Cervical Self-Exam

By using a speculum, a mirror, and a flashlight, you can see your own cervix!

Why are cervical self exams important?


Self exam is a empowering way to befriend your genitals and support your health. More than simply seeing what your cervix looks like, self exams can be a tool for self-discovery. They allow you to monitor changes, secretions, variations during the menstrual cycle, and indicators of fertility.

Through self-exams, it's also possible to identify yeast imbalance, a common vaginal condition. A yeast infection is an overgrowth of natural vaginal yeast, which can cause a white, cottage cheese-like discharge and uncomfortable itching. Treatments include garlic vaginal suppositories, yogurt douches, herbal or natural remedies and over-the-counter medications.

What exactly is a cervix?


The cervix is the neck, or narrowed lower end, of the uterus where it extends into the vagina. In the center of the cervix is a small opening, called the “os”, through which menstrual blood exits the uterus, babies are born and pregnancies are terminated.

Several methods of birth control (e.g. Diaphragm, Cervical Cap) place a barrier over the cervix which keeps sperm out. During ovulation, cervical mucous has a distinctive texture and appearance.

 

Self Exams are not Paps


Self cervical exam is not a replacement for regular Pap Smears, nor for screening for sexually transmitted infections (STIs).

When you have a Pap test, the clinician removes a few cells from the os. The cells are sent to a laboratory and examined under a microscope for signs of cancer.

Most STIs cannot be seen during self-exam. Chlamydia, gonorrhea, HIV/AIDS, hepatitis and other STIs can only be identified by a clinician and require prescription medication.


3 Easy Steps to Self Exam


What you need: hand-held mirror, flashlight, and speculum. You may also want to use some water-based lubricant to help insert the speculum.

Before you start, practice opening and closing the speculum and make sure you understand how to lock it open and unlock it to close.

It's helpful to first insert a finger into your vagina and feel your cervix, which is at the very back of your vagina, generally about 7-15cm deep. The cervix can be quite hard or a bit softer and squishier, and feels like a little nub protruding into your vagina.

Then sit comfortably on a flat surface, in a semi-reclined position, with your knees up and open, and heels together, and follow these 3 steps:

  1. Insert the speculum: Put some lubricant onto the speculum's mouth (the rounded part). Take a deep breath, and as you exhale, let your muscles relax. Insert the speculum (handles up) into the vagina.  

    When you have inserted it as far as it comfortably goes, press the handles together to open the mouth of the speculum until you hear it click and lock into place. You will feel the speculum stretch your vagina open.

  2. Take a good look: With both your hands free now, you can hold the flashlight and mirror. Shine the light directly into the vagina, or into the mirror so it reflects inside. At the back of your vagina is your cervix. It looks like a little wet donut.

    Cervices aren't always mid-line, so if you can't see yours, try reinserting the speculum at a different angle. If after a few tries you still can't see your cervix, wait a few days and try again. The cervix moves during the menstrual cycle and may be easier to find later.

  3. Remove the speculum: When you are finished looking, unlock and close the speculum. Then gently pull the speculum out. If you want, smell the speculum to become familiar with the scent of your secretions and examine the mucus on the speculum. An acidic smell is not unusual. A yeasty or fishy odor may indicate an infection.


What's Normal


Your cervix may be pink and smooth or it might have reddish blemishes. It can also be uneven, rough or splotchy. All of these are normal.

The cervix can also be blue or purplish in colour, usually due to increased blood flow.  Around 50% of people who are pregnant will have blueish cervices.  During pregnancy, the cervix may also look puffy and softer and the os more open.

There may be mucus covering the cervix or coming out of the os, which changes throughout the menstrual cycle in response to hormones. Cervical mucus ranges from pasty-white (non-fertile) to clear and stretchy like egg-whites (fertile), and generally doesn't have a strong odor.

The cervix may have fluid-filled sacs on it that look like blisters, called Nabothian cysts. These are caused by a blockage in the mucus-producing glands of the cervix and are not a problem. In some people they come and go, and others have them for years. They do not need treatment.

You may see polyps: outgrowths of tissue that dangle on a stalk and protrude through the os. They may bleed easily but do not need to be removed unless they bother you.

What's Not Normal


It is normal to have vaginal and cervical discharge. However, green, gray, or dark yellow discharge, significant changes in the amount or consistency of discharge, or any strong odor that's unusual for you, could indicate an infection.

If you suspect an infection, you may choose to visit a clinician. Infections such as chlamydia or gonorrhea can cause serious complications if left untreated. Other conditions may be easily addressed with natural remedies.

Recognizing what's normal for you is the primary reason for performing self exams. By knowing what's normal, you can tell what's unusual for you.

This info has been adapted from the Feminist Women's Health Center's website www.fwhc.org.