What is a speculum?

A speculum is a duck-bill-shaped device that doctors use to see inside a hollow part of your body and diagnose or treat disease.

One common use of the speculum is for vaginal exams. Gynecologists use it to open the walls of the vagina and examine the vagina and cervix.

A speculum is made from stainless steel or plastic. Metal devices are reusable. Plastic ones are disposable.

Vaginal speculums

Vaginal speculums have one, two, or three blades.

Bivalve speculum (Cusco’s speculum)

The two-bladed, or bivalve, speculum is the most common type of instrument gynecologists use to examine the vagina and cervix. The doctor inserts the speculum into the vagina and opens up the blades, which exposes the inside of the vagina and cervix.

Vaginal speculums come in different sizes. Which one of the following speculum types your doctor chooses depends on your age and the length and width of your vagina.

Pediatric speculum

Gynecologists use this shorter version of the speculum to examine the vagina in infants and children.

Huffman speculum

This long, thin speculum is narrower than a regular speculum. It’s used in teenaged girls who haven’t yet been sexually active.

Pederson speculum

Doctors use the Pederson speculum in teenage girls who’ve been sexually active. Its blades are narrower than those of a regular adult speculum, but larger than the blades of a Huffman speculum.

Graves speculum

The Graves speculum has the widest blades of any speculum. Gynecologists use it to examine adult women. It comes in a larger size for those with an especially long vagina.

Anal speculum

An anoscope is a tube-shaped instrument that widens the opening of the anus. Doctors use it to diagnose diseases of the anus and rectum.

Ear speculum

This funnel-shaped device lets your doctor examine your eardrum and ear canal. It’s attached to a lighted instrument called an otoscope, which the doctor uses to look inside your ear.

Nasal speculum

This two-bladed instrument is inserted into the nostrils. It lets doctors examine the inside of the nose.

There are several reasons why your doctor might use a speculum.

Pelvic exam

Gynecologists do a pelvic exam to check the vagina, cervix, and other reproductive organs for problems. The speculum opens up the vaginal canal to make these organs easier for the doctor to see.

During this exam, the doctor might use a special brush to remove a few cells from the cervix. This is called a Pap test or Pap smear. The cells go to a lab, where they’re checked for early signs of cervical cancer.

Cell samples can also be removed from the vagina and cervix to check for sexually transmitted diseases (STDs).

Doctors also use a speculum for procedures like these:

  • Vaginal hysterectomy. This procedure removes the uterus through the vagina.
  • Dilation and curettage. This procedure opens (dilates) the cervix and removes part of the uterus lining.
  • Intrauterine insemination (IUI) and in vitro fertilization (IVF). These procedures help women with fertility problems get pregnant.
  • Intrauterine device (IUD) placement. IUDs are a reversible form of birth control that is placed inside of the uterus.

Anal exam

Doctors use an anal speculum to diagnose and treat conditions such as:

Ear exam

An ear speculum lets an ear, nose, and throat (ENT) or primary care doctor examine the inside of your ear. It’s used to look for problems like:

  • swimmer’s ear
  • eardrum perforation
  • wax buildup in the ear
  • foreign objects in the ear
  • acute ear infection (otitis media)

Nasal exam

A nasal speculum widens the opening of the nose to help the doctor diagnose disease or perform procedures such as:

Pelvic exams can be a little uncomfortable when your doctor places the speculum inside your vagina and opens it. However, there are few risks involved as long as the speculum is sterile. If it hurts, you can ask the doctor to use a smaller speculum.

The speculum might feel like it’s stretching out your vagina, but it only opens up the vaginal canal temporarily. It won’t widen or loosen your vagina. A speculum shouldn’t cause damage or injury when used by a trained doctor.

Most young women should have a pelvic exam by age 21.

It’s normal to be nervous about your first pelvic exam. Remember that this exam is just a way for your doctor to check your reproductive system. It should be quick, and it shouldn’t be painful.

Let your gynecologist’s office know that it’s your first exam. The doctor and nurse should talk you through the process and answer any questions you have.

In the two days before your exam, avoid the following:

  • vaginal creams
  • suppositories
  • douches

During the exam, you’ll first tell the nurse about your medical history. The nurse may ask when you started getting your periods, and if you have any symptoms like itching or burning in your vagina. Your weight and blood pressure will also be checked.

Then you’ll change into a hospital gown, or undress from the waist down and put a drape over yourself. During the pelvic exam, you’ll move down to the end of the table, bend your knees, and put your feet in holders called stirrups.

Your doctor will first examine the outside of your vulva.

Then, the doctor will insert a speculum into your vagina to view the inside of your vagina and cervix. You might feel a little bit of pressure when the speculum is opened, but it shouldn’t be painful.

Using a small brush, the doctor might remove a sample of cells from your cervix — called a Pap test. The doctor will also insert a gloved finger into your vagina to check your ovaries, uterus, and other pelvic organs.

The whole exam should take about three to five minutes. Your doctor will let you know if there are any problems with your reproductive tract.