Bringing HRT and Trimix to Japan: Hormones, Injections and Compounded Medicines

Is it legal to bring HRT to Japan?

Yes, within the personal-use rules, because hormones are not controlled drugs in Japan. Estradiol, progesterone and testosterone do not appear on Japan’s psychotropics list, and they are not narcotics. In Japan, testosterone itself is an approved prescription medicine (testosterone enanthate, sold as Enarmon Depot エナルモンデポー). The papaverine, phentolamine and alprostadil in Trimix are not controlled either.

As a result, the Narcotics Control Department permit system does not apply when you bring HRT to Japan. The Ministry of Health, Labour and Welfare (MHLW) personal-use rules do, and they depend on the form of the medicine.

Bringing HRT to Japan: the rule for each form

MHLW counts the contents, not the number of packs. In addition, splitting a supply across bags or shipments in the same period still counts toward one total.

Injectable HRT to Japan: vials, syringes and needles

Injections are where most people run into trouble. MHLW’s English guidance allows injectable medicines up to one month’s supply only as a pre-filled syringe or a self-injection kit. Its Q&A adds that syringes on their own are medical devices that need an Import Confirmation even for one piece.

• Contact the Regional Bureau for your arrival port: Kanto-Shinetsu (Tokyo, Yokohama and Hakodate customs areas) 048-740-0800, or Kinki (Nagoya, Osaka, Kobe, Moji, Nagasaki and Okinawa customs areas) 06-6942-4096.
• Describe the medicine, the vial size, how many vials and how many syringes and needles you need for the stay.
• If a long stay is planned, ask a Japanese clinic early whether it can continue your treatment locally.

Trimix and other compounded medicines

A compounded product, made by a pharmacy to a specific recipe, is not an approved medicine in Japan. Its ingredients, dosage form and quantity need a product-specific check, so ask the Regional Bureau of Health and Welfare whether an Import Confirmation or another procedure applies. If you apply, the application has to describe the product itself because there is no Japanese label to refer to.

1. List every active ingredient and amountFor Trimix: papaverine, phentolamine and alprostadil, with the amount of each per millilitre or per vial.
2. Prepare a product explanationThe Kanto-Shinetsu Bureau asks for a product explanation form for unapproved medicines: name, ingredients, specifications such as form and strength, and use.
3. Get a dated prescription or doctor’s instructionsShowing your name, the product, the hospital and the doctor, dated within six months.
4. Add the arrival or shipping detailsFor carry-on, how and when the medicine arrives; for a shipment, the invoice and shipping document.
5. Apply online before you travelThrough MHLW’s Import Confirmation Information System.
6. Carry the confirmation with the medicineShow it to customs on arrival.

Keep in mind that many compounded injections must be kept cold. Plan storage for the flight and your accommodation.

If you cannot bring enough HRT to Japan: continuing treatment locally

For a long stay, ask your prescriber how to keep your treatment continuous. If you need more than one month's supply, you can apply for an Import Confirmation, or you may be able to continue with a doctor in Japan. Arrange this before your supply runs out, and do not stop or change hormone treatment because of travel rules. Many hormone products are approved in Japan, so a Japanese doctor can often continue treatment with a local equivalent. Approved uses and doses differ from other countries, and the choice is the doctor’s. An approved ingredient does not mean your exact product, strength or form is stocked: ask a pharmacist in Japan to confirm local availability, and ask the Regional Bureau of Health and Welfare about your exact product before you travel.

• Estradiol: patches エストラーナテープ and gels ル・エストロジェル, ディビゲル are approved.
• Progesterone: vaginal products and an oral capsule エフメノ are approved for specific uses.
• Testosterone: enanthate injection エナルモンデポー is approved; it is usually given at a clinic.
• Alprostadil: Caverject is not on Japan’s approved list. The approved alprostadil injection lists intracavernous use only for diagnosing erectile dysfunction, so Trimix-style treatment is unlikely to be available locally.

Bring a translated letter from your doctor with your diagnosis, products, doses and history. It helps at customs and at the clinic. For LGBTQ+ travellers and residents, our LGBTQ+ healthcare in Japan guide covers finding supportive care.

Can hormones be posted to Japan?

Unlike narcotics and psychotropics, hormones are not banned from the post. Ordinary medicines mailed to your own home within the personal-use limits are treated as personal imports. However, the Kinki Bureau says mail sent to any other address, or held at a post office, needs an Import Confirmation. The same one-month limits, syringe rules and compounded-product rules apply to the post as to your luggage.