How do you determine which speculum size to use?

I apologize if there is already a thread for this, but when you're performing a play exam with somone, how do you decide which size speculum to use? Is there a one size fits all?

Why not try them all. Slowly. One at a time. Until you find the one that's just right. 😃

It depends on how you want to show your inexperience and attitude toward your women patients.

You can start by trying to stuff in the biggest one, blocking out the screaming and tears until you find a smaller size that goes in easily OR you can start small and work your way up in size until it meets resistance and the woman tells you that's a comfortable maximum size.

See this sizing chart

http://www.wallachsurgical.com/products/gynecology/gyn-instruments/speculum-sizing-chart/

I like the painful option 😃 working the way up till it hurts

It's a good idea to have a few options well before you are at the part of an exam that a speculum comes into use. If you planning an exam with someone who has explored their medical fetish for some time, you might get lucky and have some insight from the patient.... otherwise it's always best to start small and gradually move to a larger size or different style that gives a better unobstructed view of the patient. It may not take much... and worst case is you have a large speculum on the instrument tray that makes her eyes grow wide.

Using à collins has a dilatator before some assplay

Help has starter to get open anoff to get à good prostate massaging

I have smaller ones we always use and usually one large florescent blue that looks intimidating just to leave out within view. I only used it once and I could tell she completely wasn't into it. But it remains out there just as a reminder of what is possible for the session .

The way I understand it, large is for women who have given birth, medium is for women who are not virgins but have not given birth and small is for virgins. This is not hard and fast, though. I am not a virgin and have never given birth but medium is too big for me.

I know from attending my wife's exams that a medium Pedersen is used on her. She has never had kids and her vagina is on the small and tight side. The speculum portion of the pelvic exam tends to be more uncomfortable for her than the bimanual or rectovaginal/rectal exams. So we first bought a plastic medium Pedersen, then a stainless one. I use the stainless one on her more often than the plastic one now. That is about as big as she willing to go. She only had a large Graves used on her once, for an IUD insertion. She told me that the insertion and opening of that large speculum hurt almost as much as the IUD insertion itself. She definitely isn't looking forward to the day that the IUD needs to be removed and replaced!

Depends on the women. Size medium I don't believe their is a one size fits all speculum

The choice of speculum is not only dependent on the size of the vaginal opening, but also on variables such as the length of the vagina, the elasticity of the vaginal walls, the position of the uterus, and what I need to accomplish while up there. As a guide :

The Pederson speculums are designed for women with more narrow vaginas and can be used for ladies who have never had children before.

The Graves are particularly useful in women who have delivered babies vaginally. The curvature allows for better visualization of the cervix.

The pediatric speculum is excellent for patients who have not been sexually active. The population, however, that gets the most benefit from pediatric speculums is ironically the elderly and postmenopausal women.

Sometimes it worth to do a quick vaginal exam , as it can help you to assess the vagina before choosing the right size speculum.

This reminds me of a book I was just reading by Mike Collins the Apollo 11 astronaut. He describes the penis sleeve that they had to wear while in a space suit. He said the sizes were Extra Large, Massive and Immense. He said he learned the hard way not to grab one too large as he had to sit in pee for 4 hours.The technicians called these rookies "Wetbacks" because the urine would run down their backs since they were reclined. I think it would be just as uncomfortable if not more so, to get the wrong sized speculum. I have used one in play sessions several times and never had a problem but now realize I sure could have. Good learning thread for me.

Moppy, that is just hilarious!

Thank you!

I think someone was having fun with the sizes there. Somehow I can't see them using the same sizes for something that goes in the butt.

Moppy tk loll