are recommended as the first line to avoid polypharmacy.