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Vaginal and Cervical Self-Examination
Vaginal and cervical self-examination is one of the most useful health tools a woman can have. It enables us to see a vital part of our anatomy which is hidden from plain view-the vagina and cervix (the neck of the womb). By using a speculum, you can observe changes in your cervix, secretions, the menstrual cycle and indications of fertility; you can identify and treat common vaginal conditions such as yeast, trichomonas or bacterial infections (which often cause itching or discharge); and you can learn what your cervix looks like day by day, rather than depending on a physician to look once a year to pronounce what is normal for you.


2-1 A woman inserting a speculum

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To insert a plastic speculum, spread the inner lips of the clitoris with two fingers of one hand, hold the bills of the speculum tightly together with the thumb and index finger of the other and guide it into the vaginal canal. You can use a water-soluble jelly or just plain water to make insertion smoother. This woman is inserting her speculum with the handles up- right, but some women prefer to insert it sideways initially. Inserting the speculum with the handles down is strictly for the doctor's convenience, and it requires that a woman put her feet into stirrups at the end of an exam table.
 

 
2-2 A woman opening a speculum

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When the handles of the speculum are pinched together, they force the bills open, stretching the vaginal walls and revealing the cervix. With the handles held tightly together, the short handle slides down and the long handle slides up. When there is a sharp click the speculum is locked into place.

2-3 A view of the cervix in a mirror

Click for larger pictureWith the speculum locked, both hands are free to hold a mirror and a flashlight or gooseneck lamp. If a flashlight is used, the beam shines into the mirror and it will, in turn, be reflected into the vagina, illuminating the vaginal walls and the cervix. The cervix won't always pop instantly into view. Sometimes you have to try several times. If it stubbornly refuses to appear, you can move around or jump up and down a few times. Sometimes it is also helpful to move to a firmer surface, like the floor or a tabletop. When the cervix is visible, you can see a rounded or flattened knob, between the size of a quarter and a 50-cent piece, like a fat doughnut with a hole or slit in it. The hole, called the cervical os, is where the menstrual blood, other uterine secretions and babies come out. Your cervix might be pink and smooth, or it might have a few reddish blemishes. It can also be uneven, rough or splotchy. In any case, the only time to worry is when abnormal cells are found in a Pap smear.
View pictures of women's cervixes
29 years old, Menstrual Cycle
46 years old, Menstrual Cycle
19 years old, Menstrual Cycle
Order your own Speculum or a Speculum Kit.
 
Go to website Women's Health in Women's Hands to learn more about self-help.
Go to the Beautiful Cervix Project's website for more pictures of the cervix.

To purchase a copy of A New View of A Woman's Body, visit our shop books section.