I love my speculum. I absolutely love it. I bought it at a trade show, and one of my friends affectionately dubbed it my “disco witch speculum” because it’s titanium coated, so it’s rainbow which gives it an aura of magic, intrigue, and approachability in a tool that is usually entirely repulsive.
But not mine. Mine is magic.
And it’s mine in that I’ve not had a pelvic exam in the past three years where a speculum other than this one was used. I brought it with me to my family doctor for a pap smear. I used it to teach aspiring midwives and health care supporters about respectful pelvic exams. I used it to demonstrate MVAs on papayas to eager students. I fumbled with it for home insemination experiences with my husband. It’s my speculum. Nothing goes up my vagina or into my cervix without its magic. I’ve come to feel so fondly about it, using it doesn’t scare me anymore. I know its ins and outs, I know it’s knobs and how to best reflect light in it. I know the exact angle for minimum discomfort in my body and I know just how to warm it up right before it’s in me. We’ve developed a relationship, this tool and me. We love each other.
It was a journey to get here. Like most people, my first experiences with speculums were clunky, uncomfortable, and at times downright painful. Most people don’t love speculums. They’re a necessary evil, with a complicated history, that we choose to accept (or reject!) for moments when our cervix needs to be seen by another person, or by ourselves. But it doesn’t have to be this way. You, too, can reclaim this tool! You, too, can love your speculum!
1. First of all: get one that’s yours.
This will involve experimenting. There are actually tons of kinds of speculums out there, and you may need to find the right one for your body.
First of all, there are different materials:
Plastic: usually these are designed to be single-use, and should never be shared between bodies. Some have a receptacle and special battery-pack-flashlight insert that illuminates the whole thing, others are nice and simple. They’re not the greatest on the environment, but they’re really affordable. They’re also always room-temperature, while metal ones are really cold.
Metal: different metals are used, but usually they’re designed to be sterilizable, so they can be used between different bodies when sterilized properly, or repeatedly in one body. They’re usually cold (unless you warm them). They usually have knobs for adjustment and you have to angle light just right to use them properly. They’re better for the environment but a little more expensive than plastic.
There’s also lots of different models:
Pederson speculums are typically narrow, and used for older people, people who have never had vaginal penetration before, or anyone who feels more comfortable with narrow speculums. Sometimes, they are harder to find a cervix with than a Graves below, because they hold back less of the vaginal walls, and require more precise placement.
Graves speculums are wider, and generally recommended for “sexually active” people. It’s often easier to find a cervix more quickly with a Graves speculum, but they may be more uncomfortable.
Collins speculums are unique in that they don’t have the long handles of traditional speculums and have more discreet opening mechanisms. I find they have a smaller range of options (sizes, etc.) when purchasing them, but are a bit less clunky, especially if most of your exams are self-exams.
“Full View” refers to a wider square of vision on the outside, and “Extended View” are often extra long to reach cervixes far far back in the body.
And different sizes:
Pediatric (for children)
Small: I find most adults like the idea of using a small speculum because they imagine it will be narrower, but in reality it just means it’s shorter, so even though it might be less uncomfortable, I often cannot get it back far enough to see a cervix and need a medium instead. So, it could be a good idea if you’re super petite or have a really low cervix.
Medium: I find most adults use a medium speculum, it’s the right length to reach a cervix.
Large: Especially useful for people who have had many babies before, and vaginal walls tend to fold inwards when a speculum is opened, obstructing view, OR for cervixes that are very far back in the body.
Extra Large: I’ve never even seen one of these in practice, but I know they exist, presumably for similar reasons as the large above.
2. Learn how to use it really, really well.
Now, familiarize yourself with your speculum. Practice with all its opening and widening mechanisms, knobs, slides, clicks, until you can maneuver it deftly. Get yourself a good lube, a flashlight, and a comfy bed, and practice inserting it, and removing it, until you can do it in a way that feels smooth and not uncomfortable. Then, practice opening it. Eventually, peer in with your flashlight and speculum and see how easy it is to locate your cervix. For some people, it just pops out easily, for others, it hides and you’ll have to search around with lots of small movements to locate it directly.
If you’re really clumsy at first, try it after a glass of wine, or some moments of meditation, or with your favourite music on, or all of the above. Use deep breathing, and don’t push yourself beyond whatever your limit is that day. You have plenty of time, go slow. Make it something you learn to find as empowering, not painful.
A few tips as you continue to use it: Use plenty of good lube. I like a nice organic water-based one, or coconut oil. Also, as mine is metal, I warm it up wither by running it under warm water for a minute or so, or resting it on an electric heating pad for a few minutes. I find my body has less of a visceral reaction to it when it’s warm. After all your body is naturally warm. There’s a natural recoiling to cold!
3. Insist on using it for all speculum-related activities (including any outside your home!)
Once you’re good at using it, and you feel connected with your speculum, don’t settle for anything less! I’m totally that dork who takes my own speculum to my family doctor for a pap smear. Not gonna lie… she thought I was insane, but at the end of the day I insisted that I could find my cervix more easily and comfortably than she could and if she could just give me a moment, it would actually make her job easier. I’m sure I was the weird story she told for the rest of the week, but hey… I got my pap smear on MY terms with MY speculum so for me it was worth it.
4. Instill magic and thankfulness
I’ve learned to approach my speculum with gratitude and reverence. Before inserting it, I always check it’s knobs to make sure it’s functioning well, and while doing that I always say a little blessing and a little thank you. A thank you for helping me accomplish what I need to accomplish in my body today. A thank you for helping me approach this gently and slowly as I need to. A blessing for ease and comfort. A blessing on why-ever I need to see my cervix that day. I feel it solid in my hands, and I breathe deep.
5. Care for your speculum well
When you’re done using it, thank it for service. Wash it right away, with gentle soap and warm water. If it’s a plastic speculum, they’re meant for one-time use. If you choose to use it more times in your body, make sure you clean it well with soap and water and store it somewhere clean. Washing and use can dull the clarity of clear plastic: I wouldn’t use it more than a few times. If it’s a metal speculum, in the same body, soap and water is likely sufficient. If it’s metal and will be in other bodies, sterilize it by popping it in an autoclave, or boiling it at a roiling boil for 20 minutes. Consider scrubbing any residue off with a gentle brush and tucking it away somewhere contained and clean until next use.