1. How do I get birth control and how much does it cost?

In Japan, birth control pills and IUDs are available at most gynecologists’ offices. You will need to make an appointment (or walk-in visit; check with the clinic/hospital to see if an appointment is necessary) with a gynecologist to discuss your options. If you plan on using the pill or an IUD as birth control, neither of them are covered by insurance. The pill is typically between ￥2,000 and ￥3,500 per month. Unlike other countries, however, your doctor will not give you a prescription that you refill on your own at the pharmacy every month. After the first doctor visit, you will receive one month of medication, and you will need to go back for a follow-up before the end of your first pack. After that, you may receive up to 3 months of pills at a time. You always need to go to the clinic for follow-up to receive refills.

IUDs can cost up to ￥50,000 depending on the IUD you choose, your doctor, and your hospital. IUDs, however, can be used for 3 – 10 years, depending on the IUD type, greatly reducing the per-month cost of contraception compared with the pill. If you decide you want an IUD, see your gynecologist for a consultation. After you and your doctor decide which type of IUD is best for you, you will need to make an appointment for insertion. Insertion is a non-surgical procedure that is typically over in less than 15 minutes.

2. What if I need it to control a disease or condition?

If you need the pill or a hormonal IUD for health-related issues (endometriosis, dysmenorrhea, menorrhagia, fibroids, etc.), insurance may cover a portion of the cost. However, you will need exams and diagnosis from a gynecologist, deeming the pill or IUD necessary for control of your condition. A Mirena (hormonal) IUD may be inserted for as little as ￥15,000 yen, depending on your doctor/hospital.
For more options and more knowledgeable doctors, it is recommended you see a gynecologist at a large, reputable hospital for diagnosis and treatment of conditions and diseases of the female reproductive system.

3. What if I need it to control a disease/condition, but I also need it as a contraceptive?

If you have a health issue that requires a birth control pill or hormonal IUD for control, and also want to use it as a contraceptive, you can tell your doctor the reason you want it is for control of your condition (in order to have insurance coverage). The contraceptive effect of the treatment (i.e. pill or IUD) will then be considered a side-effect of your condition/disease treatment. It should be noted, however, that if you become pregnant while using an insurance-covered contraceptive as a condition/disease treatment, you forfeit your right to file a complaint/sue the company for drug/device failure as a contraceptive.

Also, keep in mind that you cannot just say you need it to control a disease or condition in order to receive insurance coverage; you require a diagnosis from a Japanese gynecologist in order to qualify for the coverage.

4. What if my doctor won’t listen/won’t diagnose me, even though I know something is wrong?

Dealing with doctors, especially gynecologists, in Japan can be frustrating at times. There are good doctors and bad doctors in every country, though, so don’t throw in the towel on a bad egg. As a patient, you are entitled to a second, or even third, opinion. See as many doctors as it takes to find the one that fits, and never feel bad for leaving one behind. Your health is important, and you never have to feel like you’re stuck with an arrogant doctor who won’t listen to you. There are tons of excellent doctors in Japan, so don’t give up if you have trouble at first.

5. I don’t want the pill or an IUD. What about Depo, implants, NuvaRing, etc.?

Alternative contraceptives such as Depo-Provera (injection), contraceptive implants, contraceptive patches, and NuvaRing are not available and are not approved by the PMDA (Pharmaceuticals and Medical Devices Authority), the regulatory authority in Japan. Some of these products can sometimes be found on online stores, but the integrity of the product and credibility of these stores is highly questionable at best. These products are prescription only and obtaining them without a prescription is very dangerous and ill-advised. If you want alternative contraception, receive it from your doctor in your home country before coming to Japan.

Birth Control Pills (Oral Contraceptives)

Birth control pills come in two basic types in Japan: monophasic and multiphasic. In a pack of monophasic birth control pills, all pills have the same hormone dose, with the exception of hormone-free reminder pills in 28-packs. In contrast, the pills in a pack of multiphasic birth control have a gradually strengthening hormone dose over the 21-day period (followed by a 7-day period of reminder pills which contain no hormones in 28-packs).

If you are considering switching to a Japanese birth control pill, check the insert on the brand you are currently using to see if the hormones/dosage of the ones available in Japan (listed below) are comparable to what you are on now. If there isn’t one, talk to your Japanese gynecologist about your options for replacing your current pill.

To learn more about birth control pills, how they work, and their safety and effectiveness, visit Planned Parenthood for reliable information at:

IUDs, or Intra-Uterine Devices, are long term birth control devices that can be used for years before needing to be replaced. To learn more about how IUDs are inserted, how they work, and their effectiveness, visit Planned Parenthood for reliable information at: https://www.plannedparenthood.org/learn/birth-control/iud

Condoms are widely available and come in a huge variety. The vast majority of condoms in Japan are 0.001 – 0.003 mm thick. While condoms this thin may not be the norm in your home country, you do not have to worry about Japanese condoms. With proper use and fitting, they are just as strong and reliable as thicker condoms.

The vast majority of condoms are latex, but polyurethane and polyisoprene types also exist. Sizes vary by company, but a general range of sizes is listed below:

Small:

I need an STD test. What do I do?

STD testing can be obtained at any clinic, though it can be very expensive, as testing is conducted by disease. If you cannot afford to be tested at a hospital, or cannot be tested at a hospital due to your living situation or simply want anonymity, STD Lab offers safe, accurate, confidential testing by mail. You can also arrange to have the test available for post-office-pickup in case you cannot have it sent to your home.

You simply purchase the testing kit you want, perform the tests at home, and send the prepaid envelope back to the lab. Your results will be sent to you online within 1 week of testing. The tests themselves are wrapped in tamper-proof black bags and shipped in unmarked cardboard boxes. It should be noted, however, that upon opening the box, if the black bag containing the test kit is damaged or open, that you should NOT take the test and you should contact STD Lab.

Visit STD LAB here to see available tests and purchase online: http://www.std-lab.jp/shopping/list.php

When you get your STD Kit.

Make sure the box is undamaged, and the black bag containing your kit inside the cardboard box is sealed and unbroken. Lay out the test materials on a clean surface. Fill out the form in the envelope. Your name or other personal information is not needed. The carbon copy will stay with you. This will be used to collect your online test results later, so keep it somewhere safe. Wash your hands thoroughly before the test. After you have conducted the tests, place the urine/blood/swab samples and the form you filled out into the prepaid envelop that was in the test box. Simply drop it in the mail and wait for notification from STD Lab about your results.

STD Lab provides free guidance for what to do in the event of a positive test result. If any of your results come back unclear due to a variety of factors (not enough blood or urine given, etc.), they will send you a new test for free. STD Lab does not collect any personal identification information for your tests or results, and their system is 100% anonymous. The only personal information you will be required to give them is for the purchase only (address, credit card number, name). The serial number of the test they send you is unknown to any person besides you, so no test result could be traced back to you personally.

The tests available at STD Lab are as follows:

What if I just want an HIV test but I can’t afford/don’t want to pay for one?

In an effort to cut down the incidence of HIV and AIDs in Japan, there has been more awareness of the subject and testing can be obtained for free.
Visit the link below to see what facilities are available in your area. There is often (but not always) English-speaking staff available.