Depending on where back home is for you, managing your sexual health might have been a relatively straightforward process. In Japan, it might seem a little more daunting, but don’t worry, there are options available to keep you safe and healthy.
In general, only the male version is available. They come in different sizes so be sure to always wear the right size. You can find them at most major chains of convenience stores such as Lawson or drugstores like Drugstore Mori (look for the smiling apple). You may not be able to recognize the box, so always be sure to ask the clerk if you need help (kondomu ga arimasu ka?). If you want to be even more discrete about buying, another option is to search the Internet. There are many websites from which you can order condoms discretely and they will ship to Japan. Usually, you need a credit card or PayPal account for these sites.
Birth Control Pills
These are also easier to get a hold of in the West, but not difficult if you are aware of how it goes. It must be prescribed by a doctor, so you will need to go to the nearest women’s clinic (a hospital specifically for women). If you are nervous about being in a small town you might have better luck going to the Nakamura clinic in Kajiki (a good in-the-middle location, Dr. Yokohama speaks good English). Talk to the doctor, tell them that you want to take the birth control pill (the Pill means something different here). They will likely ask you uncomfortable seeming questions like “Are you married?” “Do you have a boyfriend?” but don’t be turned off by this. The birth control pill is still largely a new thing in Japan, and was only legalized in the late nineties. It is still uncommon for a woman to actually request it. You can be prescribed up to three months worth of pills with you at one time, after those three months you can come back and get another three months worth. They are expensive (about ¥3000 for a month’s supplies) and unfortunately there are no pill variety options, so whatever you had at home you probably won’t be getting here. The pill they provide is called “Ange 28” and is taken the same way as any birth control (same time every day for the duration of the pack).
NOTE: There are no tests and very few medical questions asked before you are prescribed the pill. As with any medicine there can be certain health risks involved. The information booklet and health warnings that come with the Ange 28 are all in Japanese so it is advisable (if you or your partner cannot read Japanese and you don’t have someone you trust to translate for you) to know the risks involved with taking the birth control pill, and your personal and family medical history. There are many reliable medical websites that describe the side effects, major and minor, associated with birth control and it is important to be aware of these effects before starting any medication.
Other forms of protection (such as IUDs, female condoms, etc.) are woefully unavailable in Kagoshima. You can try and ask, it never hurts to try, but overall they are simply not available. There are clinics available in the Tokyo area but be warned before hopping onto a plane that doctors tend to avoid donning out IUD’s if the woman has not “finished her family” and it is possible that you will have problems, so always make an appointment where the intentions are clear.
The morning after pill is easily available from many women’s clinics in Kagoshima. (Disclaimer: very small towns may not have this available, but the next medium-sized town over should, and it’s worth the drive or train in!) The Morning After Pill, Plan B, etc, is simply known as The Pill in Japan. If you have a doctor who has become very used to foreigners, they might actually think you mean birth control, but explain your situation and they will know what to do. As with the morning after pill in your home country, taking the pill within 24 hours following the event is most effective, but up to 72 hours afterwards has been known to work (the effectiveness is decreased by 30% each day, so it is best to take a day of nenkyuu if you have to and head to the clinic! You might want that nenkyuu/byoukyuu too as most women can become pretty sick for the day to follow as the Pill does its job).
NOTE: Women’s clinics can keep some strange hours. It is best to familiarize yourself with the schedule for just such emergencies (a click with your smartphone camera at their schedule board outside and you have a handy reference). If the women’s clinic in your town is closed, head to the next one. There are usually several in the area.
Viagra is available in Japan as prescribed by a doctor. You will have to give a urine sample, and if there are no serious conditions detected you can have it right away.
STIs and HIV
It is a good idea to get tested regularly. Once you find a doctor whom you are comfortable with, you can ask them about getting tested. They might be able to administer the one you need.
Free and anonymous HIV and STI testing is available in Kagoshima City at the Kagoshima Chūō Health Centre close to the Korimoto Tram Station (Kamoike 2-25-1-11, 099-258-2321). Testing is available on Tuesdays at 13:30-15:00 and every second Thursday at 17:30-19:00. HIV, Hepatitis B and C, and chlamydia tests are free. You will need to pay a small fee for syphilis and gonorrhea testing (the gonorrhea test is not available on Thursdays). Just say “Kensa ni kimashita” (“I came to be tested.”) when you reach the reception desk. You will be given a number, directed to fill out a Japanese form (copy of English translation), and asked to wait outside room. When your number is called, a staff person will privately confirm which test(s) you’d like performed and answer any questions you might have about HIV and STIs (in Japanese). Next, you’ll be directed to another window where you’ll slide your form through the window and wait to be called. After they draw your blood, it will be about 20-30 minutes until you have your HIV results. You’ll have to call about a week later for the results of the other tests.
You can also use this website to find other clinics in Kagoshima.
If You Might Be Pregnant
First, don’t panic. If you are late/have pregnancy symptoms, you should take a test. Remember, a test taken too early can show a false negative result when you are actually pregnant. Make sure that you are taking the test no earlier than ten days (two weeks is best, however) after ovulation (so that means if you have a regular cycle the first day of your missed period), or after the suspect date of intercourse.
A reliable test can be purchased at most pharmacies or kusuri, or drugstore. Drugstore Mori is another good bet; it is a common chain, and if you live in the inaka and fear recognition from the people around you, all large towns and cities in general will have a Drugstore Mori so you should be able to get to one via train or car relatively easy.
In Drugstore Mori, strangely, the tests are located in the nylon and panty hose row. There are several types of tests, but a reliable one seems to be the DoTest. It is the Japanese version of the Clear Blue test in America and Canada. The boxes are empty, just take the size you want (pack of one, or double packs just in case!) up to the counter. The double pack will set you back about ¥1000.
The DoTest has two windows. In the second window a vertical line will appear. When it is clear it means that the test is complete. In the first window will be the result: one horizontal line (-) means not pregnant. A “plus” sign (+) means you’re pregnant. If you are still not convinced either way or you think that the results are unclear (foggy, never really brightened, or dull) take another test in a few days. If the result is positive on the stick it is time to head to a women’s clinic (see list of clinics in Hospitals and Clinics section) and get a blood test. This will give you a definitive answer (pee tests can show positive results and still be wrong.
What To Do Now That You Know
If your pregnancy was anticipated, desired and/or planned, then congratulations, you’re having a baby! If this is unexpected, not planned, and you’re experiencing a sense of dread then, again, don’t panic; you have options, and a support network.
The first thing will be to take care of yourself. If you need a day off to digest this take a day of byoukyuu or nenkyuu; think about your options. The Prefectural Advisors are here and trained to help whenever you need to review your options or just talk.
Ask your gynecologist for information on birthing classes in your area/ if there are any programs sponsored by, held by, or that the clinic is aware of that you can become a member of. Find some books on the subject. (The classic What to Expect When You’re Expecting can be ordered off of amazon.co.jp and arrive at your door/local Lawson’s in days.) Research what costs are covered by your medical insurance and what will need to be paid out of your pocket if you wish to deliver in Japan. If you wish to return to your home country for the delivery you must discuss these details with your BOE and supervisor. The details may change from placement to placement.
If you decide that you/you and your partner are not ready for pregnancy and motherhood/parenthood, be aware that in Japan abortions are an available option. Your gynecologist at your women’s clinic can help you set up an appointment at an abortion clinic. If you are considering abortion as your option, know that the Japanese do not have the same stigma attached to the operation as in the West; it is considered a “necessary sadness” and if you feel that terminating the pregnancy is what you must do, it shouldn’t be an issue to find a doctor to perform the operation. That said, however, it is an expensive operation. Abortion costs vary from ¥80,000 to ¥100,000. Also, for a woman to undergo an abortion she must have the consent of the father. This can seemingly run afoul should you not know who the father is. However, the hospitals won’t run paternity tests. It seems that you can bring in any replacement male friend and have him claim to be the father in the event that they ask for the father to be present/sign the form to say that he is aware of your decision.
Regardless of whether you are the father or mother, an unplanned pregnancy can be a very stressful situation and the decision on whether not to have the child is not an easy one to make. Do not hesitate to discuss your feelings on the matter, whatever they may be, with someone you trust. The PAs are an extremely helpful resource. Should require additional professional counseling, the PAs have resources they can refer you to.
Laura Keating, Kajiki Town ALT, 2009 – 2011
Perry Pollard, Tarumizu City ALT, 2008 – 2013