TIPS for how to reduce pain with a speculum exam .

The use of Speculum exams is often used during gynecological screens and examinations to improve visualization. However many women experience pain or discomfort and because of this delay or stop regular screenings and care.

Please know that Pelvic floor physical therapy can help improve pain!

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1. Ask for a pediatric speculum 

• The average length of a speculum is 6.3 inches long, whereas the average vaginal canal is 3.6 inches. Due to these anatomical considerations and past history with any painful examinations or any form of insertion it is always an option to advocate for a pediatric speculum.

2. Insert your own speculum 

• For some individuals who experience pain or discomfort during speculum exams, requesting to insert their own speculum may allow them to have more control over the process. This approach can potentially reduce anxiety and make the examination more tolerable for the patient by allowing the pelvic floor muscles to relax which then allows for control of depth, speed and pressure.

3. Ask for a mirror

• Requesting a mirror during a speculum exam can be helpful for a patient experiencing pain for several reasons:

• Empowerment and Control: Having a mirror allows the patient to see what is happening during the exam. This visual feedback can help them feel more in control of the situation, potentially reducing anxiety and discomfort.

• Education and Understanding: The mirror can provide an opportunity for the healthcare provider to explain the examination process visually. This educational aspect can enhance the patient's understanding of their anatomy and the purpose of the exam, which may contribute to a more positive experience.

• Communication: The mirror facilitates communication between the patient and healthcare provider. The patient can express any concerns or discomfort more effectively, allowing the provider to adjust their approach or provide additional support.

• Increased Comfort: For some individuals, being able to see the examination in progress may make them more comfortable. It can help demystify the process and create a more collaborative and transparent healthcare environment.

4. Utilize lubricants 

• Choosing a lubricant that is hypoallergenic and free from irritants is important to reduce the risk of discomfort or irritation. Here are some clean lubricant options that are often considered:

• Water-Based Lubricants:

• Good for all types of sexual activity.

• Easy to clean.

• Less likely to cause irritation.

• Silicone-Based Lubricants:

• Long-lasting and provide a smooth feel.

• Less likely to cause irritation.

• Not compatible with silicone toys.

• Oil-Based Lubricants:

• Can be moisturising.

• Not suitable for use with latex condoms.

• Examples: Coconut oil, avocado oil 

• Glycerin and Paraben-Free Lubricants:

• Free from potentially irritating ingredients.

• Suitable for those with sensitivities.

• CBD lubricants 

One recommendation is to test a small amount of the lubricant on a small area of skin to check for any adverse reactions before widespread use. 

5. Bringing a friend to your exam 

• Requesting to bring a friend or support person to a speculum exam can be helpful for a patient experiencing pain or discomfort for several reasons:

• Emotional Support: Having a friend present can provide emotional support during a potentially stressful or uncomfortable medical procedure. 

• Emotional reassurance and the presence of a familiar person may help alleviate anxiety.

• Distraction and Relaxation: A friend's presence can serve as a distraction, helping the patient to focus on something other than the discomfort of the exam. Engaging in conversation or simply having someone to talk to can contribute to a more relaxed atmosphere.

• Advocacy and Communication: A friend can serve as an advocate for the patient, helping to communicate their concerns, preferences, or any additional information to the healthcare provider. This can be particularly valuable if the patient finds it challenging to express themselves during the exam.

• Comfort and Trust: The presence of a trusted friend can create a sense of comfort and trust for the patient. Feeling supported may make the experience more tolerable and help build a positive patient/provider relationship.

It's important for patients to communicate openly with their healthcare providers about their preferences and concerns. Healthcare professionals are typically willing to work with patients to make the examination experience as comfortable as possible as well as being educated by your provider can oftentimes reduce the fear and stigma of advocating for your comfort. 

Pelvic PT should be an automatic referral if you have experienced pain with any form of penetration (speculum or digital exams, tampon insertion, penis toys). Pelvic floor physical therapists use different strategies and techniques to reduce tension in the muscles which can improve bladder bowel and sexual function as well as pain free gynecological exams! 

Regular Gyn exams can save our lives! If you are having pain please see a pelvic PT!  

Work with our team of Pelvic Floor Physical Therapist