Issue 173  /  September 29, 2026  /  Feature

Japan Made Women's Health a Business Metric

The world's third-ranked country for women's health puts a yen figure on the problem and grades employers on fixing it.

Japan Made Women's Health a Business Metric

Japan ranks third in the world for women's health. On gender parity, it ranks 117th.

The World Economic Forum's 2026 Global Gender Gap Report, released September 16, placed Japan 117th of 145 countries and last in the G7. The drag is economic participation, at 119th, and political empowerment, at 121st. On health and survival, Japan placed 49th.

The women's health ranking comes from the Hologic Global Women's Health Index, which Hologic, a maker of women's health diagnostics and devices, commissions from Gallup.

Its fifth edition, released in March 2026 and based on surveys in 144 countries, gave Japan 66 out of 100. Only Taiwan scored higher, at 69. The United States placed 13th at 64. Japan was 24th of 116 countries in the first edition and 22nd a year ago.

What sets Japan apart is that it made women's health a business metric. The government puts a price on women's health problems and grades employers on solving them.

The climb itself needs a caution. The Index is built from what women report in surveys, and Latvia jumped from 21st to second in the same edition, so a single year's move can overstate real change. The Year 5 survey was also fielded in 2024, before several of the changes below. Japan was already strong on the basics. In the Year 4 edition, the latest with published scores by dimension, Japanese women scored 90 on basic needs and 77 on emotional health.

It starts with the price tag.

In February 2024, the Ministry of Economy, Trade and Industry estimated that menstrual symptoms, menopause, gynecologic cancers and infertility treatment cost Japan about ¥3.4 trillion a year in lost work and productivity.

It estimated that employers acting on those issues could recover up to about ¥1.1 trillion a year. The estimate moved women's health out of the welfare budget and onto the balance sheet.

Then comes the scorecard.

Since 2016, the ministry has certified companies for "health and productivity management." Companies apply and are scored, and those that pass can show the certification to recruits and investors. In March 2026, 26,850 organizations were certified, 3,765 large and 23,085 small and midsize, a record. The ministry's review committee materials put the large-company count at about 16 times its 2016 level and the small and midsize count at about 73 times. The criteria include a dedicated item on efforts to maintain and improve women's health, scored alongside work-life balance and support for older employees.

That makes women's health part of a credential companies compete for, and it gives employers a reason to act that does not depend on goodwill.

Smaller companies are the next target. Committee data from December 2025 showed about 33% of large companies certified, against 0.59% of Japan's roughly 3.36 million small and midsize firms. In July 2026 the ministry set out plans for a women's health support desk for companies and their local advisers, and for bonus points on government subsidy applications for certified small firms. In May it published guidance for companies and local governments on choosing femtech products.

The state has built infrastructure behind the scorecard.

In October 2024, the National Center for Child Health and Development opened the Integrated Center for Women's Health, a government hub for women's health research and clinical care.

In its first year, according to its director, it ran sex-difference analyses on cancer, diabetes and cardiovascular disease using Japan's national claims database, and helped lift a pregnancy contraindication on the anti-nausea drug domperidone. In June 2026, the government's annual women's policy blueprint put health first among its priorities for the year, starting with a larger role for the center.

Japan also used a touchpoint it already had.

Japanese labor law requires employers to run an annual health checkup. In January 2026, following an expert committee report, the health ministry published manuals adding a women's health question to it. The question asks whether menstrual pain, PMS or menopausal symptoms are causing difficulty at work. Answering is optional. The clinic can follow up with information and a specialist referral, and employers see only aggregated results. Most countries trying to reach working women on menopause are building new programs. Japan added one question to a checkup employers already run every year.

Access has widened outside the workplace too.

Since February 2, 2026, emergency contraception has been sold without a prescription in Japanese pharmacies, following a pilot at selected stores. The health ministry's first list of approved sellers, published in January, named 5,444 pharmacies and drugstores. By June 8, the list had reached 14,588.

The market is following the policy.

Fuji Pharma, a Tokyo-listed drugmaker focused on women's medicine, reported ¥51.7 billion in revenue for the year to September 2025, up 12% from the prior year, with women's medicine among its main drivers. It is targeting ¥80 billion by fiscal 2029 (company-stated). MTI, which runs the LunaLuna cycle-tracking service, signed women's health agreements with Ishikawa Prefecture and the city of Miyakonojo in August 2026. The startup Flora, which builds AI tools for women's health data, said in April 2026 that a new round brought its total funding to about ¥500 million (company-stated). On August 7, 2026, Astellas filed for Japanese approval of fezolinetant, already approved in 48 countries, which would be Japan's first non-hormonal drug targeting the NK3 receptor pathway behind hot flashes.

For companies selling into Japanese women's health, the buyer is increasingly institutional. Yano Research Institute, a Tokyo market research firm, sized Japan's market for women's health apps, online consultations, mail-in testing, gynecology record systems and pelvic-floor training devices at ¥8.49 billion in fiscal 2024, measured by vendor revenue.

It expects growth to come mainly from contracts with employers, health insurance societies and local governments. The larger consumer market for women's health goods and services reached ¥80.4 billion in 2024 by Yano's estimate, with menopause care alone at about ¥28 billion after double-digit growth every year since 2021.

Reach is where the model still has to prove itself. In the ministry's 2024 survey of 3,869 large companies, 85% said they ran women's health training, but where the training was open to all employees, median participation was 15.1%. Preventive care was also Japan's weakest dimension in the Year 4 Index, at 21 against a global average of 19. The ministry has started a project to test whether the women's health measures companies adopt actually work, a step voluntary programs rarely take.

That gap between adoption and participation is the opening for the next wave of products. Most large employers in the survey have a women's health program. Most of their employees are not using it yet.

The United States, the United Kingdom, and Australia are all debating menopause at work, largely through employer pledges and new benefits.

Japan's approach runs on numbers the government publishes, and a credential employers want, and none of it requires a new insurance program.

Everywhere else in the world, employers are asked to care about women's health.

In Japan, they are scored on it.

Certification also pays. As of fiscal 2022, there were 96 loan and guarantee programs offering certified companies better terms, and 49 local government programs giving them extra points when bidding for public contracts. Since 2023, national grant programs for small businesses have given certified applicants extra points too.

Women's health is one of the items companies are scored on to earn those perks. It is optional, but for employers that invest in it, the return comes as cheaper credit and better odds on government work.

Japan never had to call it a women's health subsidy. It built one into the scorecard.

This article is for informational purposes and is not medical advice.

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Sources

Primary

Market research firm estimates

Vendor-commissioned survey

Company-stated

— Keisha, Editor of The Luteal