Doctors Rant on the Internet, “You’ve Been Nakadashi’d”… Doctors, Pharmacists Angered at Lack of Understanding of “Emergency Contraceptive Pills”.

No understanding of cases of lack of consent for contraception

It’s not easy to take it while people look at you and say, “You must have ejaculated inside you.

I feel like I’ll be treated like an idiot if I come here too often, so why don’t I just go to a different store, you know, take care of myself.

The expressions seem to condemn self-responsibility and thoughtlessness, without taking into consideration the circumstances and background of the women. This post about a woman seeking emergency contraceptives caused quite a stir on the Internet (the post has since been deleted). The fact that the sender was a physician has caused anger and disappointment in the field.

On February 2, 2026, pharmacies began selling the emergency contraceptive Norlevo. What is the real meaning of the system? We interviewed Dr. Kenichiro Sakaguchi, President of Sangenjaya Art Clinic, and a female pharmacist working at a dispensing pharmacy in Tokyo.

Q: The opening statement was spread on social networking sites. As a medical practitioner in the field, how do you perceive it?

Dr. Sakaguchi : “I don’t think that doctors in the field would think so. Patients who need emergency contraceptives are not only suffering from contraceptive failure, but also from cases in which they did not consent to contraception, sexual harm, and other circumstances that cannot be managed by the patient’s will alone.However, unless the patient talks to us, we cannot find out more about them. During the consultation, we consider ‘what is the safest thing to do physically and psychologically right now?

Pharmacist : “It is the same in the pharmacy. Many patients come to the pharmacy in a state of anxiety, impatience, and confusion,

Is the drug safe for them to take?
Can they use the drug without misunderstanding?
Can we connect them to the next necessary medical treatment?

That’s all we think about.

Q: Once again, how do you view the introduction of OTC (over-the-counter) emergency contraceptive pills?

Dr. Sakaguchi : “The purpose of the system is very simple: to deliver time-sensitive medicines to those who need them in time. Emergency contraceptive pills have a clear limit of 72 hours after intercourse.The reality is that some people lose the option because the hospital was closed, they could not afford to see a doctor, or it was psychologically difficult for them to see a doctor. Now that they can buy it at the pharmacy, they appreciate having more options.”

Q. What is the actual process for purchasing at pharmacies?

Pharmacist : “It can be purchased at drugstores as long as there is a pharmacist who has completed the training.
You do not need a prescription, but we will check the timing of sexual intercourse and your physical condition during a pre-dose check. If it is determined that the drug is safe to take, it is taken in front of the pharmacist. There are no age restrictions, and even minors can purchase and take the drug at their own will. However, consideration is required to connect the patient to a medical institution or consultation service if necessary.

Q: The introduction of OTC drugs also brings up the issue of privacy.

Pharmacist: “An unspecified number of people come in and out of pharmacies. In order to discuss emergency contraceptive pills in this environment, it is necessary to be considerate of voices, stares, waiting time, and everything else. Even if there is a private room, during busy times, some people may give up on the consultation while waiting for the room to become available. Consideration must be given to time, space, and flow lines. I think this point will be handled differently in different pharmacies.”

I can’t ask what’s going on.

ーーWhat is the difference from “abortion pills” such as mefigopak?

Dr. Sakaguchi : “Emergency contraceptives are not drugs that interrupt pregnancy. They delay ovulation and create an environment that makes it difficult for fertilization and implantation to occur, but they do not terminate an already established pregnancy.

Pharmacist : “Some people may misunderstand that they are abortion pills, so we think we need to be very clear about this point. In our training, we always learn the difference between emergency contraceptives and abortion pills.Emergency contraceptivesare drugs that prevent pregnancy and are ineffectiveif the woman is already pregnant.

On the other hand, Abortion pills are used after a pregnancy has formed, They have completely different purposes and actions. If these two are confused, it will lead to the misunderstanding that this is a system that treats life lightly. I think it is an important role of pharmacists to prevent this misunderstanding.

There are cases where sexual harm is suspected in the background of a request for emergency contraceptives. What is your response in such cases?

Dr. Sakaguchi : “It is a very sensitive issue. Even a doctor cannot determine whether or not a person has been sexually harmed unless he or she tells us. Forcing the person to talk about it may drive him or her into a corner. That is why it is important to create a respectful environment, whether the person speaks or not.

Pharmacist : “We can connect you to medical institutions and support services, but we will not ask you what is going on.Some people who areconsidering purchasing emergency contraceptivesmay worry that they will be asked a lot of questions at the pharmacy. We pharmacists only check what we need to know to determine if you are physically able to take it.”

-I was surprised that the doctor posted, “If I come here too often, I’m going to be treated like an idiot. How do you think the field will take it if someone comes in repeatedly needing emergency contraceptive pills?

Dr. Sakaguchi : “If someone is using it frequently, it is not something to blame, but a sign to connect them to the next medical care. Emergency contraceptives are an emergency option. If it is needed repeatedly, we should consider more stable contraceptive methods together, such as low-dose pills. In that regard, I think we should have discussed selling emergency contraceptives in pharmacies at the same time that they became OTC.”

Q: If a pregnancy occurs after taking the pills, will there be any effect on the fetus?

Dr. Sakaguchi : “There is no adverse effect on the development of the fetus. Even if you take emergency contraceptive pills, if a pregnancy is established, it will continue to proceed as is. Therefore, it is important to check for pregnancy approximately three weeks after taking the pills.

–What happens if a woman decides not to give birth even if a pregnancy has been established?

Dr. Sakaguchi: “If you do not wish to give birth, you will need to have an abortion.

Q: Some people are concerned about the abortion procedure itself.

Dr. Sakaguchi : “Currently, the equipment and methods have been improved, and safety has greatly improved. The risk of affecting future pregnancies is extremely low.

Q: If a pregnancy has already been established, I would like you to consult not only with the woman herself but also with those around her and think about it thoroughly.

Dr. Sakaguchi : “According to the Maternal Protection Law, abortion surgery is possible up to 21 weeks and 6 days (less than 22 weeks) of pregnancy. Considering the growth of the fetus and the burden on the mother, the safest time for an abortion is between 6 and 9 weeks of pregnancy.

The earlier you think “I’ll think about it a little more,” the more the weeks progress and your options narrow, so you need to consult with a doctor at an early stage. With the introduction of OTC emergency contraceptives, pharmacies are likely to become the first point of contact for consultation in more cases.

Pharmacist : “I think so. Pharmacies are places where the psychological hurdle is lower than at medical institutions. That’s why we are conscious of not ‘ending it here.

. the possibility of pregnancy.
The need for confirmation
The need to connect to a medical facility.

We calmly tell them these things and connect them to a doctor if necessary. We do not want to be a place where we just give you the pills and that’s it; we want to be a place where we can think about the next step together.

The background behind the need for emergency contraceptives is completely different from person to person. That is why we must not allow some prejudice or careless words to limit women’s choices and health. We will need to share this with society.