Bill 420.

Summary.

The bill establishes a framework for early detection, care, education, and research concerning primary ovarian insufficiency (POI) in the Republic of Panama. It defines POI as loss of ovarian function before age 40, characterized by amenorrhea, elevated follicle-stimulating hormone levels, low estrogen levels, and other medical criteria. It provides that the State would guarantee people diagnosed with POI free, continuous access to gynecological and endocrinological consultations, genetic assessment, medical treatment and hormone replacement therapy, individual and family psychological support, and reproductive support options.

The Ministry of Health (Ministerio de Salud) and the Social Security Fund (Caja de Seguro Social, CSS) would provide continuing training for healthcare personnel in multidisciplinary care. The bill calls for protocols to prevent, diagnose, and treat osteoporosis, including periodic bone density scans, calcium and vitamin D supplements, drug treatment, and physical activity programs. It also promotes a balanced diet and supervised exercise.

On education, the Ministry of Health would work with other public bodies and social organizations to conduct annual activities about POI and menopause, using October 18, World Menopause Day, as a reference. The Ministry of Education (Ministerio de Educación) and the Ministry of Health would add age-appropriate scientific information on hormonal and reproductive health to existing guidance programs. The bill promotes research into POI prevalence, causes, consequences, treatments, and new therapeutic options, including assisted reproduction, through collaboration with the Gorgas Memorial Institute for Health Studies (Instituto Conmemorativo Gorgas de Estudios de la Salud), universities, and medical research centers. It would create a voluntary national registry to collect statistics, support research, and inform public policy while protecting patient privacy and confidentiality.

People diagnosed with POI would have a right to information, guidance, and assisted reproduction services within the public health system. The Ministry of Health could coordinate with specialized clinics and strengthen existing services, particularly for people with greater economic or social need. Together with the CSS, it would implement protocols addressing cardiovascular risks, bone health, metabolic disorders, mental and neurocognitive health, and quality of life. It would also establish a nationwide multidisciplinary network of specialists to provide care throughout the country.

The bill recognizes other medical circumstances that can affect ovarian function before age forty (40) and provides affected women with medical follow-up, psychological support, fertility guidance, and prevention of bone and cardiovascular risks. The Executive Branch (Órgano Ejecutivo), through the Ministry of Health, would review the law after three (3) years and issue implementing regulations within no more than twelve (12) months. The law would take effect one year after promulgation. Its provisions concern the Ministry of Health, the Social Security Fund, the Ministry of Education, and the Gorgas Memorial Institute for Health Studies, and could be of interest to patients, healthcare professionals, research centers, universities, and assisted reproduction clinics in Panama.