Pelvic Exam Lube - Bring Your Own?

Health & Wellness

Pelvic Exam Lube - Bring Your Own?

Advocating for comfort during your gynecological exams

by Aleece Fosnight, PA-C, CSC-S. CSE, NMCP, IF, HAES Medical Consultant

Have you ever thought about bringing your own lube to an annual pelvic exam? Most
gynecology offices either do not use a lubricant during a pelvic exam or use a surgical
based lubricant during a speculum examination. Misconceptions have circulated
amongst many OBGYN offices that using a lubricant can interfere with a PAP smear
and to only use warm water to help lubricate the speculum. However, there has been
enough research and evidence over the past several years to debunk this thinking.

Why Lubrication Matters

When using a speculum, insertion can cause discomfort and unnecessary trauma
during a routine pelvic examination as the vaginal introitus or opening does not
physiologically have lubrication. Using a lubricant to the external surface of the
speculum will not compromise the PAP smear cytological evaluation of the cervix. For
those gynecological offices that do use a lubricant, one of the most common used is
called SurgiLube. Although SurgiLube, a water-based lubricant, has undergone
thorough testing that does not interfere with PAP results, many patients find the
lubricant sticky and continue to have discomfort during speculum examinations.

The Benefits of Silicone-Based Lubricants

Did you know that there are different kinds of lubricants? Silicone-based lubricants last
longer, glide easier, and do not need to be reapplied. For vulva owners dealing with
genital dryness (menopause, lactation, allergy medications, radiation/chemotherapy
treatments, etc), using a silicone-based lubricant during a speculum examination can
improve discomfort. As many gynecological offices only carry a water-based lubricant,
bringing your own lubricant allows you to advocate for your health and comfort during a
physical examination.

How to Advocate for Your Comfort

During the intake portion of your office visit, let the nurse or healthcare provider know
that you have brought your own personal lubricant to be used during the speculum
insertion portion of the pelvic examination. Let them know how important it is that they
respect your wishes to have a smooth and comfortable examination if there is any push
back from the staff. You can also call the office ahead of time and ask what type of
lubricant they use. It is also okay to tell your provider that the lubricant they use irritates the vulva and vaginal mucosa, and that you would like to use your own.

References:
Hill DA, Lamvu G. Effect of lubricating gel on patient comfort during vaginal speculum
examination: a randomized controlled trial. Obstet Gynecol. 2012 Feb;119(2 Pt 1):227-
31. doi: 10.1097/AOG.0b013e3182426275. PMID: 22270273.

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