10 yrs on, Japan has yet to fully embrace 'the pill'

Sat, Sep 12, 2009

The Yomiuri Shimbun/Asia News Network

September marks the 10th anniversary of the start of birth control pill sales in Japan. How wide has their use become?

The birth control pill provides the body with a supplement of a small amount of female hormones, which are usually secreted from the ovaries, to prevent ovulation.

Formerly, there were drugs to control female hormones to treat conditions such as menorrhalgia, but due to their strong side effects such as nausea, a pill containing the minimum amount necessary of female hormones was developed specifically for birth control purposes.

Birth control pills have been widely used in Europe and the United States since the 1970s as a sure contraception method with a 99.7 percent success rate, compared with 98 percent for condoms.

But it took nine years for Japan to approve the birth control pill, and the start of domestic sales were delayed until 1999. The number of users increased more than threefold from about 200,000 in 2001 to about 660,000 in 2009. But the ratio of users to the total population of women aged 16-49 still stands at 3 percent, far less than France's 44 percent, Britain's 26 percent and the United States' 18 percent.

When Prof. Yuji Taketani of Tokyo University's Department of Obstetrics and Gynecology conducted a survey in which he asked women who had answered they "don't want to use [birth control pills]" or "won't use [them] under the current circumstances" to cite reasons for saying so, more than half of the respondents, or the largest portion, said they "are concerned about side effects."

The most worrisome side effect is thrombosis--the formation of a blood clot inside a blood vessel that obstructs the flow of blood through the circulatory system to cause stroke and heart attack. According to research conducted in the United States and Europe, thrombosis occurs in about 15 to 25 people in 100,000, higher than the rate of about five people per 100,000 when the pill is not used.

Nevertheless, the incidence of thrombosis is lower than about the 60 per 100,000 rate recorded during ordinary pregnancy. Kunio Kitamura, director of the Clinic of Japan Family Planning Association in Tokyo's Shinjuku Ward, said: "Compared with Europe and the United States, Japan has fewer incidence of thrombosis, estimated at two to six people per 100,000 who've used the pill in the past decade."

The birth control pill is used by healthy women for long periods, so its safety is, needless to say, extremely important. In foreign countries, the pill's merits are generally stressed over concern about side effects. If vague concern about side effects serves to hamper the prevalence of birth control pills, it is necessary to provide correct information.

Discussing why it took nine years for the pill's approval in Japan, some people pointed out there was concern that the incidence of sexually transmitted diseases such as HIV infection would rise as a result of an increase in sexual intercourse without the use of condoms.

In reality, the number of women who became infected with HIV as well as those cases that developed into AIDS has leveled off over the past decade. The heterosexual infection rate accounted for 20 to 30 percent of total HIV and AIDS cases.

"It can't necessarily be said that lifting the ban on the use of pills led to expanding the number of AIDS patients," Kitamura said.

The birth control pill is also useful to ease the pain from menstrual cramps and endometriosis. Of Japanese women who use the pill, only about 30 percent do for contraception purposes, according to a survey.

The contraceptive pill is an effective method not only to prevent pregnancy but also to help women maintain health. Providing correct information and bolstering education programs are needed to promote the prevalence of the pills.

THE YOMIURI SHIMBUN / ASIA NEWS NETWORK

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