What Is a Speculum Exam?

A diagram of the female reproductive system.
A speculum.
Doctors use the speculum to gain greater access to, or more easily observe, the vagina, rectum or other body opening.
A gynecological speculum can be inserted into a woman's vagina during a regular exam.
A speculum might be used to the hold the vagina open for intrauterine device (IUD) placement.
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  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 03 December 2014
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A speculum exam is one method for visualizing the cervix, or opening of the uterus, and the interior walls of the vagina. It is normally performed in context of a total pelvic examination. Though it may sound frightening or very serious, it is generally not an uncomfortable thing, though some women attest to slight discomfort, and the exam usually only takes a minute or two.

There are a variety of specula used in medicine, but the kind most familiar especially to women is the gynecological speculum. They are useful because they can be inserted into the vagina to give a doctor or other health care worker a better view of the cervix and vaginal walls. They are often made of one of two types of material, typically either metal or plastic. The type used by a doctor isn’t significant of anything except personal preference of one material over the other. Specula are sterilized in between uses to prevent the spread of disease.

The gynecological speculum has two arms, which are sometimes call blades. These are not likely to cut the skin, as they are not sharp. However, some women may note a little light bleeding or spotting after a speculum exam.

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The principal reason the blades exist is so they can be adjusted in a speculum exam. This makes the interior of the vagina much easier to see. This adjustment takes place after the closed blade speculum is inserted into the vagina, and the doctor may use a crank or turn that adjusts the blades. The degree to which this usually widens the vagina is not significant, and again not usually painful unless there is injury in the pelvis. Most women would describe the sensation of adjustment as feeling a little strange.

One of the reasons that a speculum exam is called for is to clearly visualize the cervix. If a woman is having an exam that will include a PAP smear (collection of cells to test for cervical cancer), the PAP smear typically occurs when the speculum is in place. Other small biopsies or samples could be collected at this time to test for presence of certain sexually transmitted diseases. A speculum exam may also be used to evaluate the cervix for signs of damage as from injury, to look at secretions of the vagina to determine if they are abnormal, and in some case it may also be used to the hold the vagina open for intrauterine device (IUD) placement.

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angelBraids
Post 3

@Valencia - I know what you mean, although personally I prefer the metal version. It just makes me imagine something that's more sterile for some reason.

When I was in a teaching hospital for a minor procedure I was asked about allowing medical students to practice their speculum exam technique on me. I agreed because I know how important it is for them to learn this kind of thing. (I also made sure to mention that they need to warm the metal speculum before use!)

Valencia
Post 2

Ask any women who's had a gynecological exam which type of speculum they prefer and I guarantee the answer will be plastic! A vaginal speculum made from metal is rarely warmed before being used, and without warning can be quite an uncomfortable shock!

CookieMonsta
Post 1

The term speculum is actually taken from the Latin word for "mirror." (how I remember that from my late-night study sessions in med school is beyond me...) It is used for much more than the common vaginal exam.

It is used for rectal examinations, in the form of the anoscope or sigmoidoscope, to observe intestinal and rectal areas during surgery. Speculums are also common in nasal, aural, and oral exams.

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