Japan

OVERVIEW

In Japan, you will find very high-quality and responsive healthcare. However, you will also find that certain resources, whether it be lesser-known contraceptives or certain abortion methods, are unavailable. Generally, contraception (birth control) and emergency contraception (morning after pill) are legal but require prescriptions. They are not covered by NIH, the Japanese national healthcare system, and birth control pills were only legalized in 1999. You will be able to get STI tests at many facilities, and there are no known travel restrictions assigned to people with STIs. You'll be able to find mostly pads and tampons in Japan, but menstrual cups will be much more difficult to locate. Maternity leave is protected, though with only 60% of wage coverage. Abortion is technically only legal under certain circumstances, but the law is far-reaching and women seem to find adequate coverage. The abortion pill, also known as a medical abortion, is not available.

Contraception (Birth Control)

Laws & Social Stigmas

In Japan, contraception (birth control) is by prescription only. If you choose to take hormonal birth control pills, you'll probably need to visit the doctor every 1-3 months to renew your prescription. Unlike in many other countries, where prescriptions last for a year, Japanese birth control prescriptions last for 1-3 months. Note that Japan only legalized hormonal birth control pills in 1999, supposedly due to health concerns (though many believe the abortion industry prevented legalization). For this reason, hormonal birth control is not very commonly used in Japan. Condoms, which are much more common, are preferred by 80% of married women in Japan. Currently, the Japanese government only permits the usage of low-dosage hormonal pills. This means that, if you're currently using a higher-dosage pill, you may not be able to find it in Japan.

What to Get & Where to Get It

The Patch

While the patch is available in Japan, you won't generally find it in most places. You'll need it buy it online or visit select clinics. The main brand available is Ortho Evra.

IUDs

IUDs are available in Japan, and they're known as 子宮内避妊器具. For copper IUD, you say 銅付加タイプ or 銅付加IUD. The most popular is the Multiload CU250R (マルチロードCU250R). You can access Mirena (known as ミレーナ５２ｍｇ).

Condoms and Spermicide

You can find spermicide, male condoms and female condoms at drug stores (no prescription needed).

Oral Contraceptives (Birth Control Pills)

For birth control pills, you can say "経口避妊薬" (けいこうひにんやく, "keikouhininyaku" in Japanese). The most common way to refer to birth control pills is "ピル" (piru). Note that only low-dosage pills are sold in Japan. You'll need a prescription. Here is a comprehensive guide. Check out this useful guide to finding a clinic that will prescribe for you.

In 2010, it was reported that "The mini-pill (ミニピル) has not been approved in Japan, and does not seem to be available except in online stores/pharmacies."

Here are some pill brands you can expect:

21 active (21錠タイプ):

1. Marvelon (マーベロン)

2. Ortho M-21 (オーソ M-21)

Multiphasic pill - 2 or 3相性ピル:

21 active - (21錠タイプ)

1. Triquilar (トリキュラー)

2. Ange (アンジュ)

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:

• HealthyTokyo.com provides appointments for clinics prescribing birth control pills across Japan
• 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:

• Here is a helpful guide to find morning after pill in Japan.
• 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 in Tokyo where you can get EC:

• 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

• HIV Home Test Kits are available online in Japan. They are accurate, discreet and can be more cost effective than visiting a clinic, waiting and returning again for your results.
• For testing facilities, please visit city pages, like the Tokyo, Osaka and Kyoto pages, for local recommendations.

Support

• Here is a helpful guide for HIV testing centers across Japan.
• 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

Costs

You can get a HIV Home Test Kit for ¥6000 here.

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

Here is a helpful guide about tampons in Japan. 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

Any women's clinic will perform gynaecological exams (Pap smears and STI testing), though it is good to be aware that most gynaecologists in Japan are male. Furthermore, it is common practice for exams to be performed with the doctor behind a modesty sheet that lies over the patient's stomach, so it is common not to see the doctor at all during the procedure and only meet them afterward when you meet to discuss results. Many doctors also will use an ultrasound wand with a camera on it to view the patient's reproductive organs, and some will even show you live during the procedure. With all this said, the vast majority of clinics are clean, professional and very friendly, so while the procedure can be different from what many non-Japanese people are used to, the staff are invested in making the patients feel comfortable, so be sure to discuss any concerns with the staff before beginning.

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)

HealthyTokyo.com can make appointments for abortions throughout Japan.

Resources & Reading Materials: • Reddit Thread: Medical Abortion in Japan?, 2018

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

• HealthyTokyo.com appointment service and free chat support.
• 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