Health Self-Exam for Women How to Examine the Vagina and Cervix Part 1

How to perform a self-exam of the vagina and cervix for woman for their medical and gynecology health.

HOW TO EXAMINE THE VAGINA AND CERVIX

You will need a plastic speculum, directional light (flashlight or gooseneck lamp), and a mirror (preferably long-handled).

Before the exam, do not douche. Douching removes vaginal secretions which are important in diagnosing a possible infection. (Some doctors advise against douching at any time since it upsets the natural balance of micro-organisms in the vagina.) Do urinate. A full bladder presses against the uterus, causing discomfort during the examination.

Manipulate the sterilized speculum until you can open and close it easily.

1. Lie on a firm bed or table, supported by pillows so that you are half sitting up, with legs apart and knees bent (doctors call this the lithotomy position).

2. Using the mirror, examine the outer genitals (labia majora and labia minora--literally, large and small lips) to see that they are not tender or inflamed and are free of sores.

3. Separate the labia and insert the speculum--blades closed and handle pointing up--into the vagina. Press the handle sections together. This opens the blades of the speculum and spreads the vaginal walls. Push the thumbhold of the outside handle section down as far as it will go until it clicks into place.

4. Arrange the mirror and light (if possible, have a friend hold them in position) until you can see the inside of your vagina.

5. If the cervix is not visible, pull the speculum out slightly and push gently in again, aiming a little to the right or left, up or down. Keep searching gently until you find your cervix. Most cervixes are not dead-center, and you may need a little time to locate yours. Its angle will tell you whether your uterus is tilted right, left, forward, or backward.

6. Appearance of the cervix: If you have never had a child, your cervix will be one to 1 1/2" in diameter, pink, smooth, and firm. If you have delivered one or more babies, your cervix and the cervical canal (the opening in the middle of the cervix, called the cervical "os") will be larger and possibly darker in color.

7. Appearance of the vaginal walls: The vagina should be pink and firm with ridges in it, and not sensitive to touch. Its normal secretion is clear or whitish, and will vary in quantity from woman to woman.

8. Changes during the menstrual cycle: During the 1st 2 weeks after menstruation, the healthy cervix and vagina will be pink, firm, and smooth. There may be clear mucus secreted from the cervical canal. Just before the menstrual period, the cervix may be swollen and blue with prominent veins, and the vaginal walls swollen and tender. Vaginal secretions may increase at ovulation or about one week before the period. A woman who takes the time to follow herself daily through a full month will learn the changes normal for her and later may be able to detect an early pregnancy in this way.

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