Improving women's experience during speculum examinations at routine gynaecological visits: Randomised clinical trial

Objectives: To determine if a standardised method of leg positioning without stirrups reduces the physical discomfort and sense of vulnerability and increases the sense of control among women undergoing speculum examination as part of a routine gynaecological examination. Design: Randomised clinical trial. Setting: Family medicine outpatient clinic. Patients: 197 adult women undergoing routine gynaecological examination and cervical smear. Intervention: Examination with or without stirrups. Main outcome measures: Women's perceived levels of physical discomfort, sense of vulnerability, and sense of control during the examination, measured on 100 mm visual analogue scales. Results: Women undergoing examination without stirrups had a reduction in mean sense of vulnerability from 23.6 to 13.1 (95% confidence interval of the difference -16.6 to -4.4). Mean physical discomfort was reduced from 30.4 to 17.2 (-19.7 to -6.8). There was no significant reduction in sense of loss of control. Conclusion: Women should be able to have gynaecological examinations without using stirrups to reduce the stress associated with speculum examinations.