She became empress consort (皇后, Kōgō) when her husband ascended to the throne on 30 July 1912 following the death of her father-in-law, Emperor Meiji.

Given her husband's weak physical and mental condition, she exerted a strong influence on imperial life, and was an active patron of Japanese Red Cross Society.

She openly objected to Japan's involvement in World War II, which might have caused conflict with her eldest son, Emperor Hirohito.

From 1943, she also worked behind the scenes with her third son Nobuhito, Prince Takamatsu to bring about the downfall of Prime Minister Hideki Tōjō.

She was a Buddhist adherent who had faith in Nichiren Shoshu and prayed with the Shinto ritual ceremonies of the Tokyo Imperial Palace.