Why does a speculum hurt so much? Pain may be a sign that your muscles are overly tense or that you have a condition that's making the experience painful. To prevent pain, communicate your concerns and relevant health information to your provider. Let them know at any point if you're experiencing pain.
The pelvic floor muscles are a group of muscles at the base of the pelvis surrounding the vaginal opening. If these muscles are tight or tense, they can narrow the vaginal opening and cause pain with insertion of the speculum. Relaxing the pelvic floor muscles can help decrease pain during pelvic exams.
Ask to change position
"Slow your breathing down, put your hands by your side, and think about dropping your bottom into the couch. "We might ask you to put your hands underneath your bottom, or we might ask you to cough." That can help the speculum be inserted easier.
It's human reflex to tighten up when we're anticipating that something—like a pelvic exam—will hurt. But when our pelvic floor muscles contract and tighten, it can lead to more pain during the exam. A way to prevent this pain is to 'bear down' during the early part of the internal exam.
Despite how exposed you may feel with your legs in the stirrups, you might be surprised to learn that no matter which speculum you get, it is not holding your vagina open several inches wide. In fact, the opening is only about 2 centimeters wide during a Pap, says Dr. Shirazian.
There are many different physical and psychological reasons why a smear test might hurt or be very uncomfortable. You'll probably find it difficult if you have a condition like vulvodynia or endometriosis, or if you've been through the menopause and you're experiencing vaginal dryness.
Anxiety and fear are common before and during the pelvic examination. In fact, the pelvic exam is one of the most common anxiety-provoking medical procedures. This exam can provoke negative physical and emotional symptoms such as pain, discomfort, anxiety, fear, embarrassment, and irritability.
Speculae up to 4 cm wide and 12–16 cm long are appropriate when redundant vaginal walls prolapse between the bills and obscure the view of the cervix; this occurs most commonly in obese and multiparous women.
The gynecological instrument measures 3-inch by 1/2-inch used by doctors to open the walls of the vagina and examine the vagina and cervix.
Ask for a smaller speculum
Speculums come in different sizes. If you find the standard size too uncomfortable, you can ask to try another size.
Speculum insertion can be associated with considerable discomfort during routine pelvic examination. Physiologically, vaginal entry requires lubrication. However, traditional teaching recommends, if anything, warm water only for lubrication, because lubricants are believed to interfere with Pap and infection tests.
You may feel some pressure or mild discomfort when the speculum is put in and opened. Usually a small spatula or tiny brush is used to gently collect cells from the cervix for the Pap test. You may feel a light scratching when they take the cells, or you may feel nothing at all.
You should always shower with soap before your appointment with a gynecologist to maintain proper vaginal hygiene. However, it is not necessary to shave or wax your pubic area beforehand.
Pelvic Exam Procedure
(You will be given a gown or other covering.) Talk to you about any health concerns. Ask you to lie on your back and relax. Press down on areas of the lower stomach to feel the organs from the outside.
Try using a vaginal moisturiser before your appointment.
You can get vaginal moisturisers from most pharmacies, without a prescription however you can also ask your nurse or GP to prescribe it for you.
Researchers found 17% more women were screened when they had the option not to use a speculum during the exam. Instead, a doctor or nurse could take a vaginal sample without a speculum. Under-screened and unscreened women have the highest risk of developing cervical cancer.
The short answer to this question is, yes, you can be sedated to get a pelvic exam and Pap smear. This is not common practice however, and usually only done when there is suspected clinical concern and a routine exam is not possible.
Sometimes, but not always, gynecologists conduct a pelvic exam, which is usually the most uncomfortable part for patients. A doctor uses a speculum to examine the vagina and cervix and then places fingers of one hand inside the vagina and presses on the abdomen with the other hand.
Specula are about the size of a tampon, made of disposable plastic or sterilized metal, and have no sharp edges. The speculum will be gently inserted into your vagina.
Insert speculum blades into vagina at a 45 degree angle so posterior blade is parallel to posterior vaginal wall. Blades should be held and pressure exerted toward posterior wall of vagina. Avoid pulling pubic hair or pinching labia with speculum.