Using lubricant for speculum insertion.

Speculum insertion can be associated with considerable discomfort during routine pelvic examination. Physiologically, vaginal entry requires lubrication. However, traditional teaching recommends, if anything, warm water only for lubrication, because lubricants are believed to interfere with Pap and infection tests. There is level I evidence that modest lubrication of the external surface of the speculum does not impair cytologic and infectious evaluation of the cervix. This should be reflected in contemporary teaching and guidelines.