Speculum

What Is a Speculum?

A speculum is a tool a healthcare provider uses to look inside hollow openings in your body. It’s most often used in your vagina during pelvic exams and Pap smears. A speculum widens your vaginal walls just enough for your provider to see your vaginal canal and your cervix. It also allows your provider to check for growths, take samples for testing and do certain procedures through your vagina.

What does a speculum look like?

Speculums come in different designs based on what they’re used for.

You’ll most likely see one with two arms joined by a hinge. The arms look like a duck’s bill. The duck bill part goes into your vagina. When your provider opens the arms, they spread your vaginal walls so your provider can see inside. It only spreads your vaginal walls about one inch.

Speculums can be made of stainless steel or plastic. Some plastic ones have a small light to help your provider see your vagina and cervix better.

What are the different types of vaginal speculums?

Speculums come in different sizes. Your provider will choose a size that fits your body and keeps you comfortable. During an exam, they usually start with the smallest speculum that still lets them see your vagina and cervix.

Common types of vaginal speculums include:

• Pediatric: This is the smallest size speculum. It’s short and narrow. It’s used after menopause or if you haven’t had vaginal sex.
• Huffman: It’s a little bigger than a pediatric speculum, but still small. It’s often used on people who haven’t had sex.
• Pederson: This is one of the most common types. It’s medium-sized and narrow. It’s often used if you’ve had sex but haven’t given birth vaginally. It also comes in various sizes.
• Graves: It’s larger and wider than the Pederson speculum. Your provider may use it if you’ve given birth vaginally or have a longer vaginal canal. It’s also used during certain gynecological procedures. It comes in various sizes.

What is it used for?

You’ll most likely see a speculum during a routine pelvic exam or Pap smear. This is where they’re most common.

Speculums are also used for certain gynecological procedures, like:

• Biopsy
• Dilation & Curettage (D&C)
• Loop electrosurgical excision procedure (LEEP)

Does a speculum hurt?

It’s normal to feel some pressure or mild discomfort when your provider inserts and widens the speculum. But it shouldn’t be painful. If it does feel painful, your body may be tensing up. Tight muscles can make the exam more uncomfortable. Slow, steady breathing can help your body relax.

Some health conditions can also make the exam painful. These conditions include:

• Lichen sclerosus: This is a skin disorder. It may make your skin less stretchy and more susceptible to tears during a speculum exam.
• Vaginal atrophy: This occurs when drops in estrogen make your vagina feel irritated, dry or sore. You may be more likely to have discomfort during a speculum exam if you have this condition.
• Vaginismus: Vaginismus causes the muscles around your vagina to tighten without your control. This can make a speculum exam uncomfortable or painful.
• Vulvodynia: This is chronic pain in your vulva. This pain can extend to your vagina, making a speculum feel painful.

It’s important to let your healthcare provider know if you have these conditions. They can take extra steps to make your exam more comfortable.

Is it safe?

Yes. Speculums have been used for many years to help diagnose and treat conditions. Speculums are sterilized before providers use them.

You don’t need to worry about your vagina being stretched. Any widening during the exam is temporary. Your vagina will return to its usual shape after your exam.

How can I make a speculum exam more comfortable?

If you’re comfortable doing so, talk to your provider about:

• Your sexual activity: Having a clear understanding of your history with vaginal sex can help your provider choose a speculum that fits your vagina best.
• Your comfort with penetration: Let your provider know if things like sex or inserting a tampon are painful for you.
• Any history of sexual trauma or abuse: Pelvic exams may be difficult if you’ve had sexual trauma. It may be hard to talk about this with your provider. But letting them know can help them take steps to make you feel more comfortable.

You can also ask your provider to:

• Use the smallest speculum possible.
• Warm or lubricate the speculum before they insert it.
• Describe what’s happening so you know what to expect.