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Speculum is the Latin word for mirror, with roots in the word specere, which means to look or observe. A pelvic speculum is a medical instrument used to perform a gynecological exam on a woman. It is also referred to as a vaginal speculum because it is inserted into the vagina during the exam. One of the most common types of specula is the bi-valved vaginal speculum which has two blades that separate to allow access to the cervix; this is also sometimes called a graves speculum and shaped like a duckbill. There are also pelvic specula with one blade, three blades, or even no blades, as with the glass specula.
Physicians commonly use both plastic specula and metal specula. Traditionally, a pelvic speculum is made from metal. It is sterilized after each use and can be reused countless times. Some gynecological offices use disposable plastic vaginal specula, which are used only once prior to disposal. Glass specula are less common; they are tubular in shape and contain no moving parts.
During a speculum exam, the woman lies on her back on an examining table, with her knees bent. Her feet may be placed into metal stirrups attached to the table, or she may place her feet directly on the table. The physician inserts the pelvic speculum into the vagina while the speculum is in the closed position. By separating the blades of the vaginal speculum, the physician is able to observe the vagina and cervix. A screw is used to keep the blades separated throughout the exam. A weighted pelvic speculum may also be utilized to enable the examiner to use both hands for other actions, as in surgery.
There are other types of specula besides the pelvic speculum. For example, a rectal speculum may be used during colonic hydrotherapy. A rectal speculum is inserted into the anus so that a small hose can enter the lower intestinal tract for irrigation purposes. Both vaginal specula and rectal specula are commonly used for anal surgery.
An eye speculum is used during eye surgery, such as laser-assisted in situ keratomileusis, commonly referred to by the acronym LASIK. The eye speculum holds the eyelids apart and prevents the patient from blinking. Similarly, a nasal speculum is used to comfortably hold the nostrils open for examination or procedures. Unlike most other types of specula, ear specula are cone-shaped and do not contain moving parts.
@MrsWinslow - I find a pelvic exam when the speculum is plastic is not as painful. The plastic speculums are more lightweight and they don't tug as much.
Also, if you are having annual exams, you may not need them. AACOG (the major professional organization of OB/GYNs) does not recommend annual exams for healthy women. It's every other year from 21 to 30 and then if your last three Paps were all normal, you can do once every three years.
A lot of doctors are still doing Paps (I assume that's what you're talking about, since that the main use for a speculum) every year, but that's just out of force of habit. If your doctor is one of them, tell him or her that you know it's no longer recommended and you don't want it. (Assuming, of course, that you do not have HPV.)
I find my pelvic exams incredibly painful. The weight of speculum just seems to pull on everything and it hurts so bad. I've never seen a doctor who's able to mitigate it at all. Does anyone have any suggestions?
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