Down There Care

What Is A Speculum?! Your Pelvic Exam Questions, Answered

By Gabi Powell Jillian LoPiano, MD

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Upcoming pelvic exam giving you a case of the pre-appointment jitters? We get it, Betties! Women’s health can often feel murky with annuals, exams, checkups, and smears (oh my!) not well explained + understood, leaving a Betty in the dark about *why* these are essential for their health and *what* to expect when they head into a GYN appointment.

And that’s why we’re here, to walk you through a pelvic exam, step by step, and go into the details to get you feeling ready for your appointment.

what is a pelvic exam, anyways?

A pelvic is a physical examination to check up on your internal reproductive organs including your vagina, cervix, uterus, and ovaries.


Unlike a Pap test, which The American College of Obstetricians and Gynecologists (ACOG) recommend Betties get every three years after they hit 21, a pelvic exam is made on a shared-decision basis between patient and provider. Meaning, if you have symptoms – like abnormal bleeding, abnormal vaginal discharge, or pelvic pain – your provider may recommend an exam to diagnose the issue. Shared decision-making also implies that as a patient, you are empowered to request an exam from your provider if you feel one is needed!


1. First, you’ll be asked to undress completely and put on a medical gown. When the exam begins, you will lie on your back on the exam table and put your feet into foot holders—aka stirrups—that stick out at the end of the table. You may be feeling pretty exposed and your instinct might be to clamp your knees together. Betties, that’s perfectly okay! Feel free to point your knees inward while you and the provider get set up.

2. Next, you’re going to scoooootcha booty towards the end of the table (Think: a squat position while lying on your back). This position can help relax your pelvic muscles + allow your provider to see your vagina and cervix.


This women’s health *wundertool* is made of metal or plastic with two duckbill-shaped parts. When separated, these “bills” push the walls of the vagina out to allow a provider to see the entire length of the vagina and the cervix at the top.

3. Now you’ll need to separate your knees so they’re pointing out toward the walls. Your provider should allow you to open your knees on your own. No one should ever force your knees open or hold them open.

4. Your provider will place the speculum inside your vagina and open it so they may examine your reproductive organs. You’ll most likely feel some pressure in your vagina + rectum, so take some deeeeep breaths to help relax your muscles.

 we specialize in awkward!

Betties, you may feel like you need to pee, pass gas, or poop—and this is all normal! You’ll likely not do any of those things, but even if you do, just know that it’s okay. Your provider has seen it all!

5. Your provider may take samples from your cervix using a brush that resembles an oversized Q-Tip. This could be to check for sexually transmitted infections (STIs) or abnormal cells (aka Pap test!). If they do, they should always discuss what tests they are doing and why. After swabbing, the provider will remove the speculum.

6. The last part of a pelvic exam is called a bimanual exam, in which your provider feels the uterus by placing two gloved + lubricated fingers inside the vagina with one hand while using the other to press on the lower part of the abdomen. This allows a provider to feel the size + shape of your uterus and ovaries. You’ll likely feel uncomfortable pressure, but it should not be painful. Just keep those deep breaths coming to help you relax, Betties.

7. Alllllll done! *applause*

Betty’s Co. exists to help untangle some of those question marks, so you feel empowered in participating in your health, rather than ghost your GYN health altogether. By simply showing up (literally and mentally!), you’re taking action to protect your whole-self health.


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