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Japan / Kanto / Tokyo

Présentation générale

Au Japon, le système de santé est de haute qualité et réactif. Cependant, certaines ressources comme des moyens de contraceptions moins connus ou certaines méthodes abortives ne sont pas disponibles. En général, les moyens de contraception et la contraception d'urgence (pilule du lendemain) sont légaux mais nécessite une prescription. Ces derniers ne sont pas couvert par la NIH, la sécurité sociale japonaise, et la pilule contraceptive n'a été légalisée qu'en 1999. Il est possible de faire un dépistage d'IST dans de nombreuses structures et il n'y a pas de restriction de déplacement pour les personnes infectées. Vous trouverez principalement des serviettes hygiéniques et des tampons à Tokyo mais les coupes menstruelles sont encore rares. L'avortement est techniquement autorisé que dans certaines circonstances mais la loi est large et les femmes semblent pouvoir obtenir ce service assez facilement. La pilule abortive, aussi connu sous le nom d'avortement médicamenteux, n'est pas autorisée.

Contraception

Lois et stigmatisation sociale

Au Japon, il faut obligatoirement une ordonnance pour obtenir un moyen de contraception. Dans le cas d'une pilule contraceptive hormonale, il vous faudra probablement prendre rendez-vous avec votre médecin tous les 1-3 mois pour renouveler votre prescription. A noter que le Japon n'a légalisé la pilule contraceptive qu'en 1999, invoquant des doutes concernant les risques sanitaires bien que beaucoup croient à une pression des services d'avortement pour empêcher cette légalisation. C'est pourquoi la pilule contraceptive n'est que peu utiliser au Japon. 80% des femmes mariées au Japon favorise le préservatif, beaucoup plus commun. Actuellement, le gouvernement japonais n'autorise que les pilules micro-dosées. Cela signifie que si vous utilisez actuellement une pilule avec un dosage plus élevé, il ne sera sûrement pas possible de la trouver au Japon.

Méthodes disponibles & Où les obtenir

Le Patch

Bien que le patch soit disponible au Japon, il est cependant difficilement trouvable. Il faut les acheter en ligne ou dans des cliniques spécialisées. La marque la plus répendue est Ortho Evra

DIU

Les DIU (Dispositif Intra-Utérin anciennement connu sous le nom de "stérilet") sont disponibles au Japon.

DIU se prononce 子宮内避妊器具 ( しきゅうないひにんきぐ / Shi-kyuu-nai-hi-nin-ki-gu)ou à l'anglaise IUD (ai-yu-dii).

Il existe deux types : le DIU au cuivre 銅付加IUD (どうふかIUD/doo-fu-ka-ai-yu-dii)et le DIU hormonal 黄体ホルモン付加IUD (おうたいホルモンふかIUD / Oo-tai-ho-ru-mon-fu-ka-ai-yu-dii).

Le DIU au cuivre le plus courant est le Multiload CU250R (マルチロードCU250R) et celui hormonal est Mirena (ミレーナ５２ｍｇ)

Préservatifs et Spermicide

Les préservatifs masculins, les préservatifs féminins et le spermicide peuvent se trouver en pharmacie (sans prescription nécessaire)

Contraceptifs Oraux (Pilules)

La pilule contraceptive se dit 経口避妊薬(けいこうひにんやく / kei-koo-hi-nin-ya-ku) mais est plus souvent mentionnée en utilisant le mot ピル (pi-ru). A noter que seules les pilules micro-dosées sont vendues au Japon. Une prescription est nécessaire.

Allez sur ce guide pour trouver une clinique qui peut vous la prescrire.

En 2010, la mini-pilule (ミニピル) n'a pas été approuvée au Japon et ne semble pas disponible sauf sur des pharmacies en ligne.

Voici quelques pilules disponibles :

21 pilules par cycle (21錠タイプ/21jou-tai-pu)

1. Marvelon (マーベロン/ma-ru-be-lon)

2. Ortho M-21 (オーソ M-21 / O-sso M-21)

Pilules multiphasiques - 相性ピル(Ai-Shoo-pi-ru):

21 pilules par cycle (21錠タイプ/21jou-tai-pu)

1. Triquilar (トリキュラー/to-ri-kyu-raa)

2. Ange (アンジュ/an-ju)

3. Ortho 777 (オーソ 777)

28 active - (28錠タイプ):

1. シンフェーズ ("New Phase")

2. Triquilar (トリキュラー)

3. Ange (アンジュ)

4. Marvelon (マーベロン)

Not all doctors prescribe birth control pills. Here are some clinics to check out:

• Japan Family Planning Association
• Primary Care Tokyo: "Tri-phasic and monophasic oral contraceptives are available at the clinic for dispensing. Prescriptions can also be issued if dispensing at an outside pharmacy is preferred... We do not place or remove IUDs at our clinic... Please note that consultations for dispensing of oral contraceptives and the cost of the medications are not covered by National Health Insurance. Consultations that are only for the prescription of oral contraceptives are ¥3,000 and the cost of a one month supply dispensed in-house is ¥2,500 (plus tax). Prescriptions can also be issued in which case the cost of the medication may vary depending on the pharmacy."
• K Ladies Clinic: Address: 5F Shinjuku Center Building, 1-25-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, Tel: 03-3343-9555, Open: Mon, Wed–Sat, 11 a.m.–12:30 p.m. and 2:30–6:30 p.m.; Sun, 11 a.m.–12:30 p.m. and 2:30–5:30 p.m.

Costs

Birth control is not covered by Japanese health insurance. Depending on your doctor and birth control brand, you can expect to pay between ¥2,000 – ¥3,000 for a one month supply of oral contraceptives (birth control pills). For copper IUDs, you can expect to pay ¥30,000-¥50,000. Mirena costs ¥80,000 and up.

Emergency Contraception (Morning After Pill)

Important Notes: The earlier you take emergency contraception, the more effectively it works. After unprotected sex, take EC as soon as possible. If you don't have access to EC, you can use oral contraceptives as EC, but remember the following: 1) Only some contraceptives work as EC (so confirm they work as EC) 2) Different contraceptives require different dosages to work as EC (so get the proper instructions) 3) You must only use the first 21 pills in 28-day packs and 4) You must also take the pills as soon as possible.

Laws & Social Stigmas

Emergency contraceptives (also known as "the morning after pill") are by prescription only in Japan. Check out this useful guide to finding a clinic that will prescribe for you. It's unknown if there are any age restrictions.

What to Get & Where to Get It

Here is the EC you can expect to find in Japan (see below). This information was found on the Princeton EC website:

• In Japan, you can purchase dedicated emergency contraception (morning after pill) that is progestin-only. You can find NorLevo 0.75 mg (take 2 pills within 120 hours after unprotected sex).
• If you can't access dedicated emergency contraception, you can use regular birth control as replacement EC. To do this, you must remember that, in 28-day packs, only the first 21 pills can be used. You can take Duoluton or Planovar (for both of these brands, take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later).

Some clinics where you can get EC in Tokyo:

• Primary Care Tokyo: "NorLevo®, a progestin-only pill similar to "Plan B" is available by prescription. Planovar, a progestin-estrogen combination pill, is also available for this purpose, and can be dispensed directly to you at the clinic. We also stock a limited supply of ella® (ulipristal), which is a progesterone receptor modulator. ella® is not yet approved in Japan, but has been available in Europe since 2009 and the U.S. since 2010. The cost for consultation and medication for Planovar is ¥3,400 (plus tax). For NorLevo®, a consultation fee of ¥3,000 yen is charged and the medication can be obtained at a prescription pharmacy at an estimated cost of ¥15,000, which will vary depending on the pharmacy. ella® is dispensed in the clinic for a total fee of ¥9,500. A urine pregnancy test and completion of a consent form is required prior to dispensing of ella®."
• K Ladies Shinjuku: Cost 14140yen (including anti nausea).

Costs

You can expect to pay between 14,000-15,000 yen for EC.

Sexually Transmitted Infections (STIs/STDs)

Important Note: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment that may prevent HIV infection, and it may be available in your city (see below for details). Take PEP as soon as possible.

Laws & Social Stigmas

There are no known travel restrictions or residency restrictions for people with HIV/AIDS or any other STIs.

What to Get & Where to Get It

Testing Facilities

• Primary Care Tokyo: "A panel of screening tests for sexually transmitted diseases, including HIV, gonorrhea, chlamydia, and syphilis are available for a fee of ¥12,000 (plus tax). Testing can be done anonymously and results can be reported in person, via telephone, e-mail, or regular mail. Results are typically available in 4 days. Free, anonymous HIV testing is available through many local health departments. Some areas also offer other STD screenings."
• Shinjuku Health Center: Offers free, anonymous tests, supposedly twice a month, as well as regular tests on all days open. Address 7-5-8 Nishi-Shinjuku, Shinjuku-ku, Tokyo. Telephone: 03-5273-3859.
• Tokyo Metropolitan Testing and Counseling Office in Minami-Shinjuku: The Tokyo Minami-Shinjuku Bldg., 3rd floor, 2-7-8 Yoyogi, Shibuya-ku (3-min. walk from JR Shinjuku Station).
• http://www.shirakaba-clinic.jp/ Shirakaba Clinic]: Supposed to be affordable and offers quick results.
• Nishi Shinjuku Koken Center: Offers free tests every Thursday (in 2006... may still be the case). Call to confirm: 03 3369 7110
• Japan Healthcare Info: "JHI can arrange a home testing kit to be sent to you. You can take samples at home then send back to our contracted lab, receive result one week later via email. The kit can be sent anywhere in Japan but not overseas."

Support

• International Medical Centre of Japan: Toyama 1-21-1, Shinjuku-ku, Tokyo, Phone: (03) 3202 7181
• Metropolitan Clinic Komagome: Honkomagome 3-18-22, Bunkyo-ku, Tokyo, Phone: (03) 3823 2101
• HIV Kensa
• Life AIDS Project

Medication & Vaccines

What to Get & Where to Get It

Note that PrEP is not promoted in Japan. It seems you can buy generic versions of PrEP, which are imported from India. Here's a story of an American using PrEP in Japan.

Menstruation

What to Get & Where to Get It

In Japan, you can find pads, tampons and menstrual cups. For pads, you may notice that many are bulky and wide (with wings). You can also buy pantyliners. You can find tampons with applicators. For menstrual cups, most brands (like DivaCup, MoonCup and LadyCup) are not carried. But there is a website for Lunette Japan so that may be your best bet -- otherwise, order a menstrual cup brand of your choice online.

Gynecological Exams

What to Get & Where to Get It

• "Many expat women use Tokyo Medical & Surgical Clinic. The favorite OBGYN is Dr Sakamoto." - From a Tokyo local

Pregnancy

Laws & Social Stigmas

In Japan, maternity leave covers before childbirth (6 weeks, or 14 weeks for a multiple pregnancies on request) and after childbirth (8 weeks mandatory leave). On average, 60% of the woman's monthly salary is covered when she goes on maternity leave. If women are covered by NHI or their husband's insurance, they don't receive maternity benefits.

Abortion

Laws & Social Stigmas

In Japan, abortion is legal for up to 24 weeks of gestation. The reasons for permitted abortions include: to save the life of the woman, to preserve physical health, economic or social reasons, rape or incest. In all other cases, including preservation of the woman's mental health, risk of fetal impairment, or by request, are not permitted. For an abortion to be performed, consent must be given by the pregnant woman and her partner. The procedure must occur in a designated clinic.

In 2009, the Japan Times reported that the "...most oft-cited reason for terminating a pregnancy is that the couple are not married, accounting for 28 percent of the 122 women with experience of abortion who were surveyed for the report last year. Financial difficulties came second, with 16 percent."

What to Get & Where to Get It

Medical abortions (also known as the "abortion pill") are not available in Japan. Only surgical abortions are available.

Here's some useful vocabulary, found on HealthyTokyo.com:

Abortion:　妊娠中絶 (nin-shin-chuu-zetsu) Induced Abortion:　人工妊娠中絶 (jin-kou-nin-shin-chuu-zetsu) Spontaneous Abortion:　自然妊娠中絶 (shi-zen-nin-shin-chuu-zetsu) Emergency Contraceptives:　緊急避妊薬 (kin-kyu-hinin-yaku) First Trimester (Abortion):　妊娠初期（中絶）(nin-shin-sho-ki) (chuu-zetsu) Second Trimester (Abortion):　妊娠中期（中絶）(nin-shin-chuu-ki) (chuu-zetsu) Third Trimester (Abortion):　妊娠後期（中絶）(nin-shin-kou-ki) (chuu-zetsu) Maternal Protection Act:　母体保護法 (bo-tai-hogo-hou)

Advocacy & Counseling

What to Get & Where to Get It

• Housing in Emergency of Love and Peace (HELP) Asian Women's Shelter: Emergency shelter that helps anyone in crisis, regardless of visa status. Works with the Japanese, migrant and foreign community, including victims of human trafficking. Note that this organization is Christian-based. Telephone: 03-3368-8855 (also consultation), Fax: 03-3368-9791. Email: rasedill@gbgm-umc.org. Address2-23-5 Hyakunin-cho Shinjuku-ku, Tokyo. Hours10:00 a.m. - 17:00 p.m. Here's an article about HELP.
• TELL (Tokyo English Life Line) - Tokyo: TEL: 03-5774-0992. From 9 a.m. to 11 p.m. daily. Free anonymous telephone counseling.
• International Medical Information Center (AMDA): TEL: 03-5285-8088 (Tokyo) and 06-4395-0555 (Kansai). Services are available in English, Spanish, Chinese, Korean and Thai via telephone from 9 a.m. to 5 p.m. weekdays. Medical information, interpreter assistance, referrals, and information about the Japanese health care system.
• Tokyo Metropolitan Health and Medical Information Center: Foreign Language Assistance - TEL: 03-5285-8181. Services available from 9 a.m. to 8 p.m. weekdays. Information about medical facilities and the Japanese health insurance system. Emergency Translation Services - TEL: 03-5285-8185. Interpretation services for hospitalized foreign patients are available in English, Spanish, Chinese, Korean and Thai from 5 p.m. - 8 p.m. weekdays and from 9 a.m. - 8 p.m. on weekends and holidays.
• Counseling Center for Women - TEL: 050-1501-2803, Monday to Friday, 10:00 - 17:00
• Tokyo Crime Victim Hotline (by Tokyo Metropolitan Police Department) - This is in Japanese only. TEL: 03-3597-7830. Services available from 8:30 a.m. to 5:15 p.m. weekdays.
• Women's Human Rights Hotline (by Ministry of Justice Legal Affairs Bureaus) - This is in Japanese only. TEL: 0570-070-810. Services available from 8:30 a.m. to 5:15 p.m. weekdays. This service offers support and advice to women who are victims of bullying, sexual harassment at work, domestic violence or psychological abuse.
• Counseling Center for Women: May only have Japanese-speaking counselors. 050-1501-2803, Monday to Friday, 10:00 - 17:00
• Domestic Violence Counseling and Support Center (PDF 212.10KB)- Each prefectural police department has a Domestic Violence Counseling and Support Center (DV Center). Japanese speaking staff only.

List of Additional Resources

• FEW: For Empowering Women in Japan: "For Empowering Women (FEW) in Japan is an exceptionally active and ever-growing Tokyo-based non-profit business and social networking organization whose mission is to “enable internationally-minded women in Japan to achieve their full professional and personal potential. Originally standing for “Foreign Executive Women”, who were literally “few” when the organization was founded in 1981 by two foreign female entrepreneurs, FEW has evolved tremendously over its almost 35-year history, having empowered thousands of women in and outside of Japan."
• Tokyo Women's Foundation: 3-8-1 Marunouchi, Chiyoda-Ku, Tokyo 100, Tel: 81 3 3213 0021, Fax: 81 3 3213 0185
• International Movement Against All Forms of Discrimination and Racism: 3-5-11 Rappongi, Minato-Ku, Tokyo 106, Japan, Tel: 81 3 3586 7447, Fax: 81 3 3586 7462, E-mail: HCA0241@nifty.org.jp
• Institute for Women's Studies, Ochanomizu University, Otsuk 2-1-1, Bunyo-ku, Tokyo 112, Japan
• Asia Japan Women's Resource Center: Shibuya Coop 311, 14-10 Sakuragaoka, Shibuya-ku, Tokyo 150, Japan, Tel: 03-3780-5245, Fax: 03-3463-9752, Email: ajwrc@jca.or.jp
• Friends of Thai Women: Shibuya Coop 211, 14-10 Sakuragaoka, Shibuya-ku, Tokyo 150, Japan, Tel/fax: 03-3463-9752
• International Feminists of Japan: c/o Agora, Shinjuka 1-9-6, Tokyo 160, Japan
• The Women's Action Group: Nakazawa Building , 3rd Floor, 23 Arakicho, Shinjuku-ku 164, Tokyo, Japan
• Women's League For Protection Of Human Rights (Fujin Jinken Yogo Domei): 2-32-25, Koenji Minami, Suginami-ku, Tokyo 166, Japan