When you carry out a speculum examination or a bimanual examination, it may be necessary to use a lubricant. Sometimes, water may suffice. However, it is necessary to use a proper lubricant if the vaginal walls are too dry. This can be the case in postmenopausal women and in breastfeeding mothers. What you opt for is dependant on the situation, the indication for the examination, the composition of the lubricant and your own preference.
Water
The advantage of water is that it’s a neutral lubricant, which does not lead to irritation and is readily available. In addition, warm water can be used to slightly pre-warm the speculum. A speculum can become hot quite rapidly, but a cold speculum adjusts to the body temperature. The disadvantage is that it has a limited lubricating potential, which is often insufficient in postmenopausal women.
Hibitane® (cream)
Hibitane is a white, mildly disinfecting liquid. Hibitane has good lubricating characteristics, but it can cause irritation or a stinging sensation when used. It cannot be used when performing a smear or taking a sample for a vaginal culture because it may influence the outcome. Hibitane is a white liquid and can therefore, make the assessment of vaginal discharge more difficult.
Neutral Lubricant (Lubricare® or Ky-jelly®)
This lubricant is fairly viscous and sticky, but has good lubricating characteristics [Figure 9]. It is transparent and rarely causes the patient any irritation. If performing a smear or a vaginal culture, check if it’s possible with this type of lubricant, to ensure that it will not affect results. It can be applied hygienically from a tube.
Figure 9
Oil
Oil is transparent and fairly sticky [Figure 10]. It rarely causes irritation and performs quite well as a lubricant. You apply sweet oil by dipping the tip of the speculum in it, allowing excess oil to drip off. This method of application and the fact the sweet oil is stored in an open container, makes it less hygienic. The latter can be counteracted by regularly replacing the content of the container. It is possible that sweet oil may also influence a culture and/or a smear.
Figure 10