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How to Use a Speculum for Vaginal Self-Examination

A speculum is the device used in gynecological exams for spreading the vaginal walls apart enough to see the cervix. This duck-bill-shaped device enables the person performing the exam to get a clear view of any changes in the cervix, vaginal secretions, indications of fertility, and to identify and treat common vaginal conditions such as yeast, trichomonas and bacterial infections. A speculum is most often used by doctors, but it’s also a useful health tool that can be used by any woman who wants to perform self-examinations and monitor her own vaginal health. Rather than depending on a physician to look at your cervix once a year, you can learn what your cervix looks like day by day and keep your health in check.
To insert a speculum, use two fingers to spread the inner vaginal lips while holding the bills of the speculum tightly together with the thumb and index finger of the other hand. Guide it into your vaginal canal; you can use a lubricant or even water to make insertion smoother. In most examinations the speculum is inserted with the handles upright (which is for the doctor's convenience) but inserting it sideways works just as well, and many women find this more comfortable.

To open the speculum, pinch the handles together. This forces the bills apart and stretches the vaginal walls to reveal the cervix. Hold the handles tightly together and slide the short handle down while sliding the long handle up. You will hear a sharp click, locking the speculum in place. You may want to practice this locking maneuver a few times before actually using the speculum, so you can do it comfortably. Once the speculum is locked, your hands are free to hold a mirror and a light, such as a gooseneck lamp or flashlight. When using a flashlight, shine the beam into the mirror to reflect the light onto the cervix.

You may not be able to see your cervix right away, and it may take several tries to get a clear view. If you don't succeed on the first try, adjust your body a bit; moving your pelvis a little will sometimes bring the cervix into view. Try lying on a perfectly flat surface; a tabletop or the floor both work well for self-exams. When you see the cervix it will look like a round or flattened knob (between the size of a quarter or 50-cent piece) in the shape of a fat donut with a hole or a slit in it. This small hole is called the cervical os. Menstrual blood and uterine secretions pass through this opening, and so do babies during childbirth.

Your cervix might appear pink and smooth, uneven and blotchy, or may even have a few reddish spots. The variations in appearance have nothing to do with sex drive, your size, or whether or not you have had children. Do the exams regularly so you can spot marked changes at unusual times in your menstrual cycle. Get to know your body's rhythms and the ways in which your cervix changes throughout your cycle, and if you notice changes notify your doctor right away.