How to Perform a Vaginal Self-Exam

Benefits, Limitations, and Risks

speculum

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While not recommended by medical professionals, some women give themselves vaginal and cervical self-exams. Supporters of these exams say they help women learn what is normal, allowing women to more quickly recognize changes—a way that you can get to know your body better.

Considerations

A vaginal self-examination is a way for a woman to look at her vulva and vagina to better understand her body and to spot problems that may need medical attention. It is not diagnostic since few vaginal diseases can be diagnosed visually.

A vaginal self-exam is not the same as a vulvar examination. When using the term vagina, many people think of the external genitals; however, examining the outside area would be performing a vulvar exam.

Vulvar exams are easier to perform and can detect physical abnormalities that could be caused by genital herpes or HPV. If you see something abnormal on or near your vulva or labia, you should follow up with your doctor for appropriate testing.

A vaginal self-exam should never be considered a substitute for an annual pelvic exam, during which a Pap smear and other tests can detect abnormal changes in cervical and vaginal cells.

Performing a Vaginal Self-Exam

To perform a vaginal self-exam, you will need a strong light such as a flashlight, a mirror, a vaginal lubricant, antiseptic soap or alcohol, and a plastic speculum. Speculums are available at pharmacies that sell medical supplies.

  1. Find a place to relax. This can be the floor or your couch, wherever you can feel comfortable.
  2. Lie back.
  3. Bend your knees, with your feet wide apart.
  4. Lubricate the speculum, and insert it into your vagina in the closed position. Experiment to find the most comfortable position for inserting the speculum.
  5. Once the speculum is inserted, grab the shorter section of the handle and firmly pull it toward you until it opens inside your vagina.
  6. Push down on the outside section until you hear a click while keeping a firm hold on the speculum. The speculum is now locked in place.
  7. Place the mirror at your feet so that you can see your vagina. Move the speculum, while shining the flashlight into the mirror, until you can see your cervix and vaginal walls in the mirror.
  8. Take note of the color of your cervix, as well as any vaginal secretions.
  9. Remove the speculum, after your examination is complete, either in the closed or open position whichever is most comfortable for you.
  10. Thoroughly wash the speculum with antiseptic soap or alcohol and store for your next self-exam.

Some women find it easier to have a friend or partner hold the mirror during the exam. Generally speaking, it is best to avoid self-exams during menses as it may be harder to visualize changes or abnormalities

Limitations and Concerns

There may be many reasons why a woman may choose to perform a vaginal self-exam. It may be to learn more about her own body or to detect changes indicative of ovulation or pregnancy. For example, the cervix may turn a bluish color during pregnancy. Vaginal secretion may thin during ovulation or thicken once fertilization and egg implantation has occurred.

Changes in color and texture can often indicate an infection. Sexually transmitted diseases like chlamydia will often manifest with redness, itching, pain, and cervical swelling. Yeast infections may have a cottage-cheese-like discharge and swelling of the labia.

Despite its potential uses, many health authorities question the benefits of vaginal self-exams. Some experts express concerns that it can lead a woman to assume she is "safe" if no abnormalities are found. Others may self-treat a condition based on an incorrect self-diagnosis.

Even doctors can draw few conclusions from a pelvis exam when used in isolation. Bacterial vaginosis and genital herpes may the only exceptions, but, even so, the exam is only around 39% and 48% effective, respectively, in making the correct diagnosis.

A vaginal self-exam is neither recommended nor effective in detecting cervical cancer or precancerous changes. These can only be detected through Pap screening and other direct diagnostic tests.

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Article Sources

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  1. Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(RR-03):1-137.

  2. U.S. Preventive Services Task Force. Cervical Cancer: Screening. Updated August 2018.