Speculum Speculations


Earlier this week I was skewered by the tool of the patriarchy. By which I mean, a very well meaning and elderly nurse impaled me with the cold plastic instrument of torture that is the speculum and took a sample of my cervix. You hear about your first smear test when in school, that at the magical age of 25 you become a real woman with possibly abnormal cervical cells and thus must offer up your vagina to the sterilised brush of the smear test . I thought I would write a little piece about what it’s like to encounter the speculum, as the only information I can ever find seems to drip down from mumsnet attached to the constant drivel that nothing gynecologically compares to pushing five million wailing brats out of your capacious vagina. As a woman who hasn’t and may not ever have children (shock horror) I get tired of hearing advice from ladies whose labia dangle below the knees and wax on about missing the days when Tena lady didn’t line their silk panties. I’m not trying to dismiss these women but it would be helpful if every time I Google “what to expect from a smear” the comment boards weren’t occupied with their crap. As a woman with no experience of giving birth and who regularly exercises her kegel muscles for optimal vaginal tightness (I regularly practice lifting things with my vagina, I can even carry my shopping) I figured it would be nice to get some advice from someone with a vaginal canal that doesn’t resemble the channel tunnel.

So the first time I encountered the vaginal sperlunking tool that is the speculum was when I decided to get the mirena coil popped in prior to my solo adventure around South East Asia (condoms can break and I didn’t quite fancy asking for a morning after pill in Vietnam). At the late age of 23 the coil was the first gynecological experience I had ever received, a sort of baptism by fire if you will. I remember the process (now over a year and a half ago) vividly. They ask you to try and book your procedure during your period as the blood acts as a natural lubricant and your cervix is naturally a bit more open at this time allowing for your womb lining to gush freely and the coil to insert easily. I had stupidly not been given this advice so booked my procedure a week prior to my due day. I had read online that ginger and parsley tea acts as a natural stimulant which can bring on an early period so had been chugging it by the gallon (one website I stumbled across even suggested sticking a bunch of parsley up your vagina…). The morning of the procedure I awoke like an excited child at Christmas to see that my period was early. It’s amazing what herbs and willpower can do.

Anyway, onto the procedure itself.

Guided into a fluorescent examination room I had specifically decided to wear a long flowy dress so I could cover at least some of my modesty whilst being told to hike up my knees and lie spread eagle on the bed, vagina facing the world. As my doctor (apparently being a female over the age of fifty is a mandatory requirement for a gynecological encounter) gloved up and made small talk whilst the nurse organised her tools several thoughts were running through my head:
a) this woman is the first person to finger me in months.
b) I wonder if anyone has ever orgasmed from an examination…
c) I hope the speculum isn’t that awful, the only encounter I’ve had with the speculum is reading Luce Irigaray’s Speculum of the Other Woman  and that wasn’t an easy read.
d) why does the nurse keep looking at me with pity?

I was told to expect a series of sensations, first something cold (the application of the medical lube) then some pressure (in goes the plastic duck beak) then a bit of stretching but nothing too uncomfortable (quack quack goes the duck). Then they would attach the clips which would feel like a small pinch (just opening your cervix darling, yes that bit that feels like a punch to the womb if your partner’s penis is long enough to accidently stab your insides) and finally some more pressure which hopefully wouldn’t be too painful and would just feel like a cramp (in goes the coil up the cervix).

The lube was definitely cold, the gloved hand squeaked against my thigh as my doctor pressed my stomach to make sure my cervix was in the correct position. As she was making small talk about the weather I saw the speculum come out of its wrapper and get a quick once over with the lubricant. The only things that had ever previously entered my vagina were warm body parts, the sensation of this hard plastic tool sliding in made me feel uncomfortably full (pro tip, the over full feeling can make you feel like you’re going to have a shit on the table, go to the loo before hand to avoid fecal defecation) the discomfort of it meant I had to concentrate on not automatically tensing in an attempt to push it out. The opening of the beak only increased my innate desire to clench and squeeze, in a vain attempt to expel this foreign and unwanted object. Once opened my doctor took a good look at my shiny pink cervix, gave me a small pat on the thigh and told me to prepare for the insertion of the coil.

“Just try not to move it will all be over in a few minutes”

I was feeling confident up until the moment the nurse drew up a stool and sat next to the bed, took my hand, and squeezed. As she gazed at me with a maternal air I understood her previous piteous glances.

This was going to hurt.

She rubbed my shoulder and told me to squeeze her hand if it hurt, that I had done so well up until now and it would all be over soon. (Being called a good and brave girl with accompanied shoulder strokes I felt a bit like a dog who had just been told they’re on an unexpected trip to the vets.)

The clips were cold and felt less like a pinch and more of a punch, the sheer unnatural sensation of my cervix being forcibly widened was enough to have me cutting off the circulation in my poor nurse’s hand thanks to the vice like grip I was exerting. However the party had only just gotten started. It’s difficult to remember exactly what the feeling of the coil being pushed in felt like, but I remember thinking the word “violation” felt apt. My womb protested almost instantly and proceeded to cramp like there was no tomorrow. It took all of my power not to snap my legs shut and roll into the foetal position and call my mother.

It was done.

The only thing left to do was to remove the speculum and wait for my blood pressure to return to normal. Saying that however, the removal of the speculum was perhaps the most painful part – I have no idea why, I’ve been assured by many people that it isn’t normal to have such a hamfisted technique of basically tugging it out at an odd angle and hoping for the best. Lucky me.

Now this really isn’t supposed to sound like a horror story, my medical providers were professional and supportive throughout the procedure, and the next few hours after the insertion merely felt like an especially bad period. ( Note: I then bled constantly for 28 days, they mention irregular bleeding as a side effect, apparently constant bleeding also counts as irregular, just FYI).

Despite the utter pain and discomfort of the insertion procedure I love my coil and would have it done again. I don’t have to worry about contraception for 5 years (I’m now in a stable relationship having both had STD checks so don’t use condoms) and my once disabling heavy periods have calmed down to such an extent that I no longer buy super jumbo extra absorbent tampons and do well with just a panty liner. RESULT!

On the back of the mirena the smear test was a mere walk in the park. The speculum is never going to be comfortable, though perhaps running it under the hot tap for a minute would decrease the discomfort, or maybe even making one with silicon jelly rather than cold hard plastic would improve the experience. The brush they use to tickle and scrape (yes scrape, that’s what the NHS website states the tool does) again feels odd and unwanted but is over relatively quickly. Usually you are provided with a tissue to wipe away the remaining medical lubricant before putting your underwear back on (I was not given one after my smear, and ended up staining a nice clean pair of underwear). The whole process takes around 5 minutes and hey what’s a bit of discomfort over the reassurance of a healthy cervix.

Every medical professional I’ve encountered during dealings with my lady bits has been wonderful, they are supportive and well informed and happy to answer any questions. However the fact that you feel like you’re chatting to a well meaning aunt when they’re busy penetrating you with a hard plastic tool is never something you’re going to be fully comfortable with.

I vote that we invest in designing new forms of the speculum, if women are happy to mount large thick plastic objects in their homes because they’re made of a more comfortable and giving material, surely we can transpose this into our gynecological tools. This isn’t to make the exam pleasurable, we don’t want ladies running to their nearest GP for a bit of doctor-fantasy-fun but it would be nice not to clench and cringe at the sight of a plastic or metal duck beak.

The image of Wonder Woman wielding a speculum to beat down the patriarchy is one that I love. With so much happening in terms of governmental control over women’s sexual health (take a look at any of the recent issues over Republican’s increasingly invasive policies over  women’s health in the USA) women need to start rethinking the way they deal with sexual health and whether discomfort really is key to a healthy vagina.