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The 21st-century speculum aims to put women’s comfort at the forefront of pelvic exams

Spoiler: this one won’t be made of metal

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By Lily Peschardt on

In the 1840s, British colonists arrived in New Zealand, the first-ever postage stamp was invented, Jane Eyre was published and the safety pin was patented. And while New Zealand, stamps, Jane Eyre and the safety pin all have their role in our lives today, a San Francisco-based design firm, Frog, is questioning whether another 1840s invention, the speculum, has a place in 21st-century gynecology. The speculum is the device that doctors use to open your vagina, which looks like a duck, only, unlike real ducks, the mere sight of it is enough to make your Kegel muscles contract. Frog has begun a new program, Yona, that aims to completely change the way women experience pelvic exams. While their ideas for an updated speculum are still in the design stage, they have also drawn up new guidelines for physicians on how to make patients feel more comfortable and have designed a mock-up of an app that lets patients fill out forms, asks questions or follow guided meditations before their pelvic exam.

The speculum – made up of two metal blades that hinge open and closed with a screw mechanism, so that a doctor can view a woman’s cervix – was invented by the American physician James Marion Sims, who used the speculum to pioneer treatments for fistula and other complications that arose in childbirth. It bears noting that his experiments were often conducted on female slaves who weren’t given any form of anesthesia. And in light of that, it seems safe to deduce that Sims had very little concern for his patients’ comfort. And yet this is the design that still dominates doctors’ surgeries all over the world, the only small change being that some of them are made with plastic and others with stainless steel.

The fact that the device’s design is old isn’t in and of itself a problem, but the fact that the device has limitations for doctors and makes patients feel uncomfortable is

The fact that the device’s design is old isn’t in and of itself a problem, but the fact that the device has limitations for doctors and makes patients feel uncomfortable is.

In 2014, 4.3 million women were invited to have a pap smear in the UK but more than 1 million never made an appointment. The reasons for this are varied, but one line of thinking is that women want to avoid the discomfort and embarrassment associated with pelvic exams. It’s not hard to understand their reasoning – when the team at Frog started researching the project and coming up with ideas, they listed everything that they hated about gynecological exams. Wired explains: “There was the noise (like a can opener), the temperature (freezing cold), the feeling inside (as if someone was stretching your insides like a rubber band). When they acquired a set of specula, one plastic and one metal, they realized they needed to change the aesthetics too. These things looked like medieval torture devices.”

The team at Frog has seemingly experimented with every design possible, they looked into new types of opening mechanisms, they considered new materials (no one should be putting metal near their most delicate and sensitive body parts) and settled on silicon – a material that won’t get cold, can be easily sterilised and prevents tissue in women’s vaginal canals from being damaged. They experimented with using three prongs instead of two, they shrunk the device to the size of a tampon and they borrowed design ideas from vibrators.

While they haven’t settled on the final design, in the last decade or so there have been other attempts to update the speculum, but none have taken off. For Frog, the most complicated part of this project might be in getting doctors to actually adopt the new tool. Gynaecologists have been using the speculum for over a century and, technically, there’s nothing wrong with the device, even if causes women discomfort. But Frog is aiming to take into consideration women’s experiences of a pelvic exam and it’s nice to know that there’s a company out there that is taking women’s comfort seriously.

@LilyPesch

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