Premenstrual Syndrome (PMS) /Premenstrual dysphoric disorder (PMDD)

Cat 1 · 30 days

appointment within 30 calendar days. - Severe PMDD with risk of self-harm or severe functional impairment impacting safety NB: Referral to a Persistent pain service may be considered if chronic pelvic pain coexists and remains uncontrolled

Cat 2 · 90 days

appointment within 90 calendar days. - Severe PMS/PMDD symptoms unresponsive to initial medical management (e.g., SSRIs, hormonal treatments) and causing significant impact on daily functioning, including work, relationships, or school - Co-existing psychiatric disorders that exacerbate PMDD symptoms, requiring close gynaecologic and mental health management - Moderate to severe PMS/PMDD with substantial impact on quality of life, affecting daily activities and relationships but without immediate safety concerns - Symptoms persisting despite trial of first-line treatments (e.g., lifestyle modifications, basic hormonal therapies) - Worsening symptoms requiring review for alternative treatments (e.g., second-line hormone therapy, SSRIs) or multidisciplinary input NB: Referral to a persistent pain service may be considered if symptoms are accompanied by chronic pelvic pain that has not responded to initial treatments

Cat 3 · 365 days

appointment within 365 calendar days. - Mild PMS/PMDD symptoms that do not significantly impair daily functioning but require specialist advice or management adjustments