Pelvic exams are integral to women’s health and often require a speculum. This device allows for a thorough examination of the vagina and cervix during a gynecology exam, helping your doctor assess your reproductive health.
Made from metal, plastic or medical-grade polymer, speculums come in different sizes to accommodate individual anatomical differences. Ensuring your provider uses an appropriately sized speculum can alleviate discomfort and support a more accurate exam.
Learn how to determine the right speculum size for your body to create a less invasive, more comfortable exam during your next obstetrics and gynecology (OB/GYN) visit.
What is a Speculum?
A speculum is a medical instrument used in a woman’s gynecology exam, typically during annual visits for Pap smears. Invented by J. Marion Sims in 1845, the speculum gently opens the vaginal walls, allowing doctors a clear view of the cervix and surrounding tissues.
Speculums usually consist of two main parts: the blades, which are inserted and then gently expanded and a handle for control. Most designs also use a screw mechanism to lock the blades in place once inside the vaginal canal. Although they vary in size, the average speculum is around 4” long.
During physical exams, the speculum tool allows healthcare providers to collect cell samples and inspect the health of the vaginal and cervical areas. This helps detect abnormalities or issues, such as sexually transmitted infections, cervical cancer or non-cancerous polyps.
Do Speculums Come in Different Sizes?
Speculums come in various sizes to adapt to different anatomical needs and help patients feel more comfortable during a gynecological exam.
- Pediatric or small. This size, averaging about 3” x .75”, is typically used for patients who have not given birth or who have a smaller vaginal canal. Its smaller dimensions help minimize discomfort during the exam, making it a suitable choice for young adults or those with a more petite anatomy.
- Medium. The medium speculum is the most commonly used size, around 4” x 1.5”. It’s designed to comfortably fit most adult patients who have given birth vaginally, offering a balance between ease of examination and patient comfort.
- Large. The large speculum measures about 4.5” x 1.5”. It's used for patients who need a wider opening for a thorough examination, often recommended for individuals who have given birth multiple times or have a wider vaginal canal, ensuring adequate visibility and access for the healthcare provider.
- Extra large. Averaging 6” x 1.5”, the extra-large speculum is tailored for those who need a larger size for comfort during their exam. It’s designed to ensure a thorough and comfortable examination for all patients.
- Slim. Newer, disposable speculums like the Nella offer a slimmer option – about the width of a narrow tampon, compared to traditional speculums like the Graves and Pederson, which are typically around 1.25” to 1.5” wide. This is ideal for those who might find standard sizes uncomfortable, providing a more gentle and less invasive experience during the exam.
How Does Your Provider Choose the Right Speculum for You?
When it comes to choosing a suitable vaginal speculum for you, providers consider several factors to ensure the comfort, safety and effectiveness of the gynecological examination. Here’s how your doctor will choose the right speculum for you:
- Anatomy. Your doctor will assess your anatomy, such as the size of your vaginal canal. For example, they may select a slim or small speculum if you have a narrow vaginal canal.
- Medical history. Your past medical and gynecological history influences your doctor’s decision. For instance, if you have a history of vaginal deliveries, they may use a larger, broader speculum.
Purpose of the exam. The specific reason for your exam also guides the choice. Routine Pap smears often require a standard size, but more detailed examinations or procedures might necessitate a speculum with light for better visibility in the exam room.
- Comfort and sensitivity. If previous exams have been uncomfortable for you, your provider may consider using a smaller or more slender speculum and may apply additional lubrication for easier insertion.
- Age or sexual history. Smaller models are less invasive and suited for those who have not had sexual intercourse. Also, if you’re young and it’s your first visit to the gynecologist, you will be more comfortable with the pediatric model.
- Anxiety level. If you feel anxious about the examination, a smaller, less intimidating speculum might be chosen to ease discomfort and fear. This is especially important in patients with a history of sexual trauma.
- Patient feedback during the exam. Healthcare providers often rely on your direct feedback during the exam. When it’s your turn to be on the exam table, be honest with your provider if you believe a different speculum would help reduce discomfort.
Talking With Your Provider About Nella
Gynecologist anxiety is a serious issue for many patients, preventing some women from seeking necessary care. With nearly 33% of women between 18 and 25 having never visited a provider for a gynecological exam, feelings of unease or anxiety can further reduce participation in their reproductive health.
If you typically feel anxious or experience discomfort during pelvic exams, you can cope with OB/GYN anxiety by taking deep breaths or bringing a friend or family member with you to the appointment. You can also talk with your healthcare provider about using Nella. The Nella is a slim model speculum made of medical-grade polymer, designed with the patient in mind.
Unlike thick stainless steel models, the Nella fits smoothly into your vagina, putting less pressure on your vaginal tissues and cervix. It is also less likely to scrape or bruise due to its ergonomic shape and reduced width.
We offer tips on speaking with your provider about Nella, including conversation starters and product information. Consider bringing our discussion sheet to your next appointment or calling ahead to see about using Nella during the exam.
Prioritize Comfort and Accuracy with the Nella Speculum
Take charge of your comfort and exam accuracy with Nella. If your physician does not already use the Nella, recommend that they join our list of participating providers or order your own comfort kit and bring it to the OB/GYN the next time you have an exam scheduled.
By opting for Nella, you ensure that your wellness assessments are as thorough as they are comfortable. Act now and make your next gynecological exam a more positive experience.