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.
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.