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Learning How to Use a Speculum

It's easy to learn to use a speculum, and can be a very useful tool to aid you in learning when you are fertile. If you have never seen your cervix before it's definitely worth taking a peek. Next time you go in for a pap smear ask you health care provider if you can take a look.

Or you can do it in the comfort and privacy of your own home, all you need is a mirror, a flashlight and a plastic speculum. The hardest part may be locating a source for speculums (see below for ordering info) Plastic ones are easier to operate, although you can learn to use either plastic or metal, and plastic is not cold like the metal ones are. At the doctors office they mostly use the metal ones, which they keep on a heating pad or rinse in warm water before inserting.

Find a comfortable place, on a bed or a couch with your feet on the coffee table. Give yourself plenty of time so that you don't feel rushed. Finding your cervix for the first time can be challenging, if it gets fustrating, try again later, every woman can find her own cervix with a little practice.

Before inserting the speculum for the first time, practice operating it. Squeeze the handles together, and the bills open. To lock the blades into place, the long handle slides up and the short handle slides down. The speculum will snap into place, you will hear a click, and the speculum is locked open. Then to close it do the opposite, push down on the long handle and up on the short one, you will hear another click and the handles will separate and the bills will close. Practice this a few times to get the hang of it before you insert it.

Insert the speculum in the closed position When you feel comfortable with how the speculum works, undress the lower portion of your body and make yourself comfortable in a semi-reclining position. Lubricate the bills of the speculum with a little olive oil or ky-jelly (don't use petroleum jelly). With the bills closed gently ease the speculum inside the vagina, as far as it will comfortably go, with the handles pointing up. Gently open the blades by squeezing the handles together and locking them open as described above.

Once locked open it should stay in place while you reach for the mirror, if it feels like it might slip out, keep one hand on the handles as you reach for the mirror and flashlight. Hold the mirror between you legs and point the flashlight into the mirror and angle it so that the reflected light shines up inside to the back of the vagina. You should be able to see the pink walls of the vagina around the edges of the speculum.

For me, It always felt like if I let go of the speculum it might pop out (not a pleasant experience if the bills are locked open) so I would use a very small mirror and would keep a finger on the speculum and hold the mirror with the remaining fingers, in my other hand would be the flashlight, sounds like a bit of juggling? It's not that bad, just experiment and find what works best for you. If you open the speculum two clicks you may not experience this problem. I only opened it to the first setting.

Once inserted, use the reflected light in the mirror to see your cervix Now look to the very back of the vagina, can you see your cervix? If not, wiggle the speculum around a little bit, or try pulling up or bearing down with your stomach muscles. This will sometimes pop your cervix into view. You can also gently, and slowly turn the speculum a little bit. If it still does not pop into view, take the speculum out, by unlocking it first and closing the bills. You can put a finger inside and see if you can feel it, it will feel like the end of you nose. Then reinsert the speculum this time attempting to aim for where you felt it.

If you still have difficulty locating it, try inserting the speculum with the handles pointing down. This way the handles of the speculum will be a little more difficult to grasp and operate, but when you do get the speculum open and locked into place, because this is the way they were made to be operated your cervix should clearly be in view. If not move the speculum around inside you a little and see if it will pop into view.

Remember - the first time you attempt to locate your cervix will be the most difficult. If you get frustrated, take a breather and try again later.

A cross section of a woman's body with a speculum inserted Seeing your cervix for the first time is exciting, at least it was for me. Such an important part of our anatomy which is not seen by most women. Most women have no idea what their cervix looks like. If someone asked me what a cervix looks like, I would have to say that I think it looks like the tip of a penis (forgive me for saying so, but it really does!) It is rounded and firm with a small opening in the center called the os (pronounced like "toss" without the 't'). This is the entrance into the uterus. This is where the sperm makes their mad dash, if they can get inside that little hole they are safe from the harsh environment of the vagina.

If a woman is fertile, there will be fertile mucus at the os, to guide the sperm in, if she is not fertile at this time the sperm meets an impenetrable barrier of infertile mucus which they cannot make their way through, and they die in the natural acidic environment of the vagina.

This tiny opening is also the same opening where a baby is born through. The os has to open up, dilate, to a size where the mother can push the baby's head through. Its hard to imagine something so small can open so much.

Each month, the os goes through changes that can be observed by a woman who uses a speculum, these changes can also be felt if she inserts a finger into the vagina, but this takes more practice, so lets focus on observation first. After menstruation and before ovulation the os is closed but as ovulation approaches it begins to open, fertile mucus spills from this opening into the vagina (for more info on mucus observation). As ovulation occurs the os is at its most open point. When ovulation passes, and the os closes up tight, and mucus consistency and texture change dramatically, the fertile time for this cycle has passed. Once ovulation and signs of fertility pass the rest of the cycle is non-fertile and there is no danger of conception taking place.

The os will remain closed until menstruation begins where it may open slightly to allow the menstrual blood to pass. Then the cycle repeats. For more a more in depth look on cervical changes.

Now, the last thing you should know about speculums is that they come in three sizes, narrow, medium and long. Most women can use a medium sized speculum comfortably.

How can you determine what size speculum you need? There are a couple of ways, if you go for a pap smear, ask your health care professional what size speculum is being used. Some clinics even use plastic speculums, if so ask if you can keep it after the exam, as they throw them out anyway.

You can attempt to determine your correct size yourself by using your fingers. How many fingers can you insert into your vagina comfortably? If only one - use a narrow speculum. If two or more fingers will fit comfortably, use a medium sized one. If you are unable to reach your cervix with your finger tips at all, first, where are you in your cycle? Are you fertile? ovulating? During ovulation the cervix rises up higher inside the body. Wait 5 days then try again. If you still can't reach your cervix (which will feel rounded, and like the end of your nose) then try a long speculum. Most women use a medium size speculum. If you are unsure of the size get a couple different sizes. Plastic speculums are pretty cheap, this way you'll be able to experiment and see what works best for you.

Its Ok to Peek - Feminist Women's Health Center
Further reading:
A New View of A Woman's Body: A fully Illustrated Guide

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