Women’s Health Archives - Savvy Tokyo

Epidurals in Japan: The Growing Support For Pain Relief During Labour

Kerri King — Sun, 23 Nov 2025 23:00:00 +0000

Early this year, the Tokyo Metropolitan Government announced a subsidy of up to ¥100,000 to help cover the cost of epidural deliveries, which took effect on October 1, 2025. It marks the first time a major local government has acknowledged that pain relief during labour deserves real, practical support. That may seem routine in countries like the U.S. or Australia, but in Japan, epidurals have long taken a back seat in maternal care.

Seen for years as unnecessary, expensive or challenging to get, epidurals have remained out of reach for many women in Japan. But that perception is changing. As more women share their birth stories, support for better access to pain relief in labour continues to grow.

The Reality Of Pain Relief During Childbirth in Japan

Ideas about “natural birth,” endurance and ganbaru (pushing through difficulty without complaint) have long shaped expectations around labor in Japan. Many women grew up hearing that pain was simply part of becoming a mother, making pain relief seem unnecessary or even indulgent. These attitudes didn’t appear overnight; they were passed down through families, echoed in maternity classes and normalized within hospital culture.

As a result, 硬膜外麻酔 (koumakugai masui; “epidural anesthesia”) rates in Japan remain far lower than in many Western countries. In 2018, only about five percent of births involved an epidural. As conversations around pain relief grow and expectations slowly shift, that number is rising. By 2024, the Japan Association of Obstetricians and Gynecologists reported usage had reached just under 14 percent. It’s a noticeable shift, though still well below the 70 to 80 percent reported in countries such as the U.K. and the U.S.

However, cultural attitudes are only one part of the story. Despite growing interest, the availability of epidural services in Japan is still limited. A national review found that out of more than 2,300 hospitals and clinics offering maternity care, only about 720 listed epidural services as an option. Even then, some hospitals could provide them only during daytime hours or when an anesthesiologist was on duty.

How Tokyo Is Expanding Access To Epidurals

Tokyo’s new subsidy is simple but meaningful. From October 1, 2025, residents who give birth at an approved hospital can claim up to ¥100,000 toward the cost of 無痛分娩 (mutsū bunben; “painless childbirth”) with the epidural procedure and anesthetic drugs.

To be eligible, you must:

Have registered your pregnancy with the local government in Tokyo and remain registered in Tokyo until you apply for the subsidy
Deliver at a 対象医療機関 (taishō iryō kikan; “approved medical institution”) published by the Tokyo Metropolitan Government
Receive epidural or combined spinal–epidural labor analgesia
Apply for the subsidy within one year of the delivery date.

Applications can be submitted via the Tokyo Welfare Bureau’s online form.

What Expectant Parents Should Know

If you’re considering pain relief during labour in Japan, the most important thing is to ask early. Not every hospital offers epidurals, and even those that do may only provide them during certain hours.

How To Ask Your Doctor Or Clinic

Keep it simple and direct. You can say:

無痛分娩はできますか (mutsu bunben wa dekimasu ka; “Do you offer painless delivery?”)
硬膜外麻酔は使えますか (komakugai masui wa tsukaemasu ka; “Do you provide epidurals?”)
夜間や週末も対応できますか (yakan ya shumatsu mo taio dekimasu ka; “Is it available at night or on weekends?”)
追加料金はいくらですか (tsuika ryokin wa ikura desu ka; “How much is the additional cost?”)

These phrases will help you find out what’s available at your hospital or clinic.

How to Find a Hospital That Offers Epidurals

In Tokyo

Start by checking whether your hospital is listed as an approved medical institution on the Tokyo Metropolitan Government’s official website. These are the only facilities where you can receive the ¥100,000 epidural subsidy.

You can also ask your clinic directly. Many will display a notice stating 当院は対象医療機関です (toin wa taisho iryo kikan desu; “This hospital is an approved facility”).

Across Japan

Availability varies widely, so here are a few tips.

University hospitals and larger perinatal centers are your best bet.
Private clinics in major cities like Osaka, Nagoya, Fukuoka and Yokohama increasingly offer painless deliveries.
In regional or rural areas, options may be limited, so it’s best to start researching early in pregnancy.
Always ask about staffing hours, because many hospitals can only offer epidurals when an anesthesiologist is present.

Cost of Epidurals in Japan

For most people outside Tokyo, epidurals are not covered by National Health Insurance, unless they become medically necessary, such as during an emergency c-section. The typical additional fee ranges from ¥100,000 to ¥150,000, depending on the hospital.

A Quiet Shift in Japan’s Birth Culture

Pain relief during childbirth is slowly becoming a more visible and supported part of maternal care in Japan. Tokyo’s new subsidy won’t fix every challenge overnight, but it signals a fundamental shift. More parents are talking openly about their birth experiences, more hospitals are exploring how to expand services and the national conversation around labour pain is beginning to soften.

At the heart of all this is choice. You deserve to understand your options, ask questions and feel heard throughout your pregnancy and birth. Whether an epidural becomes part of your plan or you choose another path, what matters most is feeling informed, respected and supported as you welcome your baby into the world.

Feel free to share your birthing experience in our comment section! We’d appreciate you sharing it.

UTI, Yeast Infection & More: OTC Women’s Health Products in Japan

Hilary Keyes — Fri, 07 Nov 2025 23:00:00 +0000

We all encounter health problems from time to time from PMS discomfort and yeast infections to skin flare-ups and the occasional UTI. Instead of relying solely on products from abroad, it can be beneficial to know what’s available locally. This guide highlights a range of trusted over-the-counter (OTC) women’s health essentials available here, including UTI products commonly found in pharmacies in Japan, as well as options for managing irritation and everyday self-care.

Once you get familiar with local brands, you might even find they work better—and are much easier to keep stocked when living here long-term.

The ones listed in this article function in the same way as their counterparts abroad and are available without a prescription. Most of these products cost less than ¥3,500. If symptoms persist, always consult with a medical professional.

Urinary Tract Infections (UTIs)

UTIs are a common health problem for women in Japan. As a result, there are also plenty of UTI-related medications and supplements available over the counter.

Bo-koren (ボーコレン) is a medication that helps to ease the pain when urinating and helps to wash out the bacteria that caused the infection. Similarly, Gorinsan Ekisu Jyou N Kotaro (五淋散エキス錠N コタロー) helps alleviate these problems and issues, such as feeling like you have caught a slight cold or experiencing fatigue.

Price: Bo-koren 48 pack: ¥1,600 (approx.); Gorinsan Ekisu Jyou N Kotaro 60 pack: ¥1,430 (approx.)

If the infection doesn’t clear up, see your doctor as soon as possible. However, these UTI products can provide temporary relief when you’re in a rush to grab something in Japan.

Body Skin Care

If you have rough, red, bumpy skin, then you may have sharkskin (サメ肌, same hada). It’s the colloquial term for skin that isn’t as soft and smooth as it once was or skin that doesn’t respond to regular lotions or scrubs.

In that case, you may want to pick up some Ninokyua (ニノキュア) or Zarapuro (ザラプロ). These two creams work to smooth out these rough, bumpy patches of the skin and can make your skin feel softer as well.

Price: Ninokyua 30g: ¥841 (approx.); Zarapuro 35g: ¥1,028 (approx.)

Facial Skin Care

Hormone fluctuations make women more prone to breakouts at certain times of the month or stress-related breakouts at any time. While there are plenty of acne-related face washes, many Japanese women seem to prefer to treat them from the inside out using vitamins and supplements.

Try using Chocola BB tablets or energy drinks by Eisai. These are B-vitamin-rich tablets that contain vitamin C, collagen and other ingredients to treat acne, rough skin and mouth ulcers. There are different types.

For general skin concerns, opt for Chocola BB Plus.

Chocola BB Pure is designed for sudden acne breakouts, while Chocola BB Lucent is formulated to address skin spots and freckles caused by sun exposure and aging.

Price: Chocola BB Plus 60-pack: ¥1,408 (approx.); Chocola BB Pure 40-pack: ¥1,064 (approx.); Chocola BB Lucent 120 pack: ¥3,278 (approx.)

Constipation

Another issue that many may suffer from, especially around that time of the month or if you’ve been traveling a lot recently, is constipation. In times like these, Fibe Mini by Otsuka Pharmaceuticals is just what you need. Each bottle contains 6g of dietary fiber, and it tends to work very quickly. Only drink it if you’ll be home or can quickly get to a bathroom in a hurry.

For more information, refer to our dedicated article on constipation in Japan.

Price: Fibe Mini 6-pack: ¥771 (approx.)

Vaginal Yeast Infections & Itchiness

A vaginal yeast infection is called kanjida chitsuen (カンジダ膣炎) in Japanese. The two most popular and readily available drugstore medications are called Meditreat (メディトリート) by Taisho Pharmaceuticals or Feminina (フェミニーナ) by Kobayashi Pharmaceuticals, which comes in a cream, gel and mist form.

The Feminina cream provides quick relief for generalized itching in the bikini area, such as after shaving or a “lady-jock itch.” If you suspect you have a yeast infection, ask your pharmacist for the insertable tablets, not the cream. If you find that after six days, these products aren’t working, you will probably need to see a doctor for something more powerful.

Price: Meditreat Cream 10g: ¥1,342 (approx.); Meditreat Insertable Tablet 6-pack: ¥2,489 (approx.); Feminina Cream 15g: ¥1,016 (approx.); Feminina Mist 15mL: ¥968 (approx.)

PMS/Post Menopause Support

If you have post-menopausal disorders or neuropsychiatric disorders related to hormones, consider this traditional Japanese remedy, L’amour Q (ラムールQ) by Tsumura & Co. This supplement comes with a comprehensive information PDF that explains its contents and potential benefits in English.

From menstrual pain and hot flashes to over-sensitiveness to cold, this one is a quick fix for many women’s specific symptoms.

These Japanese women’s health products have been trusted for years, so when in doubt, give them a try. Hopefully, you’ll feel better soon!

Note: *The UTI, yeast infection and other women’s health products from Japan featured in this article are not meant to treat severe medical conditions. Always consult your doctor if you have any pre-existing conditions.

Period Underwear in Japan: A Savvy Guide With Brand Recommendations

The Savvy Team — Tue, 14 Oct 2025 23:00:00 +0000

Between packed trains, last-minute overtime and spontaneous nights out, managing your period on the go can feel like running a marathon in heels. That’s where period underwear can come in clutch! They’re a reusable and eco-friendly solution helping women in Japan stay comfortable, confident and leak-free no matter how busy their day gets.

In this Savvy guide, we’ll break down the benefits of period underwear, explain the difference between absorbent and sanitary shorts, and introduce the top Japanese brands you need to know!

Why Period Underwear Is Worth Trying

Unlike traditional sanitary napkins or tampons, period underwear absorbs menstrual flow directly, eliminating the need for pads, plastic waste and any last-minute pharmacy runs. The fabric is engineered with multiple layers to absorb and lock in moisture, keeping you dry and odor-free. Some of the other benefits include that it’s:

Cost-effective: One pair can last for years with proper care.
Stylish: Many Japanese brands design their products to resemble everyday underwear in terms of both appearance and feel.
Confidence Boosting: With the ability to move freely, whether you’re at yoga, at work or exploring around.

Still, it’s not a one-size-fits-all fix. Period underwear works best when matched to your flow level. Lighter days may require just the underwear itself, while heavier days may still necessitate an extra liner or pad.

Absorbent vs. Sanitary

Not all period underwear is created equal. In Japan, there are two main types you’ll want to know:

Absorbent (Reusable) Shorts

Purpose: Designed to absorb menstrual flow directly, meaning no pad or tampon is needed.
Features: Multi-layer fabrics that lock in moisture, prevent leaks and often include odor-control technology.
Best for: Everyday wear, traveling, or overnight use, depending on your desired level of absorbency.

Sanitary (Pad-Compatible) Shorts

Purpose: Worn with a pad for extra protection, helping prevent leaks or stains.
Features: Waterproof lining, soft fabrics such as cotton or silk, and designs that facilitate easy and secure pad placement.
Best for: Heavy-duty day or nighttime use, or anyone transitioning to reusable underwear.

The Top Period Underwear Brands in Japan

We’ve rounded up Japan’s most trusted and innovative brands, from Tokyo-born femtech startups to long-standing local manufacturers.

Period. (ピリオド)

A pioneer in Japan’s femtech scene, Period specializes in beautifully designed absorbent underwear that promotes both comfort and confidence. Each pair is crafted in Japan using multi-layer technology, a combination of quick-dry, antibacterial and leak-proof fabrics. They’re available in several absorbency levels to suit your flow.

Price Range: From ¥3,960-¥8,030
Where To Buy: Various in-person stores in Tokyo, Nagoya and Osaka, or the Period online store

Bé-A (ベア)

Stylish yet practical, Bé-A is one of Japan’s most advanced femtech brands, combining lab-tested innovation with sleek design. Bé-A’s signature shorts can hold up to 150ml of liquid. They’re ideal for heavy-flow or overnight protection.

Price Range: From ¥5,720-¥8,800
Where To Buy: Various in-person stores all over Japan, or the Bé-A online store

Laqree (ラクリー) Pants

With a name that blends “luxury” and “relax,” Laqree is all about powerful performance and peace of mind. Their designs feature super absorbent (up to 160ml) and odor-control layers, perfect for all-day wear or overnight comfort.

Price Range: ¥3,980–¥7,920
Where To Buy: JF Cosme Labo online store or Rakuten

Quarter (クォーター) PP

Designed for daily comfort, Quarter offers soft, flexible period underwear that absorbs up to 50ml of fluid. Their focus is on gentle materials and minimal seams, ideal for sensitive skin and everyday use.

Price Range: ¥6,490-¥7,590
Where To Buy: Official Quarter online store

Japanese Sanitary Underwear Brands (For Pad Use)

For those who prefer pairing with a pad or want extra protection on heavier days, Japan also offers beautifully made sanitary underwear designed with leak-proof inner lining and soft, skin-friendly fabrics.

bodyhints (ボディヒンツ)

A long-loved Japanese underwear brand, bodyhints focuses on natural fibers like silk and organic cotton for breathable, gentle comfort. Their popular items include the “Rice Bran Beauty Sanitary Shorts” and the “Supima Cotton Night Sanitary Shorts.”

Price Range: ¥880–¥3,520
Where To Buy: Official bodyhints online store or Amazon

Com Sanyo (コム・サンヨー)

Crafted one by one in Nagasaki, these handmade Japanese sanitary shorts are all about quality craftsmanship and pure cotton comfort. If you’re looking for a simple, durable option with a focus on “Made in Japan” quality, this is it.

Price Range: ¥858–¥1,518
Where To Buy: Official Com Sanyo online store

NaturaMoon (ナチュラムーン)

As one of Japan’s first organic cotton sanitary brands, NaturaMoon’s products are gentle on the skin and highly stretchable, making them ideal for those prone to irritation. Their sanitary shorts pair perfectly with organic cotton pads for a soft, breathable setup.

Price Range: Around ¥3,058
Where To Buy: Various in-person stores all over Japan or Naturias online store

Extra Period Underwear Tips

If you’re new to reusable menstrual underwear, here are some Savvy-approved tips to help you find your perfect match:

Match absorbency to your flow: Use high-absorbency types for heavy days or overnight.
Check the materials: Opt for breathable cotton blends to help prevent irritation.
Start small: Try one pair before investing in multiple (period underwear might not be for everyone).
Mind your laundry: Rinse in cold water and avoid softeners or bleach to maintain performance.
Mix and match: You can always add a pad or liner if you need that extra reassurance.

Period underwear in Japan isn’t just about practicality; it’s about empowerment. The Japanese brands above prove that comfort, sustainability and style can absolutely coexist—even on your heaviest day. So go ahead and add a pair (or two) to your drawer. Your cycle (and the planet) will thank you!

Ozempic in Japan: A Savvy Guide For Foreign Residents

Kerri King — Fri, 26 Sep 2025 23:00:00 +0000

Over the past two years, drugs like Ozempic and Mounjaro have gone from quiet prescriptions for Type 2 diabetes to global household names. Thanks to celebrity testimonials, viral TikToks and endless headlines, these GLP-1 medications (short for glucagon-like peptide-1 receptor agonists) are now strongly associated with rapid weight loss. Japan hasn’t escaped the buzz. English-language ads for Ozempic and similar drugs are now common across social media, often targeting foreign residents. If the constant media push has you wondering about Ozempic in Japan, here is your Savvy Guide to these medications.

GLP-1 Drugs Approved in Japan

Can you actually get Ozempic or similar “weight loss injections” in Japan? The answer is yes, but only under strict medical criteria. The three most common medications available are:

Ozempic (Semaglutide): Approved in Japan in 2020, Ozempic is officially prescribed for type 2 diabetes management. Some doctors may provide it off-label for weight loss, but this is not common practice.
Mounjaro (Tirzepatide): This newer GLP-1 medication was approved in 2022, also for type 2 diabetes treatment. Like in the case of Ozempic, its recognized role in Japan is blood sugar control, not weight loss.
Wegovy (Semaglutide): Wegovy is the only injectable medication approved for obesity management and has been available since 2023. It’s covered under Japan’s National Health Insurance (NHI) if you meet the criteria (BMI ≥35, or ≥27 with related health conditions such as hypertension or diabetes).

Several other GLP-1 medications are also now available in Japan, including Rybelsus (oral semaglutide), Saxenda (liraglutide), Trulicity (dulaglutide) and Byetta/Bydureon (exenatide). These are usually prescribed for managing type 2 diabetes rather than weight loss.

The Cost: What You’ll Pay With & Without National Health Insurance

Whether these drugs are covered by National Health Insurance (NHI) or not makes a huge difference to your monthly costs. Japan’s NHI usually covers 70% of drug costs, leaving patients to pay about 30% out of pocket.

Here are the official 2025 prices and typical copays for the three most common medications available (monthly estimates are based on four weekly doses at the lowest available dose and exclude clinic visits or test fees):

Brand	Approved Use in Japan	NHI Copayment (Out-of-pocket Cost)	Private Clinic / Off-Label Cost
Ozempic	Type 2 diabetes	¥1,650–6,600/month	¥25,000–33,000/month
Mounjaro	Type 2 diabetes	¥2,300–13,800/month	¥22,000–40,000/month
Wegovy	Obesity (BMI ≥35, or ≥27 + comorbidities)	¥2,250–12,900/month	¥26,000 – ¥52,000

The Marketing Push To Foreigners

If you live in Japan and spend any time on social media, you’ve probably noticed the rise in ads for “weight loss injections.” Even if your feed has nothing to do with dieting, it’s now common to see English-language promotions for Ozempic, Mounjaro or similar drugs.

These marketing campaigns target foreign residents because access through Japan’s public health system is limited. Strict NHI criteria and a lack of English-language support often make it harder for foreign residents to get GLP-1 medications. Private clinics are well aware of this gap, and so they have begun to market aggressively to international residents, often charging significantly higher, out-of-pocket prices.

Private English-Speaking Clinics Offering GLP-1 Treatments

If you don’t qualify for coverage under Japan’s National Health Insurance (NHI), or if your doctor isn’t supportive, several private English-speaking clinics do offer GLP-1 medications. These clinics can be convenient, especially with bilingual staff and telemedicine delivery, but they can cost two to three times more than NHI-covered prescriptions.

It’s worth checking the fine print before signing up so you know exactly what you’re paying for. Some clinics bundle everything (consultations, follow-ups, needles, alcohol swabs, even travel letters) into one package. Others only list the medication price upfront and bill separately for extras like blood tests.

These are a few well-known clinics offering GLP-1 weight loss treatments in Japan:

Hada no Clinic (Tokyo): Bilingual clinic advertising weight-loss programs that include check-ups and counseling.
Bianca Clinic (Tokyo): Provides Mounjaro and other GLP-1 injections for weight loss, marketed as weekly treatments.
Tokyo Medical and Surgical Clinic (Tokyo): Longstanding international clinic in Tokyo offering weight loss treatment programs, including GLP-1s, with English-speaking doctors.
Juniper: Telemedicine platform with English consultations, nationwide delivery and travel letters for medication.
E-Life Clinic: Offers online consultations and pricing packages for Ozempic, Mounjaro and Saxenda.

Important Factors to Consider

If you’re thinking about trying a GLP-1 medication like Ozempic, Mounjaro or Wegovy, it’s worth looking beyond the hype. These drugs can be effective, but they also come with real risks that shouldn’t be overlooked.

How GLP-1 Medications Work (& What to Expect)

One of the main ways GLP-1 medications like Ozempic work is by slowing gastric emptying. Put simply, food takes longer to leave your stomach and move into your intestines. This makes you feel full sooner and stay full for longer, reducing your appetite. The exact mechanism, however, is also what causes many of the most common side effects: nausea, bloating, a constant feeling of fullness, stomach pain and sometimes vomiting.

Studies show that in some cases, GLP-1 drugs can cause gastroparesis, a condition where the stomach doesn’t empty properly, leading to severely delayed digestion and awful side effects. Having lived with gastroparesis myself, I can say it’s more than an occasional upset stomach and will drastically impact your quality of life.

Don’t just take my word for it. In clinical trials, nausea was reported in about 44% of people taking higher doses of semaglutide, while vomiting affected roughly 25%—making these two of the most common side effects. That’s also why you need to factor in the ongoing cost of additional medications, like anti-nausea tablets, which are often needed to manage these symptoms.

Other side effects frequently reported with GLP-1 drugs include diarrhea, constipation, acid reflux and abdominal pain. These symptoms are often worse at higher doses or when the dose is increased too quickly. Because of these risks, it’s essential to carefully weigh the benefits of these medications against the possibility of long-term side effects.

These medications can be useful tools, but they’re not quick fixes and carry real risks. If you’re considering them in Japan, always start by speaking to your doctor and making sure you understand both the benefits and the downsides.

Letters from Japan: “Getting Older in Japan”

Hilary Keyes — Sat, 13 Sep 2025 23:00:00 +0000

Dear Hilary—I am getting older in Japan.

I’m a woman in my late forties, divorced with no kids. I’ve been living in Japan for most of my adult life. I’m starting to feel left behind, unseen and out of my league, if that makes any sense. I’m getting older in Japan, and I don’t know what to do with the rest of my life. Can you give me any insight?

—Aging With Dignity

Dear Aging With Dignity,

It’s understandable that you would feel that way. Here’s a fun/random fact: as of the end of 2024, there were more than 230,000 foreign residents aged 65 or older in Japan. Japan is aging, and so is its foreign population. Things like pensions, retirement age and how to live in Japan beyond working age are topics of conversation among many people in their thirties and forties.

For many people in their late forties, it can feel like the world isn’t made for them anymore. Pop culture has moved in new directions that don’t seem to fit who you are. Fashion has looped around back to what you wore as a young teen or university student. You might find yourself feeling cut off from that side of life in general.

Add in the fact that you live in Japan and are, therefore, further removed from your peer group. It’s only natural to feel “left behind, unseen and out of your league,” as you said.

Aside from navigating perimenopause or menopause in Japan, you’re also approaching retirement age. A lot of foreigners in Japan struggle with depression or social isolation, and this only seems to get more difficult for everyone with age.

First of all, recognize that there is nothing wrong with you for feeling that way.

It happens to all of us eventually. It’s how you deal with those feelings that matters.

Some wisdom on this topic can be found in an age-old Japanese concept, and one that became globally popular a few years ago: ikigai, or finding one’s purpose. In short, ikigai is what makes getting out of bed in the morning worth it to you.

It could be your work, your hobby, exercise or simply wanting to listen to music and chill out before you deal with the day. Whatever it is, if you can find that and make sure that you do take that time for yourself, you’ll feel a lot better about going forward with your day.

I’m sure that to many, it can sound like some silly concept, and that’s true for Japanese people, too. Putting the ikigai concept into practice takes effort.

“Finding your ikigai sounds like such an old person thing. For a long time, I figured it was something that only people who had that much free time on their hands could bother with. Old people are always taking trips, joining new hobbies, going out to see museums and so on. Now I’m old and I get it. Living for work was terrible. Now I have friends, I go out, I eat better. I like living” (Japanese, 60s).

Is it easy to find your ikigai? No. Is it hard to find your ikigai? Also no.

It all depends on the energy you want to put into the process.

I’m not sure how you would categorize yourself in terms of intro- or extroversion, but one of the main things you can do to help yourself find purpose in life is getting out and seeing the bigger world around you. That doesn’t necessarily mean travelling abroad or even domestically. Going for walks and finding new things in your neighborhood can really help shift your perspective on life. Some friends of mine did this and ended up finding and joining a local meet-up group, despite not being fluent in Japanese.

You mentioned being divorced but nothing about being in a relationship. If you are interested in finding a new partner, you can also do that by going out and trying new things. Meet-cutes aren’t limited to movies or young people, after all.

You might also be thinking about moving back to your home country.

I’m not sure where you’re from, but if you do want to move back, you should look into your pension/social insurance system there and see if it is connected to or has any agreements with Japan’s system. While I’m by no means an immigration lawyer, there are a number of factors you’ll need to consider and things to take care of aside from moving itself.

If you are considering moving back to your home country, that’s certainly an option, and many people take it even after they’ve lived in Japan for many years. That being said, you may also have your reasons for wanting to stay in the country. It’s a very personal, albeit difficult decision to make, and no one can or should make it for you.

Just remember that you’ve navigated plenty of tough decisions so far in life, so I’m certain you’ll come to the right conclusion for you. Mood follows action, so try to take actions that will make you feel the way you want to feel. Best of luck.

Got a question you’d like to ask Hilary? Email it to askhilary@savvytokyo.com with the subject “Ask Hilary.”

Getting The Birth Control (Oral Contraceptive) Pill in Japan

Margot Curtis — Fri, 05 Sep 2025 23:00:00 +0000

The birth control pill in Japan is known as keikou-hinin-yaku (経口避妊薬) but more commonly referred to as “piru” (ピル). They were only legalized in 1999, four decades after they became available in the West. Japan was, in fact, the last U.N. member to approve the drug, and this delay has had a knock-on effect on its popularity even today.

But in reality, it remains a relatively cheap, effective and increasingly accessible method of birth control that you can get with a little effort.

Why The Pill Obsession?

The pill became available in the 1960s and symbolized liberation for Western women at a time when abortion was still largely illegal due to religious taboos. For many of us, that era came with awkward high school health classes and learning how to put condoms on bananas—cringe-worthy, yes, but also part of the reason contraceptive choice feels more familiar in the West than in Japan.

Here, the picture is different. Condoms still dominate the scene, along with withdrawal, temperature-tracking and the rhythm method. For some, the hesitation around the pill comes from fear of side effects or a simple lack of information—sex education in Japan still doesn’t widely emphasize female contraceptive choices.

Abortion is legal if you become pregnant, but unlike many other countries, you cannot arrange it alone unless the partner is unknown. Married or partnered women must have their partner’s written consent, and procedures are usually more expensive than back home.

How Do I Get The Pill in Japan?

The process is relatively straightforward: visit a gynecologist, have a consultation (often including a blood test on your first visit), and get a prescription. A month’s supply usually costs around ¥3,000, depending on the brand and your doctor. My gynecologist was incredibly helpful and friendly, but others may still be conservative about prescribing it, so experiences vary. Overall, access has been steadily improving.

One important note: National Health Insurance (NHI) does not cover the pill. However, if you ask your doctor to prescribe you a pill you were already taking overseas, depending on the brand, there may be options for a pill that is covered by the NHI.

What Types Of Pills Are Available?

Japan offers a selection of low-hormone combined oral contraceptives (estrogen + progestin). These come in both monophasic (same dose throughout the cycle) and multiphasic (varying doses) types.

Monophasic pills: Marvelon (マーべロン), Ortho M-21 (オーソM-21), Yaz (ヤーズ)
Multiphasic pills: Triquilar (トリキュラー), Ange (アンジュ), Synphase (シンフエーズ), Ortho 777 (オーソ７７７)

As of June 2025, Japan has finally approved its first mini-pill: Slinda 28 (スリンダ), a progestin-only oral contraceptive. Now available nationwide by prescription, it offers a safe option for women who cannot take estrogen or who prefer a lower-hormone choice.

Emergency Contraception (The Morning-After Pill)

Until recently, getting the morning-after pill in Japan required a prescription, which meant calling ahead to clinics (not all stocked with it) and making an appointment. This was a significant barrier, considering that effectiveness is highest within 24 hours.

For the first time, Japan will allow over-the-counter sales of the emergency contraceptive pill. NorLevo (ノルレボ錠 1.5mg) will be available directly at pharmacies under the supervision of a pharmacist. There will be no age limit and no need for parental consent; however, expect to pay anywhere between ¥7,000 and ¥10,000 per pill.

This follows nationwide trials where more than 80% of participants supported making emergency contraception prescription-free. While official rollout is expected later in the spring of 2026, the shift marks a historic change in reproductive healthcare here.

For now, if you need it before the rollout, you’ll still need to call a clinic and ask for the kinkyū-hinin-hō (緊急避妊法), or mo-ningu afutaa piru (モーニングアフターピル).

Find an English-speaking women’s clinic in Tokyo.

Japan still has a way to go when it comes to women’s health, but things are changing—albeit slowly. The upcoming launch of over-the-counter emergency contraception and the arrival of mini pills are significant steps toward broader choice.

Never forget: the birth control pill (regular or emergency) does not protect against sexually transmitted infections (STIs). Condoms are still the only protection for that. Stay safe, stay informed, and let’s keep the conversation going!

For other contraceptive options, don’t forget to check our full article about contraception in Japan.

This article has been updated with the latest information for 2025.

Hair Loss in Japan: The Causes & Solutions!

Rae DeFrane — Fri, 25 Jul 2025 23:00:00 +0000

I was losing so much hair! Clumps were lost almost daily after I arrived in the country. Experiencing hair loss in Japan can be hard to swallow for anyone, but as a 20-something female, it was beyond troubling. I researched my symptoms online (which is always problematic) but found very little information about what I was experiencing. I hadn’t had this issue in Canada. Was it Japan, or was I going crazy?

After scouring the internet, desperate for advice, I finally found a private Facebook group for women living in Japan. There, I found a plethora of people who were suffering in the same way I was. It turned out I wasn’t crazy, and I wasn’t the only one.

A Common Problem

We were all in our twenties or thirties, and it seemed impossible to me that our problems were completely independent of our new surroundings. How could each one of us have completely separate issues that sprang up as soon as we landed? More importantly, how were other people with the same hair loss problem supposed to find this tiny pocket of information in Japan without being members of the Facebook group?

I want to shed light on this stressor and help anyone who might find themselves in the same situation. This was something that almost cut my time here drastically short, and I don’t want others to feel alone.

So, Why Is My Hair Falling Out?

The answer to this could be equal parts simple and frustrating. Are you of European or Celtic descent? Unfortunately, this might put you at a predisposition to have more hair loss in Japan. Westerners tend to have much softer, finer hair. There are many reasons why our hair can freak out as compared to when we’re in our home countries. Let’s run down the list of some of the things that can weigh heavily on our tresses.

The Causes

1. Jet Lag

A lesser-known symptom of jet lag, outside the general tiredness and brain fog, is hair loss (who knew?!) This is likely caused by many factors, such as being at a high altitude, general travel stress and your body being thrown completely out of its regular rhythm. So, if you’re brand new to the country, it might not be time to panic just yet. Jet lag (typically) wears off at one to two time zones per day. For anyone coming from North America, that means it can take a week before the immediate effects wear off.

That being said, our hair tends to take even longer to catch up, so if you think jet lag might be the culprit, give it a couple of weeks to start getting back to normal.

2. Climate Changes

Not only does your internal clock take a beating when you first arrive, but depending on what time of year you land in Japan, the change in weather can also give you a serious beating. Summers in Japan are brutally hot and humid. Our hair is like our fur, so if we need to cool down, it tends to start shedding!

After speaking with a dermatologist here in Japan, I was told that my hair loss could be caused by dandruff, which is often caused by the humid climate (gross!). Dandruff is definitely something that happens to a lot of Westerners during the Japanese summers and winters.

It turned out that the level of severity of seborrheic dermatitis (the medical term for extreme dandruff), which would take to disrupt hair follicles, is—to spare you the worst of the details—intense. Far worse than the few flakes I was noticing. Still, if you have intense itching and flaking, you might want to speak with an expert.

3. Diet

There are a lot of changes to diet that come with moving to a new country. Japan has a lot of delicious foods, but what I didn’t notice right away was that, coming from North America, there tends to be less protein in Japanese meals. Also (at least in Tokyo), fresh veggies and fruits can be expensive and consequently, are more easily skippable. This is where things can go wrong, as nutrient deficiencies are going to manifest themselves in your hair and skin first.

When I first arrived, my diet changed a lot; I had to make a much more deliberate effort to keep the same micronutrients in my system that I was getting on a regular basis back home. Even if your diet isn’t necessarily unhealthier, a big change in food intake can still lead to a reaction in your hair weeks after the change has occurred. This can make it hard to pinpoint as a culprit for hair loss.

Some of the most important micronutrients for hair health are vitamins C and E, zinc, B-vitamins and omega-3 fatty acids. While omegas are fairly easy to come by in the Japanese diet (contained in fish and nuts), a lack of animal-based protein can decrease your B vitamins. Meat contains plenty of zinc as well, so we start to see how important protein is for hair growth. For my vegan readers, whole grains, seeds and legumes also contain these, but I would consult your physician to ensure you’re not missing any key nutrients.

4. Water

Where I come from, we drink natural, untreated water straight from the ground. Canada is blessed with a lot of accessible and fresh water. Japan, in general, also has very clean water. In a big city like Tokyo, however, it is heavily treated with chlorine to keep it free from contagions.

When I first arrived, I thought the water coming from my tap smelled like a swimming pool. The chlorine also turned my dyed, reddish-brown hair almost dirty blond in under a month, so it’s definitely heavy-duty. If your hair isn’t used to treated water, it’s likely going to take a long time to adjust to the change.

The Solutions

1. A Shower Filter

After reading through that forum I mentioned earlier, I realized that there was action I could take to slow my hair fall. The number one thing that was recommended was to purchase a shower filter. This helps to combat all those harsh chemicals in Tokyo water and can even help you adjust the strength of the water pressure so it’s more gentle on your follicles. I found this was a very quick way for me to address the issue in my drain every evening.

Savvy Recommends: I bought mine at Bic Camera for about ¥5,000, but you can also purchase the Cleansui Clean Water Showerhead online.

2. Hair Products

Here’s a big mistake people make, especially when they first move to Japan. If you don’t have hair similar to that of a Japanese person, then don’t use Japanese hair products, especially shampoo and conditioner. The Japanese hair care industry is (unsurprisingly) tailored to Japanese tresses. It’s made for thick, coarse, Asian hair. Because of this, it can be way too powerful and drying on foreign hair.

I highly recommend bringing products from home or ordering through websites so that you can make sure you’re not doing more harm than good in the shower. It also might be helpful to get something that is specifically for dandruff if you find you’re scratching your head more than usual.

Savvy Recommends: Lots of people swear by other dandruff hair products, but I prefer a more natural option called Petal Fresh.

3. A Silk Pillowcase

This is probably the thing that has helped me out just as much as the shower filter since I moved to Tokyo. Switching to a silk pillowcase is gentle on your strands, so I have stopped waking up to hair on my pillow after a night of tossing and turning. There is also an added benefit: silk pillowcases are supposed to be better for your skin! They can be expensive, at about ¥6,000, but I have found it a worthwhile investment.

Savvy Recommends: Silk pillowcases can be found at any linen store, but if you want an online option, check out this one made in Japan.

4. Mind Your Food

Diet can significantly impact hair. While you should check with a doctor before making any drastic dietary changes or introducing nutritional supplements, the right additions can really help to facilitate growth. Make sure you are eating foods rich in omegas and protein, such as fish, avocados, eggs and nuts.

Iron is also crucial for hair growth, and it is plentiful in dark, leafy greens. Another great supplement for strengthening your follicles is biotin. This is notorious for being difficult to get from foods other than eggs, but ask your physician about introducing it into your supplement arsenal. Any biotin supplements should do, and you can find them all over Amazon, Rakuten or even in Don Quijote.

5. Relax!

Moving to another country is, well, stressful! Especially if you are trying to find an apartment, a job and any sort of comfort from your old life. Things can be tense for weeks or even months and that can take a toll on your entire being. Plus, if you notice a lot of hair falling from your head, that can feed into more stress, so you get caught in this never-ending loop.

Try to remember that stress affects your hair slowly, but cuts deeper than most other factors. If you look at your life and think, ‘But I’m not stressed!’ then look back a few more months. You might remember being in a different time that is still following you around in the form of hair loss.

Savvy Recommends: There are lots of ways to relax and it’s going to be about finding what works for you. Starting a yoga and/or meditation practice will work wonders. Or, try introducing warm baths with fun bath bombs to help calm your nerves. If putting on some Netflix stand-up comedy or the newest anime release is what calms you, then do it! It’s about carving out the time in your day or week to address feelings of stress and doing what we know grounds us again.

6. Know When To Call In The Troops

Now, if a few months have passed and the problem is persisting, remember that hair loss can be a symptom of a more serious issue. This article can’t tell you if it is a cause for concern, so if you have tried all other avenues and it has been a few months of gradual thinning, or a large amount of steady thinning, it’s best to seek the help of a medical professional.

Start with a general practitioner, though it’s possible you will be referred to a dermatologist for further evaluation. Hair loss can be caused by a myriad of things (especially in women living in Japan), but it’s always good to err on the side of caution.

Things Will Get Better!

I am writing this article to ensure that, as people of all genders, ages, and ethnicities move into Japan’s four distinct seasons, they know they are not alone in their struggles. It’s not just you. It can be Japan. You are not going crazy. After a year of living here, multiple trips to the dermatologist, and adjusting my haircare routine, I have quelled the worst of the hair fall.

It took me a long time to find the products that were right for me, so I suggest experimenting with your routine and trying to address the main issues we tend to face here as foreigners. A little time and TLC will most often resolve the issues, so try not to stress yourself out more by dwelling on them. Dwelling on them can only make them worse.

Just remember, you’re not the only one experiencing hair loss in Japan, and it will be okay. Focus on all the great things Japan adds to your life, not the losses on your scalp.

Moving To Japan With A Chronic Illness: The Check List

Rae DeFrane — Wed, 23 Jul 2025 23:00:00 +0000

Moving to Japan with a chronic illness—or even discovering you have one after you’ve arrived—can complicate what is already a significant life shift. The phrase can feel dismissive, especially when symptoms are invisible or misunderstood. It can be disorienting for anyone who has moved here and suddenly finds themselves without the support, resources or understanding they once had.

The dream of packing your life into a sleek carry-on and relocating to Japan transcends age, culture and circumstance. It’s daunting, stressful and sometimes downright terrifying—but also incredibly rewarding. Few experiences will teach you more about yourself and your priorities than starting over from scratch in a new country. For anyone moving to Japan with a chronic illness, or trying to manage one post-arrival, knowing what to prepare—from medical documents to access to care—can make all the difference.

The “Other” Checklist

Your first step towards Japan will most surely look like this.

It’s a nearly universal experience in our Information Age to type something along the lines of “checklist to move to Japan” or “how to move to Tokyo” into a search engine. You can read these types of posts forever to glean the wisdom of those who have come before you… However, one thing that is almost completely missing from this narrative is what to do if you‘re not of “normal” health.

When I moved to Japan, my family was terrified. Online posts about my life-altering and potentially life-threatening illness were nonexistent. Frantically, I reached out via forums and threads to get some anecdotal advice.

Now, I don’t want people out there who have additional medical needs to think that this is simply impossible for them. There will be hoops to jump through, and you will have to be more careful than others, but you deserve your chance, too. This is for people moving to Japan with chronic physical and/or mental illness to have a quick reference for some useful information. I’m here to let you all know that there is an entire community that knows just how you feel.

I want to make a new checklist—the “other” checklist. This is for all those extra things to keep you safe and sound as you transition into life in Japan. This list can never be exhaustive since different needs will require different care. So, please remember that rule number one is to talk with your specialists in your home country before taking off.

1. Medications

Please do not leave this out until the last minute. It is number one in this checklist for a reason. This is going to be absolutely crucial for you to research prior to your departure for your new life. In fact, if medications are critical to your continued treatment, it should be the second thing you type into that search bar.

Do Your Research

Japan has some of the strictest regulations on controlled substances in the world. Many medications that are readily available for various treatments in Canada or the U.S. are restricted or outright prohibited. A fantastic example of this is the dosages of what we would not even consider a ‘medication’ in North America. For example, the doses of Dimenhydrinate (Gravol/Dramamine) or Ibuprofen, compared to their Western counterparts, are less than half.

Similarly, the list of prohibited antidepressants/anxiety or antipsychotic medication can be a concern for many. Though, luckily, they are listed on the Ministry of Health, Labour and Welfare website.

Organise A Yakkan Shoumei (Medical Import Certificate)

If you want to bring more than a 30 day supply of any medication with you into Japan—and I suggest you do this if possible, to make your move less stressful—you will need to apply for and acquire a Yakkan Shoumei or a ‘Medical Import Certificate’ before leaving your home country.

Yakkan Shoumei application forms are now available to fill in online in English.

The Yakkan Shoumei will allow you to essentially gain special permission to bring in large quantities of medications in a single trip. This actually applies to bringing in multiples of your favorite makeup or skincare, too. It is also required if you wish to mail yourself any medications from home to ensure that customs don’t whisk them away never to be seen again and leaving you in quite a pickle.

I do recommend, if at all possible for you, to bring as many supplies as possible with you to Japan. Finding specialists in Japan is not always an easy task and general practitioners will not give medical advice on specialized conditions. I wasn’t able to get a prescription until I found an endocrinologist even though my medications are needed to continue living. Give yourself time and resources to make methodical decisions on healthcare providers. Like in any other country, Japanese doctors can be really understanding and supportive or really, really not.

2. Climate Research

It’s a bit of a meme at this point for newly landed folks arriving in August or September (as many JETs and dispatch ALTs do) to be decimated by the sweltering humidity of Japanese summers or to be chilled to the bone by Hokkaido winters. Japan has many different types of weather. Compared to many places in the world, it is changeable and harsh too. It takes most people I have spoken with off guard without the first-hand experience.

This can affect many conditions. I arrived during a particularly brutal heatwave, which caused me a large amount of stress. I was traveling with months’ worth of a life-giving medication that needed to be kept refrigerated to keep its efficacy. On top of that, after being in a heat that my body hadn’t been acclimatized to, and due to an unknown kidney vulnerability, I was stricken with severe heat stroke and dehydration on day two of being in Tokyo.

You will want to be prepared for where you are moving in Japan. Make note of the time of year, as well as how your body handles different weather.

3. National Health Insurance

Japanese National Health Insurance (NHI) is mandatory for everyone. Employers must provide it to full-time employees, and it must cover pre-existing health conditions. If you’re a student or unemployed, you must register for it at your city hall. While Canadians like myself might gasp at times at the upfront costs, compared to other places (sorry, American readers), it’s pretty great. The coverage extends to 70 percent of your doctor’s visits and prescriptions. You pay out of pocket the remaining 30 percent.

Here is where things can get difficult for those of us with additional medical needs. In the event of needing to use your NHI to get prescriptions, to go to a clinic or to be treated at the emergency room, you must have your NHI card in your possession at the time of treatment or that entire lump sum is due out of your pocket then and there.

Sure, you can absolutely submit a claim for the amount if you are indeed covered, but an emergency trip to the ER could cost anywhere from ¥5,000 to over ¥50,000 and could even be required in cash if you’re particularly unlucky, depending on what they need to do for you.

That time I got sick after arriving in Japan? I was lucky enough to be covered by NHI for my work… but had not yet been issued my card. I had to pay nearly ¥6,000 in the month before being issued my card. Japanese bureaucracy when it comes to paperwork is not for the beginner local, if avoidable. Always have that card on you. Always!

4. Evacuation Information & Natural Disaster Preparedness

Everyone knows that Japan has natural disasters. From earthquakes to tsunamis to typhoons, Japan has had to streamline its evacuation protocols. They have essentially mastered the entire thing.

To ensure you’re protected by these procedures, first get settled at an address. While completing the many things required at your ward office upon arrival, also ask for an English evacuation guide. Be sure to get emergency information specific to your ward in Tokyo or a city within Japan.

It’s also never too early to begin collecting items to be self-sufficient and sustainable in the event of needing a grab-n-go emergency kit. Make sure your kit can securely hold any medications or supplies needed to support your illness.

5. Finding A Doctor

This is probably going to be one of the more intimidating steps. Since you’ve already shown that you can get yourself to Japan, by this point, I think you’ve got this. Doctors work a little differently than I was used to in Canada. In case it’s also different from where you are from, let me give you a quick run-through.

In Japan, there is not really a ‘family doctor’ situation. From colds to fevers to general aches and pains, you go to a clinic and you see a general practitioner. From there, if it is decided that they are unable to help you, and a specialist is needed, they will write you a referral and will let you know that they can no longer assist you. If you have a chronic illness or comorbid conditions, then the number of doctors you see can add up quickly. I myself have three. It can be very frustrating to have to trek across Tokyo to refill a prescription after just waiting in a busy doctor’s office, but this is the way things are done in Japan.

The Unexpected Restrictions

What most people find hard to swallow is the restriction that even doctors have in terms of their patients. Despite the fact that I will need my medication for the rest of my life (and will not be able to operate as a human without it), I must go to my specialist every two months to renew that prescription and pay the associated fees. They are not small. Since specialists often work reduced hours or specific weekdays, you’ll need to speak with them about providing your workplace with evidence. This evidence will show that frequent visits are necessary for your continued health. I want to explore this topic more deeply in a future article, so I’ll digress here for now.

This list will be different for each of us. Although we have to live our lives differently from the average populace, it’s not impossible for us to move abroad. I hope this article about moving to Japan with a chronic illness can help people navigate the haze of what they have to do to stay healthy so that they can self-realize their dreams abroad.

These are my own experiences as a person living in Japan with a chronic illness. I hope it provides insights for those who wish to move to Japan and makes resources and information more accessible and less shrouded in mystery.

Abortion Laws & Support in Japan: A Foreigner’s Guide

Julia Mascetti — Sat, 12 Jul 2025 23:00:00 +0000

For some people, becoming pregnant in Japan is great news. It can be the start of an exciting new chapter of your Japan life, and a source of great happiness. However, for some women, carrying an unplanned pregnancy to term feels like an impossible prospect, whether due to financial constraints, social pressure, health or personal reasons. In such cases, understanding your options for abortion in Japan becomes essential.

Is Abortion Legal in Japan?

Depending on your home country, attitudes and regulations regarding abortion may be more or less lenient than you are used to. In Japan, abortion is legal under the Maternal Protection Act, and permitted if continuing the pregnancy would seriously impact the woman’s physical health or cause significant economic or social hardship. It is also legal in cases of rape or incest, and must be performed before 22 weeks of pregnancy.

In April 2023, Japan approved its first abortion pill, known as Mefeego (a combination of mifepristone and misoprostol), for pregnancies up to nine weeks. However, as of 2025, medication abortions still account for a small percentage of total procedures.

Abortion is still not uncommon. According to the Ministry of Health, Labour and Welfare, 126,734 abortions were reported in fiscal year 2023. Although this number reflects a continuing decline from earlier decades, it demonstrates that abortion remains a widely utilized option for those facing unplanned pregnancies in Japan.

What To Know In Advance

If you’re facing the difficult decision of terminating a pregnancy in Japan, it’s important to know your rights, the process and what to expect ahead of time. While the experience can feel overwhelming—especially in a foreign country—having accurate information can help you feel more in control.

Timing Matters

If you suspect you’re pregnant and are considering an abortion, act quickly. Abortion in Japan is legal up to 21 weeks and 6 days (just before the third trimester), but the sooner you act, the simpler and more affordable the procedure tends to be. After 22 weeks, abortion is only permitted if the pregnancy poses a serious risk to the woman’s life or health, and even then, it requires special approval and is rarely performed.

Medical vs. Surgical Abortion

Access to medical abortion in Japan is gradually expanding, but it remains limited and closely regulated. The pill must be taken at a designated medical facility, and most clinics require you to stay for observation, even though the medication is taken orally. Currently, only a small number of clinics across the country offer this option, so it’s important to check availability early.

For most women, especially those past nine weeks, a surgical abortion is still the most commonly available option. These are typically performed at obstetrics and gynecology (ob-gyn) clinics, especially in larger cities like Tokyo, Osaka and Nagoya.

Something that may come as a surprise—particularly to women from Western countries—is that partner (or spousal) consent is often required for an abortion in Japan. This is due to the continued enforcement of Article 14 of the Maternal Protection Act, which states that both the pregnant person and their spouse must consent to a termination.

While there are exceptions—such as if the partner is deceased, missing or if the pregnancy is the result of rape—you must usually provide documentation in those cases. In practice, however, many clinics do not verify the identity of the consenting partner. This means that some women choose to have a male friend sign the form, though clinics vary in how flexible they are with this approach.

It’s also important to note:

Unmarried women are not legally required to obtain spousal consent. However, many clinics still ask for a signature, even if it is not legally necessary.
Women experiencing abuse or coercion may find this requirement particularly difficult—support organizations (listed later in this article) may be able to assist.

Preparing for Your Appointment

Once you book an appointment, the clinic will provide detailed instructions about:

How to download and complete the consent form
What documents to bring (ID, health insurance card, etc.)
Pre-procedure health checks (blood tests, ultrasounds)
Estimated costs, depending on gestational age, method and clinic location

For example, at Ikenoue Obstetrics and Gynecology (mentioned later in this article), the consent form is available online, and the staff provides detailed instructions. Some clinics also offer pre-procedure counseling in Japanese or English.

How Much Do Abortions Cost in Japan?

In Japan, abortion is generally not covered by the national health insurance system, as it is typically classified as an elective procedure. This means that in most cases—regardless of method or reason—you will need to cover the full cost out of pocket. However, in rare cases where the abortion is medically necessary to protect the life or health of the mother (such as with an ectopic pregnancy or severe complications), the procedure may be partially or fully covered by insurance. If you believe your situation may qualify, it’s important to consult with the clinic or hospital in advance.

Medical Abortion Pill (Up To 9 Weeks)

The Mefeego Pack currently costs around ¥100,000–¥150,000. This includes mandatory medical supervision and usually an overnight hospital stay, even though the medication is taken orally.

First-Trimester Abortions (Up To 12 Weeks)

It typically costs ¥80,000 to ¥150,000, depending on the clinic, region and whether it’s done under general or local anesthesia. Many Tokyo-area clinics charge closer to the upper end of that range.

Second-Trimester Abortions (13 to 21 Weeks 6 Days)

These are more complex procedures that often require hospitalization and multiple visits. Costs generally range from ¥200,000 to ¥400,000 or more, depending on gestational age and medical needs.

Additional Costs

Initial consultation and pregnancy confirmation tests (like ultrasound, blood work): ¥5,000–¥15,000
Follow-up appointments (usually required): ¥5,000–¥10,000
Consent form processing: If documents or notarizations are required in some instances, extra fees may be added.

Prices can vary widely between clinics, so it’s important to ask for a detailed cost breakdown during your first consultation. Some clinics accept credit card payments, while others may require cash.

The Procedure

The exact details may vary by clinic and your individual situation, but here’s a general idea of what to expect on the day of the procedure.

When you arrive for your appointment, you’ll first be taken to a private room where a nurse will check your documents—particularly the signed consent form, if required—ask a few questions about your health history and allergies, and collect payment.

First-Trimester Abortions

First-trimester abortions are typically completed in half a day. You’ll be asked to change into surgical wear and prepare to meet the doctor. Once in the procedure room, you’ll likely be placed on an IV drip, given medication to soften your cervix and may wait anywhere from 30 minutes to two hours. You’ll then receive anesthesia—either local or general, depending on the clinic and your personal circumstances. The actual procedure usually takes about 10 to 20 minutes.

After the abortion, you’ll be moved to a recovery area to rest for about 30 minutes to an hour. Some bleeding and cramping afterward is normal. Many clinics ask you to bring your own sanitary pads, so be sure to check in advance. You’ll be given medication to aid healing and prevent infection, and will typically be asked to return within a week for a follow-up appointment to ensure you’re recovering well.

You won’t be allowed to drive after the procedure. Even if you’re planning to take public transportation, it’s a good idea to ask a trusted friend or partner to come with you and help you get home safely.

Second-Trimester Abortions

Second-trimester abortions are more complex and usually require a multi-day hospital stay. The process often involves labor induction and more intensive medical management. These procedures are more expensive due to the extended stay and additional care involved.

In many cases, you’ll also be issued a fetal death certificate. You may be asked to arrange for cremation or burial of the fetus—this is often handled through a local temple or cemetery if you choose to proceed. While emotionally and logistically more difficult, the hospital will usually explain each step in advance.

Medical Abortion

If the medical abortion procedure is approved, you’ll take the first pill at the clinic and stay under observation. The following day, you’ll take the second pill, which causes the uterus to contract and expel the pregnancy. You’ll need to remain in the clinic during the process, which may take several hours, and some facilities may require an overnight stay for this option, too.

Clinics in Tokyo

The following are Tokyo-based ob-gyn clinics that offer abortion services. While all of these options have some degree of English language support, not all medical or administrative staff will speak English fluently. It’s a good idea to call ahead to confirm their language options and whether interpretation is available during appointments.

Ikenoue Obstetrics and Gynecology (Setagaya): All abortions are done by female doctors only, and an English-speaking doctor is usually available.
Toho Women’s Clinic (Kiba): English availability may vary depending on the staff (both female and male), but the medical abortion pill is available here.
Orito Ladies Clinic (Yurakucho): English support is minimal when booking, but the primary doctor (male) speaks English and French.

Interpretation

If an English-speaking ob-gyn is unavailable, you can opt for a medical translation service. Japan Health Info offers interpretation and assistance for women up to 10 weeks pregnant, including referrals to appropriate clinics.

Can You Get Financial Help For An Abortion in Japan?

In most cases, abortion in Japan is considered a private medical service, and as mentioned earlier, financial assistance is not readily available through national insurance or welfare programs. However, there are a few possible avenues to explore, depending on your circumstances and location.

Municipal-Level Support (Case-by-Case)

Some local governments and women’s health centers may offer limited financial support or refer individuals in difficult situations to organizations that can help. However, this is typically reserved for:

Survivors of domestic violence
Teenagers or minors without family support
Individuals experiencing financial hardship or housing insecurity
Cases of sexual assault or coercion

For example, the Tokyo Women’s Plaza or Counseling Center For Women may connect individuals with support services or crisis centers. Some 福祉事務所 (fukushi jimusho; “welfare offices”) or 児童相談所 (jidosoudansho; “child consultation centers”) may also offer confidential guidance for minors or vulnerable individuals.

Aftercare & Psychological Support

Although your ob-gyn will provide you with medication to ease the physical after effects, psychological support in most cases is minimal. Most women who voluntarily opt for an abortion feel relief after it is all over, but it is also normal to experience a wide range of emotions. You may find it helpful to talk about your feelings with your partner, a trusted friend or a family member.

If the psychological aftereffects are interfering with your daily life, there are several English-speaking mental health resources available in Tokyo.

TELL Japan
Tokyo Mental Health
International Mental Health Professionals Japan (IMHPJ)

Many international clinics also have psychologists on staff or can provide referrals to English-speaking therapists.

Personal Stories

Foreigners considering an abortion in Japan may take comfort from the testimonials of women who have been in the same situation. Two women who have had abortions in Japan agreed to share their experiences with Savvy Tokyo anonymously. Both women were satisfied with their quality of care and have now recovered physically and emotionally from the experience.

The first woman undertook abortion as an outpatient procedure and went home the same day.

“The procedure itself was quick. I was put under enough anesthesia not to feel pain, but I was conscious the entire time. My friend came and picked me up because I wasn’t allowed to drive afterwards. I was given three days’ worth of medicine to stop the blood flow and shrink my uterus. However, after three days, I had to return to work and wasn’t allowed to use tampons (due to the risk of infection), which meant running to the bathroom between every class to change my pad due to all the bleeding. The procedure was expensive, but very clean and professional. It made the emotional experience of having an abortion a little bit easier. I did have to see the final ultrasound and was asked, ‘Are you sure?’, but there was no shaming. Despite the circumstances, it was a relatively OK experience.”

The second woman chose to terminate her pregnancy based on the grounds of not being ready to start a family and because she was concerned that a medical condition she had could impact the health of the fetus. She undertook the procedure under general anesthesia.

“At no point during the visit to the clinic, hospital or any of my doctor’s visits was I told not to choose to terminate. The doctors and other medical professionals whom I encountered seemed very supportive and understanding. My partner also expressed to me that he was willing to go along with whatever decision I chose. The procedure was about ¥180,000 and was not covered by insurance. Financially, it is a burden, but the hospital allowed me to make installment payments. I don’t regret my decision because I am still being treated for my medical condition, and I can’t imagine what it would be like to be pregnant and have these issues.

I come from a very liberal family and my mother is a medical professional. Understanding the importance of doing what is right for your own health was how I was raised. This whole situation was actually a very big surprise for me. I never imagined I would have to make a decision of this nature. Even though I feel okay about my experience, I still feel sad about it sometimes. I try to keep in mind that I need to think of the best decision for myself at that moment. When the right time comes, I’ll be ready.”

Abortion can be a taboo topic that can bring up a lot of complex feelings. If you are going through this, remember any and all of your emotional reactions are valid, including a lack of feeling.

Dealing with an unwanted pregnancy when living in a foreign country can be a scary prospect. There are safe, legal options with language support available to you, and a lot of stories with happy endings.

This article has been updated with the latest information for 2025.

Body Positivity & Confidence in Japan

Hilary Keyes — Wed, 18 Jun 2025 23:00:00 +0000

Body positivity has come a long way in Japan, especially in terms of being more accepting of women who are larger than the average size. But that doesn’t mean outdated and hurtful attitudes have disappeared altogether. For many, the pressure to conform to a specific body type remains intense. Sometimes, it’s expressed in shockingly blunt ways.

“If you want to be worth anything in Japan, you’d better lose weight. Right now, you’re a joke and no one will take anything you do seriously. Forget getting married, too—no man wants to pay for your food bill.” (Japanese man, 27)

Being told something like that when your image of conversation in Japan is “polite and considerate” can crush your self-esteem.

Plus Size Visibility in Japan

Celebrity comedians like Naomi Watanabe, Barbie, Haruna Kondo from comedy duo Harisenbon, and the comedy group Morisanchu are all prime examples of pudgy girls being seen on TV and in mainstream media. Unfortunately, this is both good and bad.

Having a diverse range of women taking on public personas has made the issue of size and beauty more recognizable in Japanese society. On the other hand, most of these women are still often mocked in media. They’re called “fat,” “manly,” or other negative terms by other TV personalities. This is usually because they don’t fit traditional Japanese beauty standards. Naomi Watanabe has spoken out against this treatment publicly. She remains one of Japan’s leading body positivity figures for plus-size women.

The Reality For Japanese Women

Being thin or even underweight is considered more desirable by Japanese women across the nation. In fact, the Japan Association for Eating Disorders and Japan’s Health Ministry have both found that women in their 30s-50s are going to extreme measures to be as thin as pop icons in their teens and early twenties.

According to a nutritionist I spoke with, “while the life expectancy rate for women is almost 90 years old, most of those women are woefully underweight, suffering from osteoporosis and other nutritional deficiencies, and take more medication than their mothers’ generation did.” Generally speaking, anemia, calcium deficiencies and poor diets overall are making Japanese women suffer for the sake of perceived beauty.

A very quick text message to 10 Japanese female friends of mine confirmed this: if they had to choose between being two kilograms over or underweight, they all would rather be underweight. “I can put a little weight on and my clothes would still fit nicely, so being underweight would be nice.” (Yuki, 31) “Ugh, who would choose being fatter? No one.” (Miya, 29)

Self-Harming With Food

Eating disorders are rampant—according to the same nutritionist as above, there are “hundreds of thousands of women and men that are self-harming with food” and that “by the time they get help, it can be too late—the physical effects of the disease are well-documented but ignored.”

Japan is known for being one of the least obese countries in the world. 3.6% of Japanese people have a body mass index (BMI) over 30, while only 24.7% have a BMI of over 25. There is also the infamous 2008 “Metabo Law”. It was essentially a “fat tax” that was designed to counteract the growing rates of diabetes and heart conditions. Companies were forced to pay financial penalties for workers who had a waist size over 85 centimeters for men and 90 centimeters for women. These workers, in turn, are required to undergo counseling and are actively encouraged to diet and “become better citizens”.

Cultural Contradictions

This obsession with thinness and lowering obesity/lifestyle-related illnesses seems counterintuitive if you’ve ever watched Japanese TV, picked up a magazine or gotten a souvenir from a coworker. Food is promoted extensively in Japan! Rankings of the best restaurants, limited-edition sweets, food trends taking over Instagram—food, especially rich, indulgent dishes, are promoted via every medium possible on an hourly basis.

It is not uncommon for women to pay near ¥5,000 to go to a dessert buffet only to Instagram photos of the extravagant sweets but not take a single bite. Date courses are even planned around snacking and dining—the idea of food meaning fun is very pervasive in Japan. You are meant to be thin, but to be able to eat “just enough” of a given trending food item to fit in with society. “My boyfriend wanted to have yakiniku for dinner on our date, so I skipped breakfast and lunch that day because I wanted to enjoy our meal.” (Aya, 34)

How Does This Affect Foreign Women in Japan?

I’ve lived in Japan for over 10 years and am considered plus-size. My (former) Japanese doctor said I was at risk of dying from diabetes and a heart attack at any minute. According to a Canadian doctor I saw during a trip home, though, I’m perfectly average and in good health by their standards.

Being foreign in Japan means what’s considered average overseas is often seen as plus-size here. This is especially clear when going out shopping to find something like the perfect-fitting bra. That realization alone can be devastating. If you’ve ever struggled with weight or eating disorders, there are English-speaking counseling services available. TELL is one of the most well-known.

If you’ve never been confronted with this before, it can be hard to know how to react. You might feel defensive, laugh it off or take it to heart. I can’t say which reaction is right for you. What I can say is this: if you’re healthy and happy with who you are, there’s no need to change your body. You don’t have to meet Japan’s beauty standards. Dressing the way you want isn’t impossible here.

The Situation Today For All Women in Japan

There are far more clothing options in today’s Japan than the frumpy tunics and baggy body-hiding suits from 10 years ago. The arrival of international brands like H&M and Zara has helped expand fashion choices. Japanese brands like Uniqlo and GU going overseas has also brought wider size ranges to local stores. There’s even a magazine dedicated to plus-size fashion.

La Farfa debuted in 2014 and bills itself as a fashion and lifestyle magazine for “marshmallow girls”. It comes out six times a year. “We don’t promote losing weight or gaining weight,” says Editor in Chief Kon, “because there are women who look gorgeous regardless of what they weigh.” You can find La Farfa online or in bookstores. Its glossy, body-positive pages show that no matter your body shape, you can dress how you like and be beautiful.

There are still conflicting views on body size in Japan. Being a plus-size girl isn’t easy. But hopefully, in the future, both Japanese and international women in Japan will feel happier in their bodies. Plus, the focus should be on being healthy and enjoying life.

Do you think body positivity is growing in Japan? Share your thoughts in the comments below!

Onsen Etiquette: Things To Know Before Using Japan’s Hot Springs & Public Baths

Juliette Olah — Tue, 22 Apr 2025 23:00:00 +0000

In Japan, bathing is more than just a way to get clean—it’s an ancient tradition elevated to an art form. Long regarded as both a physical and spiritual experience, communal bathing has historically played a key role in bringing communities together. Today, public bathing remains a cherished part of everyday life, and understanding proper onsen etiquette is essential for anyone wanting to join in respectfully.

There are two main types of public baths in Japan, primarily distinguished by the water they use:

Sentō (Public Bath)

A sentō is a local bathhouse that uses heated tap water. Sentos used to exist in most Japanese suburbs, as many homes did not contain bathtubs. Nowadays, sentos are less common but are still popular with older generations.

Onsen (Hot Springs)

Conversely, onsens are bathhouses that use geothermal hot spring water, made possible by Japan’s widespread volcanic activity, and saturated with what are believed to be beneficial minerals. As you explore Japan, you’ll come across a variety of onsen experiences.

Day-use: These public baths are open to all and often don’t require reservations. Just pay the entrance fee (typically between ¥300 to ¥2,000) and follow standard onsen etiquette.
Ryokan or hotel-exclusive onsens: These are only available to overnight guests. Depending on the property, you’ll find large communal baths separated by gender, usually included in your stay, and reservable private baths popular for couples and families (though these may require an extra fee and advance booking). Some luxury rooms may even have private open-air tubs or indoor onsen baths within the room you stay in.
Ashiyu (foot baths): If you’re shy about naked full-body bathing, hot spring foot baths are a good place to stay. They’re usually free and found in or near hot spring towns—perfect for soaking tired feet after sightseeing.

Bathing Etiquette

While onsen and bathhouse setups vary a little, from small family-run establishments to luxurious spas of multiple baths with varying temperatures and mineral properties, the fundamental process and etiquette are generally the same. Whether you’ve visited an onsen before and been a little confused, or if you’re completely new to the practice, here’s a step-by-step to make things crystal clear. After all, it’s not fun to find yourself wandering around naked, having zero clue what to do. Trust me!

What To Bring

You don’t need much to enjoy the onsen, but a few small items can make the experience smoother and more enjoyable:

Small towel: For washing and modesty; often provided, but it’s good to bring your own.
Extra towel: This towel can be large or small to dry your body once you get out of the bathing area.
Hair ties: Essential if your hair is longer than shoulder-length.
Skincare basics: If you plan to freshen up afterward, bring your cleanser, toner or moisturizer. These are sometimes provided, but it’s best to come prepared.
Water bottle: To stay hydrated during and after your soak.
Change of clothes: Especially if you plan to head out afterward.
Plastic or waterproof bag: For carrying any damp items home.
Tattoo covers: If needed, pack bandages or patches for small tattoos.

Entering The Establishment

Once you remove your shoes at the entrance, if no one is there, store them in the shoe locker provided and move ahead barefoot. Or if guided to do so, leave them there and use the slippers provided. Most onsen are divided into male and female sections, usually marked by red (women) and blue (men) curtains. These areas are sometimes switched daily or weekly, so be extra careful when entering—your usual side may now be reserved for the opposite sex.

Yes, You Must Be Nude

Wearing a bathing suit isn’t an option—unless it’s an onsen theme park—onsen bathing is enjoyed in the nude. It may feel awkward at first, but it’s a central part of the experience. Nudity in the bath is not sexual or shameful in Japan; it reflects the country’s quiet appreciation for equality and simplicity. Once our clothes come off, we are all the same—just people enjoying a good soak. Savvy writer, Sharon Alphonso, writes more about this in her article about the lessons she learned about body positivity after visiting a Japanese hot spring.

Everyone uses onsen in Japan—from grandmas to teens, businesspeople to travelers. Chattering groups of friends and solo soakers coexist comfortably. Don’t let a little nudity keep you from experiencing something truly special.

Undress, Wash, Relax

Undress in the gendered locker area and store your valuables in the provided lockers. You’ll usually be given a small rectangular wash towel (bring your own if not). This towel is your companion—used for modesty, drying, and washing—but not for dipping in the water. Your larger bath towel stays in the locker; it’s only for drying off later.

Rinse Off First

Before reaching the bath, you’ll pass a row of shower stations. Each one has a stool, a handheld shower, a bucket and basic toiletries. Sit down and wash yourself thoroughly before entering the baths—this is a non-negotiable part of the ritual. Use the bucket to rinse and shampoo your hair if it’s long (tie it up afterward to avoid it touching the water).

Tattoos? Be Prepared

If you have tattoos, especially visible ones, be aware that some onsen still restrict entry due to lingering associations with organized crime. Cover small tattoos with waterproof bandages or skin-tone patches. For larger tattoos, look for tattoo-friendly onsen or try kashikiri buro (private baths) where the rules are more relaxed.

Inside the Bath Area

Once clean, head to the bath and enter slowly—most onsen baths are between 38–44°C. Keep your wash towel out of the water. You can place it on your head (a traditional move that helps regulate body temperature) or on the side of the tub. You may see various baths—some cloudy, green, yellow or even sparkling with minerals. Each bath is unique to its region’s water source.

Walking between baths? You can use your wash towel to provide a bit of modesty, but many just walk naturally. However, keep note that running, splashing or swimming is frowned upon. This is a place to soak and relax, it’s not a pool party. Also: keep voices low and phones out of sight. Most onsen ban photography entirely, so leave the camera behind.

A Note For Women

Unfortunately, menstruation during public bathing is a difficult challenge. It’s not impossible with prior precautions, but many people do consider entering the bath while menstruating to be unhygienic, and it’s often discouraged. If you want to know more, read our article about onsen while on your period.

Before You Leave

When you’re ready to head out, dry off lightly with your small towel so you don’t drip water into the locker room. Then, retrieve your large towel from your locker to dry off completely before getting dressed. Some onsen also provide “powder rooms” for grooming with hairdryers, moisturizers and sometimes even massage chairs—feel free to take your time here. Don’t forget to double-check you’ve grabbed everything from your locker before heading out!

Hydrate & Cool Down

Due to the heat and minerals, onsen bathing can be surprisingly dehydrating. Drink water before and after soaking, and take breaks between baths if you’re feeling light-headed. Some people bring cool tea to sip on after a session—very refreshing! Flavored milk is also a common after-onsen treat that many people like to enjoy. There will most likely be a vending machine full of sweet coffee, chocolate, strawberry and fruit-flavored milks, so why not try it if you’re interested!

Soothe Yourself With Aftercare

After a long soak, your muscles will feel like melted butter. This is the perfect time to treat yourself to a post-bath massage, brush out your hair or slip into a soft robe and relax. Japanese bath culture is as much about slowing down as it is about cleansing.

What Not to Do

Onsen culture is peaceful, respectful and quiet. Although we’ve already covered most of these above, double-check these key rules to avoid offense and looking foolish.

Don’t enter the bath without washing first: Always clean your body thoroughly at the shower station before entering any bath.
Don’t let your towel or hair touch the water: Keep your wash towel and hair out of the bath at all times.
Don’t wear a swimsuit or underwear: Full nudity is required, and clothing of any kind is not allowed in the water.
Don’t take photos or use your phone: Most baths strictly ban photography and phone use to protect privacy.
Don’t dive, splash, or swim: Stay calm and still in the water.
Don’t make loud noise or chat too energetically: Keep voices low and respect the tranquil environment.
Don’t bring food or drink into the bath: Stay hydrated outside of the bathing area only.
Don’t bathe drunk: Alcohol and hot water can be a dangerous combination! It can increase the risk of fainting or dehydration, so avoid it for your own safety.

Now that you know the onsen etiquette and what to expect, plan your bathing excursion by checking out one of Tokyo’s top five onsen-style spas or visiting a breathtaking onsen resort.

Happy bathing!