Cervical Self-Examination:
http://www.a-womans-touch.com/article /45/382/Cervical_SelfExamination.html

Dear Aphrodite & Dr. Myrtle,
I'm interested in seeing my own cervix. Could you tell me how to perform a cervical exam on myself?

There are many benefits to examining your own vulva and cervix. By examining yourself regularly, you can gain a sense of what your body normally looks like. You can understand how your body is put together, what your discharges look like, and see the changes in your cervical mucus if you are still ovulating. For some women, doing a self-exam allows them to see a part of their bodies that they have learned to ignore or even fear. Other women like the sense of control they get from using a medical tool to see for themselves what others see. This helps to decrease reliance on what other people tell them about their bodies.

Also, some women struggle with a medical condition called vaginismus, where the pelvic floor muscles clamp tight and the woman is not able to directly control them, making penetration difficult if not impossible. In the recovery process, women who have regained control of their vaginal wall and pelvic floor muscles often find that examining themselves with a speculum prior to an examination by a health provider can give them confidence that the exam can be completed without pain.

To perform a cervical self-examination, you will need:

   * a light source (flashlight, or lamp with a stand)
   * a speculum (available in different sizes for differently sized people)
   * lubricant (either warm water or a sexual lubricant)
   * a mirror with a long handle
   * a comfortable, secure place for the examination.

Vulva Self-examination

To begin a self-examination, let's start with the vulva. The vulva is the part of a woman's body that lies between her legs. Many important body parts are located here, yet it's a place that most women can't see for themselves without a mirror.

Let's take a look! Find some comfy clothing, privacy, a mirror, and a lamp. You may want to recline on your bed with a pillow behind your back and a pillow to prop your mirror up on. Spread your knees apart a comfortable distance (use pillows for your legs, too, if you'd like) and gaze upon your lovely vulva.

See how much it looks like a blooming flower? The labia are the petals, and you can peer down to the opening of the vagina as toward the center of a flower. Try to find a skin flap at "12 o'clock" that covers the tip of your clitoris. This is called the clitoral hood, and some women can pull it back to view the clitoris.

Your clitoris may be several different colors—from tan to pink to deep purple—and any or all of these colors are normal. The clitoral legs cannot be seen, because they lie just under the surface of the inner labial lips and circle around the vagina.

Look for your urethra (where urine comes out) and your anal opening. The skin between the vaginal opening and the anal opening is called the perineum, and can be a sensitive sexual spot for some people.

Take note of the color of your skin in the different sections of your vulva, and whether you have any moles that need to be watched over time. Touch different parts of your vulva and see how they feel. Congratulations! You've now been formally introduced to your vulva.

It is normal for every woman's vulva to look asymmetrical (some parts bigger or smaller than others) and for every woman's vulva to be different. In this way, we are all truly unique. If you'd like to see pictures of the beautiful diversity of vulvas, get a copy of the book Femalia by Joani Blank, or the Cunt Coloring Book by Tee Corrine.

Before you begin your self-examination ...

Investigate the speculum. Notice that there are two main pieces connected together with a hinge-like mechanism. These pieces look like the bill of a duck. On the plastic specula, there is also a locking clip that props the duckbill open once you've put it into position. This allows you to adjust the speculum to your personal comfort level and lets you see your cervix more easily. Be sure you feel comfortable locking the speculum in the open position, and that you can easily unlock it before you are ready for insertion.

The vaginal and cervical self-examination

If you choose to continue with the vaginal and cervical examination, lie back with your knees bent and your feet placed comfortably wide apart. Using a small bit of lubricant or water on your hands, place your thumb in the opening of your vaginal canal and gently massage the skin between your vaginal canal and your perineum. Can you make the muscle under your fingers clench? (Yes? That's great! You've just contracted your pelvic floor muscles. No? Please see our Kegels articles and brochure for more information.) To further relax your pelvic floor muscles, push down toward your anus and continue massaging. (This is also a great introduction to something called perineal massage, which is a technique that pregnant women use to prepare for vaginal delivery.)

When you're ready for the speculum exam, lubricate the speculum lightly with water or a sexual lubricant. Hold the speculum with the blades closed, with the handle pointing toward either your right or left leg. Gently slide the speculum in, pointing down toward the small of your back. If you feel discomfort, many women find that pushing the speculum straight down (away from the urethra) is more comfortable, since perineal skin and the pelvic floor muscles are most stretchy there.

Once you have inserted the speculum, turn the handle either up or down with a gentle twisting motion. You may need to experiment in order to find a comfortable path.

After you have fully inserted the speculum, slide the duckbill open. You can lock the speculum handle or leave it unlocked, depending on how easy it is for you to see your cervix with the speculum in either of these positions.

For some women, placing the speculum and finding the cervix may take some effort. Breathe deeply and manipulate the speculum gently while looking into the mirror. Focus the light source on the mirror to help you see better. (A friend might help you with this.)

The vaginal walls will appear pink and bumpy. The cervix will be smooth and glossy with a small dark opening that you may or may not be able to see. Depending upon where you are in your menstrual cycle, your secretions could be whitish, clear, creamy, or stretchy like egg whites.

Congratulations! You've formally introduced yourself to your vagina and cervix.

When you're done, unlock the speculum and carefully withdraw it without fully closing the duckbill (to avoid pinching you inside). Clean the speculum with soap and water and re-store it in its bag. We don't suggest sharing specula with others, because infections could be transferred between people.

Do I have to do all of this at once?

This is for you and your personal understanding. You can approach a self-examination all at once, or you can try one step at a time. It's okay to gather more information about your body at your own speed and to explore your own frontier.