Chronic conditions and women's health
Women's health
For period concerns, the pill and menopause
with a medical interpreter
24 hours a day, 365 days a year
OK to consult together
payment information
About
About Women's health
We cover a wide range of women's health concerns, including period problems, the low-dose pill, emergency contraception and menopause symptoms. You can discuss sensitive matters with us comfortably in Japanese.
Why it happens
A woman's body is affected by cyclical changes in female hormones such as estrogen and progesterone. Period pain involves substances that make the uterus contract (prostaglandins), and premenstrual problems (PMS) are thought to be physical and emotional reactions to hormone changes. During menopause, declining ovarian function greatly changes hormone balance, which can cause a variety of symptoms such as hot flashes, sweating and mood swings. Stress, changes in environment and sudden weight gain or loss can also affect the menstrual cycle.
What's happening in the body
Periods are regulated by hormones exchanged between the brain and the ovaries. Signals from the brain make the ovaries work, the hormones they release thicken the lining of the uterus, and if pregnancy doesn't occur, the lining is shed as a period. This process is known to be affected by severe stress, sudden weight changes, disrupted sleep and changes in environment. That is why the lifestyle changes of an overseas posting can affect your cycle. However, irregular cycles and abnormal bleeding can also have causes other than hormones, such as conditions of the uterus or ovaries, or thyroid function. In hot, humid conditions, moisture also builds up in the vulval area, and an upset in the balance of normal bacteria can cause itching or changes in discharge. Care depends on the cause, so we assess it after hearing how things have developed.
Main symptoms
- Period pain (bad enough to need painkillers or to keep you in bed)
- Irregular cycles or missed periods
- Heavy periods or large, liver-like clots
- Irritability, low mood, swelling or breast tenderness before periods
- Bleeding between periods
- Hot flushes and sweating
- Mood swings or trouble falling asleep (may occur during menopause)
- Changes in vaginal discharge or vulval itching
When you can wait and see
What you can do yourself
- Keep your lower abdomen and lower back warm, and wear loose clothing
- Record your cycle, symptoms and how heavy the bleeding is (an app can help)
- Eat iron-rich food (especially if your periods are heavy)
- Moderate exercise and enough sleep
- Avoid too much caffeine and alcohol
Please consult us
If any of the following apply
- Period pain or irregular periods are troubling you
- You want to start or continue the pill
- You're concerned about menopause symptoms
Seek care right away
If any of the following apply
- Sudden severe lower abdominal pain (strong pain on one side, with cold sweats)
- Heavy vaginal bleeding that won't stop, with lightheadedness or unsteadiness
- Severe stomach pain or bleeding when you could be pregnant
- High fever with lower abdominal pain (possible pelvic infection)
- Calf pain or swelling, or sudden shortness of breath or chest pain while taking the pill (possible blood clot)
Don't wait for a Cotovia consultation; call the emergency number in your country.
See the emergency guide for each countryIf you're not sure, ask us on LINE
Differential
Telling it apart from similar conditions
Symptoms that look the same may need different care depending on the cause. Use this as a guide to find what's closest to your situation.
Irregular periods due to a change in environment
Coincides with a posting or move, then gradually returns to normal
We monitor it while you settle into a regular routine
Dysmenorrhea (painful periods)
Period pain bad enough to interfere with daily life
Don't put up with it; please consult us. There are options
Bleeding between periods
Bleeding between periods
The cause needs to be assessed. Please consult us early
Vaginal or vulval problems
Itching, or changes in the amount, consistency or smell of discharge
Care depends on the cause. Please don't use over-the-counter medication on your own
Pregnancy
A late period, nausea and tender breasts
Be sure to tell us if you could be pregnant
Menopause-related symptoms
Hot flashes, sweating, mood swings and changes in your cycle
We consider care based on how severe the symptoms are
* This is not a complete list. If you're not sure, please consult us.
When it might be something else
Course
Typical course
This is the general course. Actual progress varies from person to person.
- Arrival to a few months
Your cycle may become irregular with the change in environment
Keeping basic records helps when you consult us
- 3–6 months
It usually settles as you get used to the environment
If it's still irregular after this point, please consult us
- If symptoms continue
We also consider causes other than hormones
An assessment with tests is recommended
- Regular checkups
A yearly check is recommended even without symptoms
You can get them while living abroad
Local Insight
For people living in Southeast Asia
The climate, healthcare and access to medication differ from Japan. Here are points specific to this region.
How to obtain the low-dose pill and emergency contraception, and the prescription requirements, vary greatly by country: in some you can buy them at a pharmacy, while others require a doctor's prescription. Availability may also be limited for religious or cultural reasons, so checking in advance is recommended.
Cervical and breast cancer screening systems differ from Japan's, and usually you won't be offered screening unless you apply yourself. Many people go several years without screening while living abroad.
Many people find it hard to discuss sensitive matters in the local language. Starting with a consultation in Japanese and being referred to a gynecologist as needed can help.
In hot, humid conditions, moisture builds up easily in the intimate area, which can make vulval itching and changes in discharge from yeast infections (Candida) more likely. Wearing breathable clothes and not staying in a wet swimsuit for long can help.
Care
What Cotovia can do
- A careful consultation in which we listen to you
- Prescribing the low-dose pill and hormone medications (prescribing is at the doctor's discretion)
- Referral to in-person care if tests or a specialist examination are needed
Tests you may have
Not knowing what will happen can make people hesitate to seek care, so here's what actually takes place.
Medical history
Understanding your periods and how symptoms have developed
Blood test
Assessing hormones, thyroid function and anemia
Ultrasound
Checking the uterus and ovaries
Cervical test
Regular checks
Treatment options
Lifestyle adjustments
Addresses factors that affect your cycle, such as sleep, weight and stress
If a change in environment is behind it, we start here
Hormone treatment
Regulates your cycle or eases symptoms
We explain who it suits and what to watch out for before deciding. Prescribing is at the doctor's discretion
Pain relief
Eases period pain
You don't have to keep putting up with it. We can also advise you on how to use pain relief
Referral to specialist services
Surgery, pregnancy and childbirth
We refer you to a partner facility and arrange for an interpreter to accompany you
* Tests, procedures and prescriptions are decided by the doctor after a consultation. Services may vary by country and location.
Preparation
Before your visit
When seeing a doctor abroad, simply organizing what you need to say makes a big difference.
What to bring
- Passport or residence card
- Insurance card and your insurer's contact details
- Your medication record and the medication you take
- Results of any checkups in Japan
- Any records of your periods
What to tell us
- The first day of your last period and your usual cycle
- When changes started and what they are
- Whether you could be pregnant, and any past pregnancies or births
- Medications you're taking (including hormones)
- When you had checkups in Japan and the results
Self Care
What you can do yourself
Along with seeing a doctor, here are things to keep in mind in daily life.
Prevention
- Get regular gynecological checkups (such as cervical cancer screening)
- Ask a doctor about the HPV vaccine
- Keep a record of your periods so you notice changes early
- Avoid sudden weight gain or loss, and keep a regular routine
How to Consult
How to be seen
Choose from 3 ways to be seen, depending on your symptoms and schedule. If you're not sure, we'll guide you on LINE.
Online consultations
See a doctor by video call from home or the office. Medication delivered or from a pharmacy.
Available for this symptom
In-person care
In-person consultations at our clinics and partner hospitals, including tests and procedures.
Available for this symptom
Cotovia Counter
Support with an interpreter for visits to general hospitals.
Available for this symptom
If an online consultation finds that tests or procedures are needed, we'll guide you to in-person care or Cotovia Counter.
From consultation to receiving medication
Add us on LINE and consult
Tell us your symptoms, and we'll recommend the right way to be seen.
Book and be seen
See a doctor online or at the nearest location, with an interpreter present.
Receive your medication
Have it delivered or pick it up at a pharmacy or the clinic (varies by country).
Follow-up
You can also consult us on LINE about how you're doing afterward.
Special Care
People who need extra care
People planning a pregnancy
There are things to check in advance, such as which medications can be used. Please consult us early
Pregnant women
You can also ask us about the local healthcare system and when to return to Japan
Women who were taking the pill or similar medication in Japan
The same medication may not be available locally. Please consult us before you run out
Women who haven't had a checkup for a while
The longer you live abroad, the longer the gaps tend to be. We'll tell you how to get a checkup locally
FAQ
FAQ
Common questions before a visit, and common assumptions that lead people to judge for themselves.
QCan I get advice on emergency contraception?
Yes. Timing matters, so please consult us as soon as possible. The methods available may vary by country.
QCan I continue the pill I was taking in Japan?
If you show us information about the medication you're taking, we can discuss continuing an equivalent medication. Availability may vary by country.
QCan I get a gynecological checkup locally?
This varies by country and location. We can advise you on facilities where you can be seen, and on getting a checkup during a trip home to Japan.
QI'm not sure whether it's menopause.
It can sometimes be inferred from your age and how symptoms have developed, but there may be another cause. Please start by telling us how your symptoms have developed.
Common misconceptions
Myth Irregular periods are just due to the environment, so you can ignore them
Fact The environment can play a part, but there may be a cause it doesn't explain
Myth Period pain is something you just have to put up with
Fact Pain that interferes with daily life is worth getting advice on
Myth Checkups can wait until you go back to Japan
Fact The longer the gap, the later you notice changes. Checkups are available abroad too
Myth Changes in discharge can be treated with over-the-counter medication
Fact What's needed depends on the cause. Using medication on your own can make the condition harder to assess
Myth Gynecologists are only for pregnant women
Fact You can consult us about a wide range of things, including period problems, checkups and menopause
Feel free to ask us on LINE first
It's fine to contact us even if you're not sure you need to see a doctor. We're available in Japanese 24 hours a day, 365 days a year.
- Symptoms
- When it started
- Your country of residence
- How you'd like to be seen
Sending these 4 things helps us respond faster. It's fine if you don't have them all.
Ask us on LINE