Ever wondered how specialists examine your vagina, take smear tests and swab tests for STIs? Heard of vaginal speculums but not sure what they are? Dr HANX tells us all we need to know..

What is a speculum?

A device used to open the vaginal walls and visualise the cervix (the neck of your womb) and your vagina. They can be made of metal or plastic and can be of varying sizes. The most commonly used speculums have two arms if you like (not in a scary way, but two sides that open up!) and the opposite end has a screw to hold the two arms in place when opened.

What are they used for in surgeries/hospitals?

They are mainly used to visualise the cervix, to inspect for abnormalities such as masses, polyps (little benign outgrowths of tissue) infections or bleeding/ discharge. They allow specialists to view the cervix to remove any blood clots or products of conception during miscarriages, or review any changes in the neck of the womb during pregnancy or labour. Specialists use speculums during some gynaecological surgery procedures, such as vaginal hysterectomies or prolapse surgery. They are useful to gain a good view of the vagina and cervix, as well as gaining better access to manoeuvre the uterus if needed.

How do speculums work? 

They work very simply to open the vaginal walls. Firstly the speculum is lubricated with water or lubricant, then inserted (with the speculum closed) into the vagina. The speculum device is then opened, so opening the vagina and viewing the cervix. Once examination is finished, the speculum is removed gently, avoiding trapping the vaginal walls on removal.

Why are sepculums useful to have at home?

Most women have not seen their own cervix, and by having a speculum (and mirror) you can have a look. A lot of the time this is mainly through curiosity. And it is not a bad thing to get to know your body! However, it’s important not to use a speculum in replacement of seeing a doctor or nurse. If you’re pregnant, it is not a good idea to use speculums yourself, nor if you’re worried about infections or masses. It can cause unnecessary anxiety if you don’t know what is normal or how to use the speculum.

How can I use a speculum at home safely?

Do not use a speculum instead of going to see a specialist, as you may not always know what you are looking for. In order to use a speculum for self-examination you will need a mirror and torch. Find a calm place, as you need to relax as much as possible to ensure your muscles are not tense. Lie back and bend your knees, bringing your heels into your bottom and then flopping your knees out to the side. Then insert the speculum using lubricant and open the handles to open your vaginal walls.

You can keep the arms of the speculum open by screwing the speculum into place. Move the mirror and torch/light until you visualise the neck of your womb clearly. Sometimes women can have difficulty visualising their cervix due to discomfort or positioning of the womb, so don’t worry if this is you! Some women find it helpful doing the examination with a partner for ease. You can remove the speculum with the arms open or closed, whichever you feel most comfortable.

Remember, the professionals do this day in and day out, so nothing shocks them! Every vagina and cervix is different and every woman has different story so nothing is “normal.” Performing a vaginal self-exam is neither recommended nor is it valuable for detecting any abnormal cervical cells that are found in smear testing. So, make sure you attend your smears to pick up any signs of pre-cancer of the cervix. Self-examination doesn’t substitute specialist review.