During a vaginal exam, a woman examines her external genitals (called the vulva), vagina, and cervix. See an illustration of the external genitals or cervix.
A vaginal self-exam helps you better understand your body, know what is normal for you, and find early signs of infections or other abnormal conditions that might require medical attention. Some infections, such as sexually transmitted diseases (STDs), are treated most successfully if they are detected early and treated immediately.
A vaginal self-exam is done using a mirror, a light, and an instrument (called a speculum) that has blunt, curved blades. The speculum is used to gently spread the walls of the vagina so the cervix can be seen.
The best time to perform a vaginal self-exam is between menstrual periods. A vaginal self-exam should supplement, but not replace, a regular pelvic examination and Pap test done by your health professional (see the medical test Pap Test).
Why It Is Done
A vaginal self-exam can be done to:
* Help you learn more about your body and what is normal for you.
* Help you identify vaginal sores, abnormal discharges, or other abnormalities (such as genital warts).
* Help locate the string of an intrauterine device (IUD) if it cannot be felt.
* Note changes in your cervical mucus as part of fertility awareness. Fertility awareness can help you determine the timing of sexual intercourse to help you either become pregnant or avoid pregnancy. For more information, see the medical test Fertility Awareness.
How to Prepare
To perform a vaginal self-exam, you will need:
* A small flashlight or gooseneck lamp.
* A handheld mirror, preferably with a long handle.
* A vaginal speculum, so you can view your vaginal walls and cervix. A speculum is a small, handheld instrument with two curved blades that open outward. It can be made of metal or plastic. A metal speculum is more expensive than a plastic one. Speculums (or specula) come in small, medium, or large sizes. Most women can comfortably use a medium size. However, if you have ever been told by a health professional that you have a deep or hard-to-find cervix, you should consider trying a large size. Ask your health professional to recommend the best size for you. Specula are available at most pharmacies that carry medical supplies.
* Vaginal lubricant, such as K-Y Jelly.
* Antiseptic soap or rubbing alcohol.
* Warm water.
How It Is Done
Remove your clothes and underwear and expose your genital area. Have all the equipment arranged so you can easily reach what you need. Sit on a firm surface (floor, bed, or couch) and support your back with pillows. Bend your knees, set your feet well apart, and lean slightly backward.
Hold the hand mirror in front of your vagina and identify the major features of the external genitals, including:
* The outer and inner fleshy lips of the vulva (called the labia).
* The bump of tissue covered by a hood of skin at the front of the labia (called the clitoris). The clitoris is the main area that is stimulated during sexual activity.
* The opening of the urethra.
* The opening of the vagina.
* The opening of the anus.
If you are using a metal speculum, warm it first by placing it in warm (not hot) water. Lubricate the speculum with a vaginal lubricant (such as K-Y Jelly) or warm water to make its insertion smoother and easier. Hold the speculum handle with the blades closed. Make an effort to relax your vagina and abdominal muscles. Using the fingers of your other hand, spread apart the vaginal lips. With the handle of the speculum facing toward either leg, gently glide the closed blades of the speculum into the vaginal opening, aiming for the small of your back. If inserting the speculum is painful, stop and wait a minute or two before trying again. When you have inserted it up to the base of the blades, turn the speculum so that the handle is facing upward and gently open the blades.
When the speculum is positioned in your vagina and open, shine the flashlight or lamp into the mirror so the light reflects into your vagina. You may want to get help with this part of the test from your partner or a friend. Adjust the light, mirror, and speculum until you can see clearly into the vagina. You should be able to see the reddish pink walls of the vagina, which have slight folds or ridges known as rugae.
Note the vaginal discharge. A normal discharge usually is clear to cloudy-white, smells slightly acidic (like vinegar), may be thick or thin, and changes slightly throughout the menstrual cycle. For more information, see the medical test Fertility Awareness.
At the back of the vagina, you may also be able to see the cervix, which appears as a rounded “doughnut” about 1 in. (2.54 cm) in diameter with a hole or slit in the center (the cervical os). It should look pink and wet. See an illustration of the cervix.
If you are pregnant, your cervix may have a bluish tint. If you are breast-feeding or have gone through menopause, your cervix may appear pale.
The cervix is often difficult to locate. Try moving the speculum in or out a little, or slightly to the right or left, until the cervix comes into view. Do not be discouraged if you cannot see the cervix on the first try. Take the speculum out and try locating your cervix by placing a finger into your vagina before reinserting the speculum. Locating the cervix gets easier with practice.
Once you locate the cervix, lock the speculum in its open position. Using the light source and the mirror, spend a few moments examining the cervix and the vaginal walls.
When you are finished, unlock the speculum but keep the blades slightly open to avoid pinching the vaginal walls, and slowly withdraw it. Clean the speculum with warm soapy water or rubbing alcohol and store it for later use.
How It Feels
When you insert the speculum, you may feel some pressure or mild discomfort. Try to relax your vaginal and abdominal muscles as much as you can. If you have a vaginal infection, you may experience pain or irritation. If you use a metal speculum, it may feel cold and hard. In some cases, you may have a small amount of vaginal discharge or bleeding after the test.
There are no risks associated with a vaginal self-exam.