We Have Introduced the Long-Acting Male Hormone (Nebido Generic)!
We offer Gender Affirmation so that we can provide holistic support to people with gender incongruence and gender dysphoria, and hormone therapy is available under the care of a doctor specializing in Gender Affirmation.
For FTM hormone therapy, we have introduced the long-acting male hormone (Nebido generic), and you can receive hormone treatment at approximately half the cost of the original product.
In addition, by measuring hormone levels during hormone therapy, you can also discuss matters such as the correct dosing interval and side effects with a doctor.
A doctor specializing in Gender Affirmation will see you, so please feel free to visit us with peace of mind.
Price: 18,000 yen (tax included)
Product name: Cernos injection (Cernos)
Manufacturer: Sun Pharma Co., Ltd.
– The price includes the cost of hormone measurement.
– An additional 2,500 yen (tax included) applies for first visits, and 1,000 yen (tax included) for follow-up visits.
Counseling and hormone therapy are self-pay only.
For our Gender Affirmation, first visits are accepted only on the “Gender Affirmation (First Visit)” dates.
Hormone treatment from the second visit onward can be administered on dates other than those listed below. Please book from “Gender Affirmation (Follow-Up)” on the appointment site.
If you have any questions about Gender Affirmation, please contact us through our official LINE.
Please select the section to jump to.
What is Nebido?
FTM hormone replacement therapy refers to supplementing male hormone by injection (short-acting or long-acting) or with a topical ointment.
(FTM hormone therapy)
Medication options:
Injection: short-acting male hormone (Enarmon Depot, Testoviron), long-acting male hormone (Nebido generic)
Topical ointment: Glowmin
Main side effects:
Hypersensitivity symptoms, abnormal liver function values, pigmentation, myelofibrosis, aplastic anemia and renal anemia
Short-acting injectable medications have a strong effect in raising blood testosterone levels, and because levels greatly exceed the physiological reference range for several days after administration, the problem is that irritability and emotional instability tend to occur.
Topical ointments show little extreme fluctuation and give relatively stable blood levels, but they take time before the effect appears.
Nebido, the long-acting injectable medication, keeps blood testosterone levels stable for about 3 to 5 months with 1 injection, so it is characterized by making irritability and emotional instability less likely.
Nebido is a medication manufactured by Schering in Germany, and it is used for the treatment (hormone replacement therapy) of male menopause (late-onset hypogonadism) caused by testosterone deficiency and of GI (gender incongruence).
It is not approved in Japan, but it has already been authorized and used in Europe and the United States, and it is a highly safe medication.
As described above, Nebido is a medication with good safety and stable blood levels, but because it costs approximately 30,000–35,000 yen per dose, many people found administration difficult for financial reasons.
In light of this situation, we have introduced a generic version of Nebido (Cernos injection) so that we can provide it inexpensively to those who need it.
Not only is it more affordable than the conventional original product, but by performing hormone measurement you can also check your hormone levels regularly and discuss them with a doctor.
For people such as the following, we recommend switching from a short-acting male hormone preparation to Nebido, or changing from the original Nebido product to the Nebido generic.
– Those who want to reduce the number of hospital visits for male hormone replacement therapy, or who find it hard to visit a hospital because of work and similar reasons
– Those who experience irritability, emotional instability, etc. after administration of a short-acting preparation
– Those who want to stabilize hormone levels during male hormone replacement therapy and manage the risk of lifestyle-related diseases and thrombosis
– Those who were interested in a long-acting male hormone preparation but had not been receiving it because of the price
Price: 18,000 yen (tax included)
Product name: Cernos injection (Cernos)
Manufacturer: Sun Pharma Co., Ltd.
– The price includes the cost of hormone measurement.
– An additional 2,500 yen (tax included) applies for first visits, and 1,000 yen (tax included) for follow-up visits.
Furthermore, since January 2024 we have introduced the Nebido generic oral medication (Cernos capsule).
Price: 5,000 yen (tax included)/30 tablets
Product name: Cernos Testosterone Undecanoate Soft Gelation Capsules
Manufacturer: Sun Pharma Co., Ltd.
Active ingredient: testosterone undecanoate 40mg/tablet
– An additional 2,500 yen (tax included) applies for first visits, and 1,000 yen (tax included) for follow-up visits.
The Nebido generic oral medication (testosterone undecanoate oral medication) is approved by the United States Food and Drug Administration (FDA: Food and Drug Administration) (the original page is here), and it has been reported academically that it is effective for maintaining male hormone levels and that no increase in the risk of serious side effects was seen (the original page is here).
For people such as the following, we recommend the Nebido generic oral medication.
– Those who want to keep a spare male hormone preparation on hand for emergencies, or in case they cannot have an injection because of work
– Those who do not want high-dose male hormone administration but do want male hormone therapy (such as those who want only a slightly more masculine change, or those who want to masculinize slowly)
– Those who do not want to have injections regularly, or who want hormone therapy centered on medication (oral)
– Those who cannot have injections regularly because of geographical issues, such as living outside the major cities
If you are interested or have any questions, please feel free to contact us via our clinic’s Official LINE.
Cautions for Hormone Replacement Therapy
Once hormone replacement therapy is started, you become more prone to a variety of comorbid conditions such as liver dysfunction, kidney dysfunction, dyslipidemia, diabetes, polycythemia, thrombosis and osteoporosis.
Those undergoing hormone replacement therapy need to have their hormone levels measured regularly. Hormone replacement therapy that exceeds permissible levels can sometimes cause fatal complications.
We recommend performing blood sampling and hormone measurement when starting and continuing hormone replacement therapy.
Gender Affirmation is basically provided on a self-pay basis only, but depending on the patient’s underlying conditions, blood tests and the like may in some cases be performed under insurance coverage.
Please contact a doctor for more details.
The following hormone tests can be performed.
Before oophorectomy: estrogen, testosterone (2,000 yen, tax included)
After oophorectomy: testosterone (1,500 yen, tax included)
In addition to hormone measurement, we can also assess lifestyle-related diseases and thrombosis accompanying hormone replacement therapy as follows.
We check liver function, kidney function, dyslipidemia, uric acid levels, etc. Based on the test results, we adjust the hormone dosage as needed.
Blood sampling set: blood count, liver function, kidney function, electrolytes, uric acid, CK, TG, LDL, HDL, blood glucose, HbA1c (3,000 yen for the whole set, tax included)
Thrombosis is a risk as a complication accompanying hormone therapy.
In addition to blood tests, we can provide comprehensive care including assessment of cerebral infarction and myocardial infarction if necessary.
Thrombosis risk assessment: D-dimer (1,500 yen, tax included)
Research and Free Testing
So that we can provide holistic support to people with gender incongruence and gender dysphoria, we conduct research on the theme of sexual health with transgender people who undergo hormone replacement therapy.
Participation is anonymous, and test results can be checked by email.
For those who consent to the research, we will perform the first testing for lifestyle-related diseases, hormone testing and STI testing free of charge. (Hormone replacement is also possible if you do not want testing)
If you have already received hormone replacement therapy at our clinic and would like to take part, please tell the doctor in charge.
Hormone measurement: testosterone, estrogen (normally 2,000 yen)
Testing for lifestyle-related diseases: blood count, liver function, kidney function, electrolytes, uric acid, CK, TG, LDL, HDL, blood glucose, HbA1c (normally 3,000 yen)
STI testing: HIV, hepatitis B, syphilis, gonorrhea (genital, throat, anal), chlamydia (genital, throat, anal) (normally 24,000 yen)
Regardless of gender, we take a variety of measures so that each patient’s treatment details and personal information cannot be identified by others.
We will continue to strive to be a clinic that everyone finds easy to visit.
We call all patients by number rather than by name.
– The consultation rooms are soundproofed.
– We do not separate the consultation rooms by department, so the department cannot be identified.
– At payment, the amount is shown on screen and is not read out loud.
Prices
Gender Affirmation is in principle provided as self-pay care.
Regular testing accompanying hormone therapy may in some cases be performed under insurance coverage, so please ask a doctor.
Self-pay fees are calculated according to the pricing system below.
(Price) = (Consultation fee) + (Testing fee) + (Medication fee)
Consultation Fee
The consultation fee differs between first visits and follow-up visits.
Anyone who has visited our clinic even once, whether under insurance coverage or self-pay, is seen at the follow-up visit fee.
Initial consultation fee: 2,500 yen
Follow-up consultation fee: 1,000 yen
(both including tax)
Testing Fee
Testing fees are as follows.
| Type of test | Cost (tax included) | Test results* |
|---|---|---|
| Hormone therapy blood sampling set | 3,000 yen | after 2–3 days |
| Testosterone + estrogen | 2,000 yen | after 4–5 days |
| Testosterone | 1,500 yen | after 4–5 days |
| Free testosterone | 1,500 yen | after 4–5 days |
| Estrogen | 1,500 yen | after 4–5 days |
| D-dimer (assessment of thrombosis risk) | 1,500 yen | after 2–3 days |
*The reported number of days for test results is a guideline measured from the “test start date”. For samples collected in the evening or later, or on Sundays, holidays, or year-end/New Year, the “test start date” will be the next business day. For self-pay care, results can be checked by email.
Treatment Fee
The costs of hormone therapy are as follows.
We carry a generic version of the long-acting male hormone (Nebido).
The price is approximately half that of the original product, making it very affordable. Please consider it.
| Type | Preparation | Cost (tax included) |
|---|---|---|
| Long-acting male hormone | Nebido generic oral (Cernos capsule) | 1 box: 5,000 yen/30 tablets 3 boxes: 14,000 yen/90 tablets 6 boxes: 27,000 yen/180 tablets |
| Nebido generic (Cernos injection) | 18,000 yen* | |
| Testosterone topical medication | Cernos Gel (1% testosterone undecanoate topical medication) |
4,000–9,000 yen/month** |
| Glowmin (1% testosterone topical skin preparation) |
4,100 yen | |
| 1UP Formula (5% testosterone topical skin preparation) |
Self-pay prescription fee: 2,200 yen (+ medication cost)*** |
|
| Short-acting male hormone | Testoviron 100mg | 2,500 yen |
| Testoviron 250mg | 3,500 yen |
*The cost of hormone measurement is included.
**Dosage and prescribed amount vary depending on each patient’s individual situation. Please consult with the doctor for details at the time of your visit.
***For 1UP Formula, you will pay a self-pay prescription fee of 2,200 yen (tax included) at our clinic, and pay the medication cost separately at a specialized pharmacy (approximately 12,100 yen).
Consultation Flow
As with our other departments, Gender Affirmation gives priority to appointments.
Visiting directly is expected to involve a long wait, so please make an appointment and fill in the medical questionnaire in advance.
Appointment
Please book from “Gender Affirmation” on our clinic’s website.
For “Gender Affirmation (First Visit)”, Dr. Ikebukuro examines every patient. There is no need to specify a doctor in charge.
For our Gender Affirmation, first visits are accepted only on the “Gender Affirmation (First Visit)” dates.
Hormone treatment from the second visit onward can be administered on dates other than those listed below. Please book from “Gender Affirmation (Follow-Up)” on the appointment site.
Filling in the Medical Questionnaire
After completing your booking, please click the link shown at the bottom of the booking confirmation email and fill in the medical questionnaire.
Visiting on the Day
Please come to the clinic at your appointment time on the day. We will give you a number at reception and call you by that number for testing, payment and so on.
Medical Interview and Consultation with a Doctor
Based on your medical questionnaire, a doctor examines you and provides appropriate advice, testing and treatment.
If you live in Hokkaido, Tohoku or the Kanto region, the Nebido generic is available at our partner clinic, Personal Health Clinic (Tokyo). For details, please see the Personal Health Clinic page.
Physician; obstetrics and gynecology specialist certified by the Japan Society of Obstetrics and Gynecology; certified physician of the Japanese Society of GI (Gender Incongruence).
In charge of Gender Affirmation at Idaten Clinic and Personal Health Clinic. Has provided care to more than approximately 3000 transgender people over 2 years, and specializes in transgender healthcare and sexual healthcare.