It is cold, hard, metallic and commonly associated with pain.
No, it is not a medieval torture instrument, but the vaginal speculum, which is used every day around the world for essential gynaecological examinations.
Two engineers at Delft University in the Netherlands are now rethinking the decades-old design of the speculum, long dreaded by many patients, to make it less intimidating and less painful.
“I have a lot of experience with the vaginal speculum unfortunately,” engineer Tamara Hoveling said.
“I’ve never seen it as a pleasurable experience and I’ve always wondered why it looks like this.”
The PhD candidate in medical industrial design then delved into the dark history behind the creation of the speculum – one version of which was developed by American doctor James Marion Sims 180 years ago.
It was “tested on enslaved women without permission”, said the 29-year-old.
“So that motivated me even more to take on this project.”
Hoveling teamed up with Ariadna Izcara Gual, who was then working on her master’s in industrial design engineering at Delft.
“As I was doing a lot of interviews, I was doing those sort of sketches with the same sort of shape, but people were still scared of the device,” said the 28-year-old Spanish researcher.
The Cusco speculum – the most commonly-used model – is a metal device with a handle, beak and screw to adjust how wide it opens once inside the vagina.
For many, its insertion is uncomfortable or even painful, and causes anxiety.
“When you get scared, your muscles clamp together and that makes it even harder to relax.
“Then the speculum is opened, pushing against these tense muscles and making it even more painful,” Hoveling said.
“So I tried to look for shapes that might be related to the reproductive organs, like, for example, the flower, that also opens.”
The result was a prototype called the Lilium, named after the lily flower.
Hoveling shows 3D-printed prototypes of Lilium. On the table are also metal speculums, which are the current standard equipment used for vaginal examinations.
Like the more familiar tampon, it is made of soft plastic and has an applicator.
“It’s designed with the patient in mind, rather than the doctor.
“And we’re really trying to improve the comfort aspect in a sensitive spot.”
The Lilium also meets doctors’ needs.
Its three-sided opening keeps the vaginal walls from collapsing, allowing better visibility during examinations.
The Lilium remains at an early stage, with further ergonomic testing and material research needed to refine the prototype.
The researchers must still secure safety certifications, run human trials and obtain regulatory approval before it can reach clinics.
To fund the next phase, they launched a crowdfunding campaign that quickly drew media attention in the Netherlands.
Within just two days, the campaign raised 100,000 euros (RM493,270), far surpassing expectations.
“It’s also a sign. It’s proof there are people who really want change, that there is a real problem here, and that the current market solutions are not the best,” Hoveling said.
“I’ve received a lot of emails from women who told me they actually don’t go to the gynaecologist because of this device, because they’re scared, because they have a traumatic experience.”
Cervical cancer is the fourth most common cancer among women, according to the World Health Organization (WHO).
It can be detected via a smear test or HPV (human papillomavirus) screening – both performed using a speculum.
With funding to allow this new gynaecological tool to be developed properly, the Lilium could be saving lives within five years. – By Stéphanie Hamel/AFP
