A vaginal speculum is a tool that doctors use during pelvic exams. Made of metal or plastic, it’s hinged and shaped like a duck’s bill. Your doctor inserts the speculum into your vagina and gently opens it during your exam.
Speculums come in different sizes. Your doctor will choose the size to use based on your age and the length and width of your vagina.
Doctors use vaginal speculums to spread and hold open your vaginal walls during an exam. This allows them to see your vagina and cervix more easily. Without the speculum, your doctor won’t be able to do a comprehensive pelvic exam.
A pelvic exam helps your doctor assess the health of your reproductive system. It can also help diagnose any conditions or problems. Pelvic exams are often done along with other medical exams, including breast, abdominal, and back exams.
Your doctor will do a pelvic exam in an exam room. It usually only takes a few minutes. You’ll be asked to change into a gown and they may give you a sheet to wrap around your lower body.
During the exam, your doctor will first do an external exam to look at the outside of your vagina for any signs of a problem, such as:
Next, your doctor will use a speculum for an internal exam. During this part of the exam, your doctor will examine your vagina and cervix. They may warm or lightly lubricate the speculum before inserting it to help make you more comfortable.
Organs like your uterus and ovaries can’t be seen from the outside. This means your doctor will have to feel them to check for issues. Your doctor will insert two lubricated and gloved fingers into your vagina. They’ll use the other hand to press on your lower abdomen to check for any growths or tenderness in your pelvic organs.
Your doctor will use a vaginal speculum when you get a Pap smear, a test that checks for abnormal cells in your cervix. Abnormal cells may lead to cervical cancer if left untreated.
During a Pap smear, your doctor will use a swab to collect a small sample of cells from your cervix. This will usually happen after your doctor looks at your vagina and cervix and before removing the speculum.
A Pap smear may be uncomfortable, but it’s a quick procedure. It shouldn’t be painful.
If you’re between ages 21 and 65, the U.S. Preventive Services Task Force recommends getting a Pap smear every three years.
If you’re between ages 30 and 65, you can replace the Pap smear with an HPV test every five years, or get both together. If you’re older than 65, talk to your doctor about whether you still need a Pap smear. If your past tests have been normal, you may not need them moving forward.
It takes about one to three weeks to get results from a Pap smear. Results can be normal, abnormal, or unclear.
If it’s normal, that means your doctor didn’t find any abnormal cells.
If your Pap smear is abnormal, that means some cells don’t look how they should. This doesn’t necessarily mean that you have cancer. But it does mean that your doctor will probably want to do more testing.
If the cell changes are minor, they may just do another Pap smear, immediately or in a few months. If the changes are more severe, your doctor might recommend a biopsy.
An unclear result means that the tests can’t tell whether your cervical cells are normal or abnormal. In this case, your doctor might have you come back in six months to a year for another Pap smear or to see if you need additional tests to rule out any other problems.
Potential causes of abnormal or unclear Pap smear results:
- HPV, which is the most common cause
- an infection, such as a yeast infection
- a benign, or noncancerous, growth
- hormone changes, such as during pregnancy
- immune system issues
Getting Pap smears according to recommendations is very important. The American Cancer Society estimates that there will be approximately 13,000 new cases of invasive cervical cancer and about 4,000 deaths from cervical cancer in 2018. Cervical cancer is most common in women ages 35 to 44.
A Pap smear is the best method for early detection of cervical cancer or pre-cancer. In fact, research shows that as Pap smear use has increased, the death rate from cervical cancer dropped more than 50 percent.
There are few, if any, risks associated with using a vaginal speculum, as long as the speculum is sterile. The biggest risk is discomfort during the pelvic exam. Tensing your muscles can make the exam more uncomfortable.
To avoid getting tense, you can try breathing slowly and deeply, relaxing the muscles throughout your entire body — not just your pelvic area — and asking the doctor to describe what’s happening during the exam. You can also try any other relaxation technique that works for you.
While it may be uncomfortable, a speculum should never be painful. If you start to feel pain, tell your doctor. They may be able to switch to a smaller speculum.
Speculums may be uncomfortable, but they’re a vital tool that allow doctors to give you a comprehensive pelvic exam. This exam helps your doctor check for sexually transmitted infections — including HPV, which is a leading cause of cervical cancer — and other potential health problems.