Protect the Sexual Health of Women Beyond Making Morning-after Pills Available

Women can now go to pharmacies and drugstores throughout Japan to purchase an emergency contraception drug without a doctor's prescription. This is intended as an option for women, after sexual intercourse, to prevent an unwanted pregnancy. 

Norlevo, which contains the progestin hormone levonorgestrel, should be taken within 72 hours after unprotected sexual intercourse. Dubbed the "morning-after pill," Norlevo has been available over the counter in many countries. But until now, it required a prescription in Japan.

Nevertheless, there are cases where conventional birth control does not work, or when men will not cooperate in ensuring contraception. In other cases, women are victims of sexual violence. Given the urgent nature of such situations, patients have strongly demanded a contraception that is accessible on weekends and at night when doctor consultations are not readily available.

The good news is that an oral contraceptive will now be easier to obtain in an emergency. However, it is important to remember that this is not a conventional method of contraception. Furthermore, it is not something to be purchased repeatedly.

Preventing Abuse

The Ministry of Health, Labor and Welfare (MHLW) is urged to publicize the background of the sale of this emergency over-the-counter birth control drug. At the same time, it must take all possible measures to prevent the spread of its casual use. 

Only the woman who will actually be taking the drug will be allowed to purchase it, according to MHLW rules. Males or proxies are prohibited from doing so. Tablets must also be sold individually and directly by an accredited pharmacist. Moreover, the pharmacist must confirm that the woman ingests the medicine on the spot.

Pharmacies and pharmacists play a key role in ensuring that Norlevo's use is not abused. They must advise women who repeatedly attempt to purchase emergency contraception to visit an obstetrics and gynecology clinic instead of using emergency contraception. 

Supporting the Victims

It is important to note that emergency contraception is only effective 80%-90% of the time, even when taken within 72 hours of sexual intercourse. Women are advised to consult with a doctor and use more reliable and safer contraceptives and oral medications whenever possible.

Victims of sexual violence and abuse are of particular concern. Some women may want to conceal their need to prevent the information from becoming public. Pharmacists and doctors need to give careful attention to the feelings of such women and help them obtain pertinent advice. 

Above all, victims of sex crimes need to receive in-depth support. That includes connecting them to appropriate support centers for victims of sexual crimes or child consultation centers. It may also mean encouraging these victims to consult with the police.

Training the Pharmacists

Pharmacists authorized to sell Norlevo must undergo special training. They also need to establish a system for cooperation with nearby obstetricians and gynecologists. Similarly, it is also important to keep track of potential patient support centers and other such facilities. 

The MHLW has published a list of approximately 7,000 pharmacies and drugstores authorized to sell the morning-after pill. However, their uneven geographical distribution presents a problem. Even pharmacies that do not stock the drug should share information. That way, they can introduce women who want to purchase Norlevo to another pharmacy where they can buy it.

Of course, privacy is also a key consideration. Hopefully, pharmacies will do their best to become the first place in the community that women look to for advice on how to protect their sexual health. 

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Author: Editorial Board, The Sankei Shimbun