Pap Series Part 5: Special Speculums

***In order to keep this series light-hearted and easy to read I am not going to quote or site any sources except the knowledge of what I have learned through conferences, school, from pathologists and others who have gone on before me. THIS IS NOT TO REPLACE ANYTHING YOUR DOCTOR/NURSE PRACTITIONER/MIDWIFE/PA etc IS TELLING YOU. This is just some easy to read information*** Part 1 Part 2 Part 3 Part 4

So I have told you how to prepare, what to expect before hand, why we do it, and additional testing but I haven't actually told you what to expect when you actually get that pap smear. Most of you reading this have already had a pap smear so some of this may explain some of the sensations that you have felt, and for those of you who haven't ever had a pap smear, this might clear up some fears that you may have.

A pap smear isn't scary. Okay fine, it shouldn't be scary. It shouldn't be scary but it may be scary if you have a history of sexual abuse, rape, vaginal trauma, a bad or painful pap smear in the past, or you just don't know what is going on or what to expect.

There aren't very many names for this instrument, I have heard a "duck bill," "clampy thing," "the scary metal thing," and that is about all. However, the real name is a Speculum. There are different kinds of speculums, but a speculum is basically the only name for it.

image via wikipedia

A speculum is an instrument that allows us to see inside the vagina so that we can visualize the cervix. A light is either attached to the speculum itself, or positioned in place so that there is a clear view of the cervix.

Sounds simple right? Well, after time it does become simple for a practitioner to visualize the cervix in order to do a pap smear, however, not all anatomy is created equal. The cervix is sometimes towards the top of the vagina (anterior), the back of the vagina (posterior), or it can be towards the right or left sides. None of these positions are bad or abnormal, but if a provider mentions to you where you cervix is, remember it! This way you can tell future providers where to look if they seem to be taking a long time to visualize your cervix.

Example, "I am so sorry it is taking so long for the pap smear Ashley, your cervix is just posterior, and sometimes that makes it hard to see. But don't worry, I found it just fine and the pap smear will be over in just a few seconds."

Now I am starting to get ahead of myself. The speculum, when placed properly, shouldn't hurt you as a patient. There is increased vaginal and rectal pressure... this is sometimes mistaken for pain. So if you start to feel like you are going to "pass gas" "toot" "fart" or whatever, that is normal. Not pleasant, but a normal feeling when having a pap smear.

If the speculum is plastic you may hear a clicking noise as it is locked into place, if it is a metal one then you probably won't hear much of anything. There isn't a big difference between the metal and the plastic, except sometimes the metal speculums are a little colder. If that is the case, hopefully your provider will give you a heads up to that so it doesn't surprise you.

Well, I am not sure how much more I can say about speculums. They aren't fun, but they are necessary for a provider to be able to see your cervix and to collect enough cells for a pap smear.