Why are pelvic exams so difficult? Ob-gyns explain.

Anyone who has been screen for any reason. cervical cancer, aka gotten a Pap smear, during a pelvic exam knows how uncomfortable it can be — and the speculum plays a key role in that.

The duckbill-shaped medical device, which has been around for more than 170 years, allows doctors to separate the vaginal walls and “see what’s going on inside the vagina and look at the cervix to obtain a Pap smear or look to see why someone is bleeding,” Dr. Christine GrevesYahoo Life was told by a Winnie Palmer Hospital ob-gyn in Orland, Fla.

It’s part of a routine pelvic exam that includes looking for any abnormalities on the external genitalia, such as the vulva and perineum, and performing a bimanual exam A doctor will examine the size, shape, and position of the internal pelvic organs including the uterus, ovaries, and check for tenderness, pain, or any other symptoms.

However, why is the insertion of a speculum during exam so painful? And why hasn’t the commonly used device been updated in well over a century and a half? Here’s what ob-gyns say — and how to make pelvic exams more comfortable.

Why are pelvic exams with the speculums frequently uncomfortable?

Experts agree that there are several reasons why these exams are painful. The pelvic pressure is created by the opening and insertion of the speculum within the vagina. most-hated featuresAccording to Cedars-Sinai, it is “

Factors such as a woman’s age and her health history can also impact the quality of her life. Ob-gyn: “Speculum devices may be difficult to tolerate for women who aren’t sexually active, or who are menopausal.” Dr. Gil WeissYahoo Life spoke with a partner in the Association for Women’s Healthcare as well as an assistant professor of medical clinic at Northwestern Memorial Hospital’s Department of Obstetrics and Gynecology. The device may be more uncomfortable for some people with certain health conditions.

Vaginal Atrophy is an example of this condition. Weiss explained that vaginal atrophy may be temporary after childbirth or more severe after menopause. He says that atrophy causes tissues to become less flexible, which makes the speculum examination more difficult.

Women who have other conditions, such as vaginismus (involuntary contraction of the vaginal muscles, which can make insertion — whether it’s a speculum, penis or tampon — painful), vulvodynia (chronic pain, burning, or irritation of the vasa) lichen sclerosus (a condition marked by genital skin that’s thin, irritated and itchy) may experience more pain with a speculum exam as well, notes Weiss.

He adds that women who have been sexually assaulted or transgender may experience more pain during speculum examinations.

People who have had trauma in the past may find pelvic exams or having a speculum placed “triggering” and more uncomfortable. Dr. Alson BurkeYahoo Life is told by Dr. Judith Burke, an ob/gyn at UW Medicine. Burke explains that the “intricate” vaginal muscles are difficult to relax. These muscles can become involuntary tense and narrow the opening, causing more discomfort.

How can you make the exam easier?

There are many ways to make pelvic examinations and cervical cancer screenings more comfortable for patients. The first is having doctors explain every part of the exam so that there are no surprises. “It’s making sure patients understand what’s going on and why this part of the exam is needed,” says Burke. Knowing the “Why” can help you understand it.

Weiss agrees. He says that communication with your healthcare provider is key during exams, especially if there are any anxiety or pain. “Slowing your breathing down is always the second step after communication,” he says. Your body will become less tense if your breathing slows down. This is usually a good thing. Weiss suggests that you empty your bladder before you go to the exam, as speculums can create pelvic pressure.

The right speculum is also important. Weiss said that there are many types of speculums. Take, for example: the Pederson speculum This is most commonly used for those who have had sexual relations but have not given birth. The Graves-speculum, on the other hand, is larger and may be more suitable for women with longer vaginal channels, according the Cleveland Clinic. For others, “switching to a smaller-size speculum such as a pediatric speculum” — which is narrower and shorter than other speculums — “or switching to a different type of device may all help,” says Weiss.

Burke says, “It’s all about finding the right shape and size for that person’s body.”

Greves suggests that a lubricant may make the process of inserting the speculum easier. There is some controversy about whether lubricants can impact Pap smear results. some studies Please show water-based lubricants They are perfectly acceptable.

For patients who are feeling nervous about the exam, Burke encourages them to bring a support person — “someone who helps you feel more comfortable at the bedside is great,” she says — or suggests they distract themselves during the exam by watching a favorite video or listening to music to stay calm. She recommends that patients who have had trauma in the past use an anti-anxiety medication. Patients who experience painful pelvic exams can also benefit from a topical numbing cream applied before placing the speculum.

Why haven’t speculums been up-dated in over a century?

Greves points to the fact that the medical device dates back to Roman times. found in Pompeii It can be traced back to A.D.79. The 19th century saw the invention of the modern speculum. It has a dark past. Dr. James Marion Sims — the controversial “father of modern gynecology,” who, starting in 1845, experimented upon enslaved woman without any anesthesia.

Weiss acknowledged that the speculum structure “hasn’t really changed” over the past 170 year.

It’s difficult to improve on the design. Burke believes that the speculum does its job in some ways. However, Burke notes that there is not a lot money for innovation due to women’s health and reproductive issues. She says, “There are areas where it could have been better.”

Weiss states that new devices are now available, and they use different methods of seperating the vagina walls and cervix. However, he claims that none of these devices have gained traction to date.

However, some are trying to change this by listening to both doctors and patients. Ceek Women’s Health Nella NuSpec speculum, for example, has a very narrow bill — about the width of a tampon — and is made out of a “temperature-neutral” material that doesn’t get cold like metal speculums. Some other examples are YonaThe, which is still being designed, uses three silicone coated metal “leaves”, rather than two bills to separate the vaginal walls. It allows for better viewing and reduces pressure. Orchid Spec This speculum is made of 100% sugarcane and does not pinch. It is also silent, so there are no clicking sounds when the speculum opens. Patients can get nervous.

“I truly believe that if there was a new device on the market that was perceived as an improvement for clinicians and more tolerable for patients,” Weiss states, “the old speculum would be abandoned.”

Learn about wellness, parenting, and body image. Who Behind the hoo Get Yahoo Life’s newsletter. Sign up here.