Visits to the gynaecologist’s clinic, while essential for women, have consistently been an intimidating, and often painful experience for most. A large part of this discomfort is often attributed to the use of the speculum, a medical instrument used to examine bodily orifices, and in this case, the vagina. Companies are now innovating new and reportedly improved designs in speculums used to examine women. Dr Neelam Suri, senior consultant, obstetrics and gynaecology, robotic surgery, Indraprastha Apollo Hospitals, sheds light on these new instruments and their usage, as well as the doctor’s responsibility during routine examinations.
Are new designs like Nella and Lilium available in India and being adopted?
Innovative speculums like Nella and Lilium are generally not widely available in India yet. Nella is a modern, patient-centric speculum you can order online internationally, but it isn’t a common tool stocked by most Indian clinics or hospitals. Lilium, designed by Dutch researchers to be softer and less intimidating, is mainly at a prototype or early development phase and hasn’t reached mainstream clinical use anywhere, including India. In most Indian settings, clinicians still use conventional plastic or metal speculums, though some disposable and slightly more ergonomic models exist locally.
How are these new designs better than conventional equipment?
Newer speculum designs aim to reduce pain and anxiety. For example, the Nella speculum has a slimmer profile, smooth medical-grade material, quiet operation and built-in lighting, which can make insertion gentler and exams quicker and less uncomfortable. Lilium uses soft, flexible materials and a “petal” shape that opens gently and can be self-inserted like a tampon, improving comfort and visibility. Conventional metal duckbill speculums are rigid, cold and can create pressure that many women find painful. These newer approaches prioritize patient comfort and reduce the physical and psychological stress of exams.
What can women do or ask their doctors to ensure more comfortable gynae exams?
Women can communicate openly with their doctor before the exam: ask for a smaller speculum size, request plenty of lubrication, and suggest gentle and slow insertion. If a clinic uses newer, more patient-friendly speculums (slimmer plastic ones), women can ask whether these are available. Women should also discuss any anxiety, past pain or trauma, so the clinician can adapt the approach or provide extra support. If the doctor’s manner isn’t respectful or gentle, women can seek a second opinion or another provider who prioritizes comfort and consent.
Is the onus on the doctor’s manner to provide a less painful examination?
Yes, the doctor’s communication, empathy and technique are crucial. Even with standard equipment, a calm manner, clear explanations, and patience can significantly reduce pain and anxiety during exams. Skillful use of lubrication, choosing the right speculum size, and allowing time for relaxation can make a big difference. However, discomfort can also stem from the tool itself or individual anatomy. So, while innovations help, the clinician’s approach to listening, slowing down, and creating a supportive environment is equally important in ensuring a less painful, respectful experience.