Menopause in Japan is 更年期 (kounenki). It is the word on the clinic sign, in the leaflet and on the side of the box, and almost nothing written about it here is in English.
Below you'll find the treatments the medical society sets out and what national health insurance covers, which screening your city offers and at what age, and the medicines you can buy off the shelf, with their ingredients, dosage and warnings taken from the Japanese leaflets.
July 26, 2026
第1類, 第2類 or 第3類 decides who can sell it to you and whether anyone has to explain it. What that means at the till.
July 27, 2026
Which clinic to go to, the three treatments the medical society sets out, what insurance covers, and what is left if HRT is not for you.
July 27, 2026
Who is on the list at which age, what is actually done on the day, and who decides what you pay.
These are sold at drugstores without a prescription. Tap a product for its full ingredients, dosage and warnings, all taken from the manufacturer's own Japanese package insert.
For hot flushes, stiff shoulders, dizziness and palpitations in menopause · Herbal, not a hormone · 420 tablets
For swelling, period pain, cold legs and menopausal disorder · Suited to people who are sensitive to cold and tire easily · A kampo formulation · 120 tablets
For menopausal disorder, difficult or irregular periods, insomnia and sensitivity to cold · Suited to people who tire easily and feel unease or irritability · Granules, 20 sachets
For irregular or painful periods, menopausal disorder, stiff shoulders and dizziness · Suited to people of comparatively good physical strength · 90 tablets
Product features
Made by Kobayashi Pharmaceutical (小林製薬). The insert lists four features:
女性保健薬 (josei hokenyaku) is defined in the insert as a medicine for the purpose of relieving symptoms particular to women and promoting health. The insert also states that it is not a hormone preparation.
The box is marked 第2類医薬品, and the product is sold under the name 女性保健薬 命の母A. Beside that it carries 和漢生薬 ＋ ビタミン類の複合薬, describing it as a combined medicine of Japanese and Chinese crude drugs together with vitamins. Rubina Meguri (ルビーナめぐり) and Tsumura Kamishoyosan (ツムラ漢方加味逍遙散エキス顆粒) are marked 漢方製剤, kampo preparations, which is a different thing.
Four sizes are sold: 84 tablets in a resealable pouch, and bottles of 252, 420 and 840. The Amazon link below is the 420-tablet bottle.
Note: The sizes are not in the insert. They come from the official product page.
What the class on the box means
The box is marked 第2類医薬品, Class 2. You can take it off the shelf yourself, a registered seller can sell it to you without a pharmacist on duty, and nobody has to explain it unless you ask.
Note: What the other classes mean, and where the rule comes from, is in The Class Number on Japanese Medicine Boxes.
Indications
The insert lists twenty-three. Sorted so you can find your own symptom, they are:
Note: 血の道症 (chinomichi-shou) is defined by Kobayashi as the psychological and neurological symptoms, such as mental unease and irritability, together with the physical symptoms, that appear along with fluctuation in a woman's hormones at times such as menstruation, pregnancy, childbirth, after childbirth and menopause. ヒステリー is an older term still printed on Japanese medicine boxes. The insert prints all twenty-three as one continuous list; the grouping here is ours.
Dosage
Four tablets at a time, three times a day after each meal, with water or hot water. The insert adds:
Ingredients and amounts
Per daily dose (12 tablets):
Also per daily dose: thiamine chloride hydrochloride (vitamin B1) 5mg, riboflavin (vitamin B2) 1mg, pyridoxine hydrochloride (vitamin B6) 0.5mg, cyanocobalamin (vitamin B12) 1µg, calcium pantothenate 5mg, folic acid 0.5mg, taurine 90mg, dl-α-tocopherol succinate (vitamin E) 5mg, calcium hydrogen phosphate hydrate 10mg, biotin 1µg, purified soybean lecithin 10mg
Added ingredients
Contains aluminium silicate, magnesium stearate, shellac, talc, calcium carbonate, titanium oxide, potato starch, gelatin, refined sugar, erythrosine, new coccine, sunset yellow FCF, beeswax and carnauba wax
What the insert says about menopause itself
Printed at the foot of the leaflet: as a woman's hormones fluctuate, symptoms may appear such as hot flushes, feeling flushed, irritability, drowsiness, fatigue and lethargy, dizziness, headache, insomnia, palpitations, stiff shoulders, lower back pain, breast tenderness, sensitivity to cold, swelling and constipation. Symptoms change from day to day. It closes by suggesting you make a point of resting and take things at an easy pace.
Note: Some of these are not in the approved list of indications above: irritability, insomnia, fatigue, breast tenderness and swelling. They appear here as part of the leaflet's description of menopause, not as claims for what the medicine treats.
What you must not do
Anyone who is breastfeeding should either not take this medicine, or avoid breastfeeding while taking it. The insert notes that not following this may worsen your current symptoms or make side effects more likely.
Consult before taking it
The insert says the following people should consult a doctor, pharmacist or registered seller before taking it:
Stop and consult
If any of the following appear after taking it, they may be side effects. Stop taking it immediately and consult a doctor, pharmacist or registered seller, taking the leaflet with you:
Constipation and diarrhoea may also appear. If either persists or worsens, stop taking it and consult a doctor, pharmacist or registered seller with the leaflet.
If your symptoms do not improve after taking it for a while, stop taking it and consult a doctor, pharmacist or registered seller with the leaflet.
After taking it, your period may come earlier than scheduled, or the volume of menstrual blood may be somewhat greater. If bleeding continues for a long time, consult a doctor, pharmacist or registered seller with the leaflet.
Storage and handling
Throwing the packaging away
Kobayashi sorts the packaging for you, which is useful given how strict Japanese rubbish separation is. Follow your own municipality's categories, and ask them if you are unsure.
Pouch (84 tablets):
Bottle (252, 420 and 840 tablets):
Any tablets left in the bottle go out with general rubbish.
Printed on the front of the leaflet
Others in the same range
Kobayashi sells several products under the 命の母 name, and they sit next to each other on the shelf. If you are reaching for this one, check the box you have picked up is 命の母A and not one of these:
Note: These are separate products with their own approved uses. We have not been through their leaflets yet, so they are listed here only so you can tell them apart on the shelf.
Product features
Made by Alinamin Pharmaceutical (アリナミン製薬). The insert lists these features:
The box is marked 第2類医薬品, and the product is sold as 漢方製剤〈当帰芍薬散加人参〉.
Note: The flow of blood and the flow of water are the insert's own words, めぐり. They are how kampo describes what a formulation is doing, and they are left as written rather than turned into other terms here.
Note: The Amazon link below is the 120-tablet bottle. The number of tablets is not in the insert or on the official product page; it comes from the retail listing.
What the class on the box means
The box is marked 第2類医薬品, Class 2. You can take it off the shelf yourself, a registered seller can sell it to you without a pharmacist on duty, and nobody has to explain it unless you ask.
Note: What the other classes mean, and where the rule comes from, is in The Class Number on Japanese Medicine Boxes.
Indications
This indication opens by describing the person rather than the complaint, and that description is part of the approved use. The insert reads: for those of weak constitution with a weak stomach, who are sensitive to cold and tend towards anaemia, who tire easily, and who at times complain of lower abdominal pain, a heavy head, dizziness, stiff shoulders, ringing in the ears or palpitations, the following complaints:
Periods and childbirth
Cold and swelling
Head, ears and aches
Skin
Note: The insert prints all fourteen as one continuous list; the grouping here is ours. Its own order runs: swelling, period pain, a heavy head, cold legs and lower back, irregular periods, abnormal periods, trouble before or after childbirth or from miscarriage, menopausal disorder, dizziness and light-headedness on standing, stiff shoulders, lower back pain, patches of darker skin, ringing in the ears, chilblains.
Dosage
Take the amount below three times a day, before a meal or between meals, with water or hot water, swallowed without chewing.
The insert adds two notes on the dosage: a child taking it should do so under the guidance and supervision of a guardian, and the dosage is to be kept to strictly.
Note: 食間 does not mean during a meal. It means in the gap between meals.
Ingredients and amounts
In 9 tablets, the daily amount for someone 15 or over: 当帰芍薬散加人参 dried extract 2,150mg, extracted from the crude drugs below.
Note: Because this uses crude drugs, the insert says the colour of the tablets can differ a little from product to product, and that this does not change how it works.
Added ingredients
Silicon dioxide, cellulose, croscarmellose sodium, hydroxypropyl cellulose, magnesium stearate.
What the insert says about the formulation
The insert gives 当帰芍薬散加人参 a section of its own. Feeling the cold is also a cause of swelling and period pain getting worse, so for anyone who has those complaints along with feeling the cold, dealing with the cold matters too.
当帰芍薬散 improves the balance of the whole body and the complaints with it, by improving the flow of blood and of water. 人参, which warms the body by making a weakened stomach and intestines work actively, is added to that. The insert says the combination shows excellent effect on feeling the cold.
The official product page adds that 当帰芍薬散加人参 is one of the three major formulations for gynaecological conditions, and that in kampo the crude drugs do not work individually but as a whole.
Note: The last two sentences are from the official product page, not the insert.
What you must not do
This insert has no してはいけないこと section, the list of people who must not take a medicine at all and the things not to do while taking it. It goes straight to 相談すること, below. Inserts differ on this: the one for Inochi no Haha A (命の母A) does have one.
Consult before taking it
Ask a doctor, pharmacist or registered seller before taking it if you:
Stop and consult
If these appear after taking it they may be side effects. Stop at once and take this leaflet with you to a doctor, pharmacist or registered seller:
The insert also says to stop, and to take the leaflet with you and ask, if about a month of taking it does not improve the symptoms.
Storage and handling
Note: The last two are easy to miss. There is a space printed on the box and the bottle to write the date you opened it.
Printed on the front of the leaflet
Others in the same range
Alinamin sells a plain Rubina (ルビーナ) alongside this one, and the two sit together on the shelf. They are not the same medicine. Plain Rubina is based on 連珠飲, a different formulation with different indications, so check which box you have picked up.
Note: We have not been through the leaflet for plain Rubina, so it is mentioned here only so you can tell the two apart.
Product features
Made by Tsumura (ツムラ). The insert lists these features:
The box carries 漢方製剤, marking it a kampo preparation. It comes as granules in sachets rather than as tablets.
Two sizes are sold: 20 sachets, which the official page gives as ten days' worth, and 48 sachets, which it gives as twenty-four days' worth. The Amazon link below is the 20-sachet box.
Note: Everything else here is from the Japanese insert, revised February 2018. The sizes and the days are not in it; they come from the official product page.
What the class on the box means
The box is marked 第2類医薬品, Class 2. You can take it off the shelf yourself, a registered seller can sell it to you without a pharmacist on duty, and nobody has to explain it unless you ask.
Note: What the other classes mean, and where the rule comes from, is in The Class Number on Japanese Medicine Boxes.
A word you will meet with this one
The official product page says this is often used for 不定愁訴 (futei shuuso), complaints whose cause is not clear, giving irritability, insomnia and sensitivity to cold from disorder in a woman's hormone balance as its examples. It is a term you will hear in Japanese clinics and see in Japanese health writing, and it has no settled English name.
Note: This is from the official product page, not the insert.
Indications
This indication opens by describing the person rather than the complaint, and that description is part of the approved use. The insert reads: for those of moderate physical strength or less, who have a feeling of heat rising, whose shoulders are stiff, who tire easily, who have mental and nervous symptoms such as unease and irritability, and who at times tend towards constipation, it lists the following complaints:
Note: 血の道症 (chinomichi-shou) is defined in this insert as the mental and nervous symptoms, such as unease and irritability, together with the physical symptoms, that appear along with the fluctuation in a woman's hormones at times such as menstruation, pregnancy, childbirth, after childbirth and menopause. It is the same term that appears on Inochi no Haha A (命の母A). Seven complaints are listed in the insert, in the order given here.
Dosage
Take the amount below twice a day, before a meal, with water or hot water.
A child taking it should do so under the guidance and supervision of a guardian.
Note: Twice a day. Inochi no Haha A (命の母A) and Rubina Meguri (ルビーナめぐり) are both three times a day.
Ingredients and amounts
In 2 sachets (3.75g): 加味逍遙散 extract (half quantity) 2.0g, from the crude drugs below.
Note: Each is prefixed 日局 in the insert, meaning it meets the Japanese Pharmacopoeia standard, and the English names above are the ones that standard uses. The half quantity in brackets is the insert's own wording.
Added ingredients
Magnesium stearate and lactose hydrate, both to the Japanese Pharmacopoeia standard.
What you must not do
This insert has no してはいけないこと section, the list of people who must not take a medicine at all. It goes straight to 相談すること, below.
Consult before taking it
Ask a doctor, pharmacist or registered seller before taking it if you:
The insert also says to ask if you are going to take it continuously over a long period.
Stop and consult
If these appear after taking it they may be side effects. Stop at once and take this leaflet with you to a doctor, pharmacist or registered seller:
The insert lists diarrhoea separately: it can appear after taking it, and if it continues or grows worse, stop and ask.
It also says to stop and ask if about a month of taking it does not improve the symptoms.
Serious symptoms, rarely
This insert carries a section that the inserts for Inochi no Haha A (命の母A) and Rubina Meguri (ルビーナめぐり) do not. It says these occur rarely, and that if they do you should seek a doctor's care at once:
Storage and handling
Printed on the front of the leaflet
Product features
Made by Kracie (クラシエ薬品). The insert lists these features:
The box carries 漢方製剤, marking it a kampo preparation. Note the 料 in the product name: this is 桂枝茯苓丸料, not 桂枝茯苓丸.
Note: The Amazon link below is the 90-tablet bottle. The number of tablets is not in the insert.
What the class on the box means
The box is marked 第2類医薬品, Class 2. You can take it off the shelf yourself, a registered seller can sell it to you without a pharmacist on duty, and nobody has to explain it unless you ask.
Note: What the other classes mean, and where the rule comes from, is in The Class Number on Japanese Medicine Boxes.
Indications
This indication opens by describing the person rather than the complaint, and that description is part of the approved use. The insert reads: for those of comparatively good physical strength, who at times complain of lower abdominal pain, stiff shoulders, a heavy head, dizziness, or a feeling of heat rising with cold feet, it lists the following complaints:
Periods and menopause
Aches, head and circulation
Skin
Note: 血の道症 (chinomichi-shou) is defined in this insert as the mental and nervous symptoms, such as unease and irritability, together with the physical symptoms, that appear along with the fluctuation in a woman's hormones at times such as menstruation, pregnancy, childbirth, after childbirth and menopause. It is the same term that appears on Inochi no Haha A (命の母A) and on Tsumura Kamishoyosan (ツムラ漢方加味逍遙散エキス顆粒). The insert prints all thirteen complaints as one continuous list; the grouping here is ours.
Dosage
Take the amount below three times a day, before a meal or between meals, with water or hot water.
A child taking it should do so under the guidance and supervision of a guardian.
Ingredients and amounts
In the adult daily dose of 6 tablets, each tablet 310mg: 桂枝茯苓丸 extract (half quantity) 1,150mg, extracted from 2.0g each of the crude drugs below.
Note: All five are in equal amounts. The half quantity in brackets is the insert's own wording.
Added ingredients
Hydroxypropyl cellulose, croscarmellose sodium, magnesium stearate, silicon dioxide and cellulose.
Note: The insert says the colour of the tablets can differ a little because the extract comes from a natural product, that white patches on the surface come from the added ingredients, and that the medicine has the smell particular to kampo because the extract contains the essential oil components of the crude drugs.
What you must not do
This insert has no してはいけないこと section, the list of people who must not take a medicine at all. It goes straight to 相談すること, below.
Consult before taking it
Ask a doctor, pharmacist or registered seller before taking it if you:
Note: The indication above is written for people of comparatively good physical strength.
Stop and consult
If these appear after taking it they may be side effects. Stop at once and take this leaflet with you to a doctor, pharmacist or registered seller:
The insert lists diarrhoea separately: it can appear after taking it, and if it continues or grows worse, stop and ask.
It also says to stop and ask if about a month of taking it does not improve the symptoms.
Serious symptoms, rarely
The insert says this occurs rarely, and that if it does you should seek a doctor's care at once:
Storage and handling
Printed on the front of the leaflet