Europe · High confidenceUnited KingdomPublic recognition but patient pathway remains operationally thin
Europe · Moderate confidenceFrancePatient association appears more informative than mainstream official health information
Oceania · High confidenceAustraliaGood public explanation and direct tools, but no obvious integrated national pathway
Europe · Moderate confidenceSpainRecognition and research are visible; national public pathway less clear
Europe · Moderate confidencePortugalProfessional recognition is now visible, but a national SNS/DGS diagnostic-referral pathway was not identified
Europe · High confidenceNorwayPublic information operationalises tracking rather than merely advising it
North America · High confidenceCanadaProvincial variation, with some genuine specialist service infrastructure
North America · High confidenceUnited StatesStrong formal recognition and research, but public pathway remains medication-list driven
Middle East · High confidenceIsraelOfficial recognition plus notable reproductive-psychiatry/research activity
Middle East · Preliminary confidencePalestinian health systemsResearch exists but no comparable national pathway identified
South Asia · Moderate confidenceIndiaProfessional/research recognition stronger than national patient pathway
East Asia · High confidenceChinaFormal recognition within psychiatric guidance; limited integrated reproductive pathway found
East Asia · Preliminary confidenceSouth KoreaRelated guideline infrastructure exists but is not equivalent to a conventional national PMDD pathway
Southeast Asia · Moderate confidenceSingaporeRecognition within mental-health information, without a dedicated PMDD pathway found
Southeast Asia · Moderate confidenceMalaysiaMeaningful official-system recognition, but not clearly a national pathway
Southeast Asia · Moderate confidencePhilippinesPMDD is visible in local academic/professional sources, but a national operational pathway was not identified
Southeast Asia · Moderate confidenceIndonesiaMenstrual-health/PMS recognition exists, but PMDD-specific national implementation was not identified
Africa · Moderate confidenceSouth AfricaSpecialist awareness without obvious national operational pathway
Africa · High confidenceEthiopiaResearch activity is high, but diagnostic methodology and translation into care remain major gaps
Africa · Moderate confidenceNigeriaResearch recognition exists, but current national implementation was not identified
Africa · Moderate confidenceKenyaCountry-specific research exists, but national guidance and service pathways were not identified
Africa · Moderate confidenceEgyptAcademic recognition is clear, but national pathway evidence was not identified
Africa · Moderate confidenceMoroccoMorocco has a meaningful PMDD research history, but a national operational pathway was not identified
Africa · Preliminary confidenceGhanaBroader menstrual-health research is visible, but PMDD-specific national recognition/pathways remain difficult to identify
South America · High confidenceBrazilProfessional endocrine/gynaecology engagement stronger than federal public pathway
South America · Moderate confidenceArgentinaProfessional engagement visible; national patient pathway not identified
South America · Moderate confidenceColombiaProfessional engagement visible, relying partly on international guidance
South America · Moderate confidenceChilePublic awareness exists; diagnostic/referral architecture is thin
North America · Moderate confidenceMexicoRecognition and research exist without a clearly integrated national pathway
South America · Moderate confidencePeruAwareness-level recognition more than an operational PMDD pathway
South America · Moderate confidenceUruguaySubstantive specialist recognition exists, but current national public/clinical implementation is unclear
South America · Moderate confidenceEcuadorAcademic recognition is growing, but national operational guidance was not identified
South America · Preliminary confidenceBoliviaPMDD is present in medical education material, but national guidance/research infrastructure is not readily discoverable
South America · High confidenceParaguayOne of the clearest Latin American examples of PMDD being embedded in a national gynaecology manual
South America · Moderate confidenceVenezuelaProfessional and academic recognition exists, especially around hormonal treatment, without a national public pathway identified
Central America · Moderate confidenceCosta RicaThere is real domestic clinical literature, but no modern integrated national pathway was identified
