Tokyo

Japan / Kanto / Tokyo

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'l be able to find mostly pads and tampons in Tokyo, 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 common 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. 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:

• 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

Note: The most effective emergency contraceptive is currently ellaOne. It lasts up to 5 days after unprotected sex. Other EC brands are generally effective for 1-3 days with occasional protection for up to 5 days. Japan currently does not carry ellaOne. If your country doesn't carry ellaOne, copper IUDs may also prevent pregnancy for up to 5 days after unprotected sex. If none of these options are available, look for regular EC, which may sometimes protect you for up to 5 days. Note that EC pills are not 100% effective, and they should be taken as soon as possible.

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

Dedicated Products / Progestin Only Take 2 pills within 120 hours after unprotected sex:

• NorLevo 0.75 mg

Oral Contraceptives used for EC / Progestin-Estrogen Combined Note: in 28-day packs, only the first 21 pills can be used Take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later:

• Duoluton
• Planovar

Some clinics:

• 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

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

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