It was a typical afternoon at the San Francisco headquarters of Frog, the renowned design firm celebrated for shaping the iconic visual aesthetic of products like Apple’s original Macintosh computers. Hailey Stewart, an industrial designer at the firm, stood before a conference table where she had scattered a striking array of unconventional prototypes. On one end lay cylinders of foam resembling sleek modern wellness products, accompanied by sketches of levers, handles protruding at various angles, and intricate screw mechanisms. On the other end rested the familiar, utilitarian speculum—the medical device used during routine gynecological examinations to inspect the cervix.
Stewart picked up a traditional speculum and cranked it open. The device emitted a loud, jarring, and painful-sounding click. "You’re literally in the stirrups with that sound," Stewart remarked, "and it’s like, excuse my language, but what the fuck?"
Most of the designers gathered in the room had never seen a speculum up close before. Some of the male designers admitted they had never truly considered the physical reality of a pelvic examination: stripping off your clothes, lying flat on an examination table, and strapping your feet into metal stirrups while a practitioner pries open sensitive tissue with a cold, rigid gadget. But Stewart had not gathered her colleagues merely to recount the typical discomforts of an annual exam. She had brought them together for a far more ambitious objective.
For the preceding several months, largely during their off-hours and weekend downtime, Stewart and interaction designer Sahana Kumar had been obsessively studying the device. They had wrenched it open and closed repeatedly, analyzed the exact curvature of the bills, and poured over historical texts documenting its origins. Now, Stewart told the rest of the Frog team, they were officially tackling an ambitious design challenge: completely redesigning the speculum for the 21st century.
A Legacy Rooted in Inequitable History
The foundational design of the modern speculum dates back to the 1840s, credited to American physician James Marion Sims. Fashioned originally with two pewter blades designed to separate the vaginal walls, the device hinged open and closed via a rudimentary screw mechanism. Sims, frequently designated in medical histories as the "father of modern gynecology," utilized the speculum to pioneer surgical treatments for vesicovaginal fistula and other severe childbirth complications. However, his pioneering medical experiments were conducted extensively on enslaved Black women without the administration of anesthesia. Consequently, stating that the speculum was originally engineered without patient comfort in mind represents an egregious understatement.
Despite the profound technological advancements of the past century and a half, the speculum used in clinical offices today looks almost identical to the instrument Sims operated in the mid-19th century. The most noticeable evolution is simply material; modern specula are typically manufactured from medical-grade stainless steel or disposable plastic rather than pewter.
The problem is not merely that the tool is old, but that its fundamental architecture serves neither patients nor physicians optimally. Practitioners must force the speculum’s bills wide apart to achieve a clear line of sight to the distant cervix, and even with maximum expansion, visibility is frequently obstructed. While certain specula feature built-in light sources, the primary visual barrier stems from surrounding tissue collapsing into the field of view rather than simple darkness within the vaginal canal. The resulting mechanical pressure generates significant physical discomfort. In fact, a comprehensive review of medical literature revealed that a notable segment of the female population actively avoids scheduling or attending gynecological appointments altogether out of deep-seated dread of the instrument.
By 2014, the situation prompted the American College of Physicians to issue clinical practice guidelines recommending against routine screening pelvic examinations for asymptomatic adult women, explicitly citing the associated "harms, fear, anxiety, embarrassment, pain, and discomfort" tied directly to speculum usage. These profound negative side effects impact healthcare providers as well. "The more comfortable a patient is, the faster they can do their job, the more patients they can see," Stewart noted, emphasizing that patient comfort carries tangible operational and economic value.
Past Attempts and Emerging Alternatives
The design vacuum surrounding women’s health has not gone entirely unnoticed, though previous attempts at innovation have faced steep adoption hurdles. In 2005, a San Francisco enterprise successfully patented an inflatable speculum known as FemSpec. Constructed from polyurethane—the identical material utilized in standard condoms—the device allowed a physician to insert it much like a tampon before inflating it gently like a tiny pneumatic balloon. Despite launching to considerable media fanfare, the product ultimately commercialized poorly. As contemporary reports in the press highlighted, the vast majority of patients never experienced the innovative speculum simply because it was so unfamiliar to the market that traditional medical practitioners declined to adopt it.
Other conceptual redrafts pursued more modest ergonomic adjustments. A notable student prototype named the Lotus, developed by a designer at the Pratt Institute, preserved the traditional bill shape while applying a subtle curvature intended to ease insertion. The concept incorporated a rotating handle designed to open the bills vertically, alongside a concealed internal lever mechanism designed to eliminate painful pinching. Although the prototype attracted attention at student exhibitions, it never transitioned into commercial production.
Meanwhile, in Oregon, a medical device startup called Ceek Women’s Health initiated clinical trials for a diversified suite of pelvic health instruments, including protective sleeves, narrower specula, and patient-administered self-insertion tools. Rather than attempting to engineer yet another universal, one-size-fits-all device, Ceek’s strategy centers on offering a modular toolkit tailored to diverse patient anatomies. "For women who have a lot of tissue, women who have had more than two vaginal births or a high BMI, for women with a history of trauma or rape, for post-menopausal women who have vaginal atrophy—there isn’t any product to address their needs," explained Fahti Khosrow, co-founder and CEO of Ceek. Providing clinicians with an expanded toolkit, she argues, enables much more personalized and compassionate care.
Perhaps the most radical departure from traditional hardware originates from Duke University, where academic researchers have explored bypassing the speculum entirely. Mercy Asiedu, a biomedical engineering doctoral candidate at Duke, spearheaded the development of a tampon-sized cylindrical device equipped with a high-resolution 2-megapixel micro-camera positioned at its tip. "The speculum was originally designed for a physician to view the cervix from outside the body," Asiedu explained, "but with current technology, you can easily view the cervix from inside the body."
Asiedu evaluated her prototype during a pilot clinical study involving 15 volunteer participants, with findings published in the open-access journal PLOS One. Every single participating patient reported that the significantly smaller, camera-equipped device provided a vastly superior and more comfortable experience compared to the standard speculum.
While Asiedu’s study focused primarily on patient satisfaction, she openly acknowledged that practicing physicians might offer valid critiques centered on workflow integration. Her design prioritizes patient comfort, modesty, and personal empowerment over traditional clinical familiarity. "With a speculum, you just shove it in and expand it as wide as you want to get the visualization you want," Asiedu observed. "With this, you have to put it in and gently move it around, kind of like a joystick."
Re-Engineering the Experience at Frog
When Stewart and her multidisciplinary team at Frog embarked on their redesign initiative, they understood the immense scale of the challenge ahead, compounded by the fact that Stewart herself had minimal prior familiarity with the device. To ground their work, Stewart and Kumar began by cataloging every specific sensory grievance associated with conventional pelvic exams: the alarming mechanical noise resembling a household can opener, the startlingly cold metallic temperature, and the unsettling internal sensation of tissues being stretched like an elastic band. Upon acquiring physical specimens of both plastic and metal specula, the team recognized that the aesthetic presentation required a complete overhaul. The existing instruments bore an unsettling resemblance to archaic medical torture equipment.
Stewart first focused on eliminating the abrasive ratcheting sound. Collaborating with Fran Wang, a mechanical engineer at Frog, the team investigated novel actuation and expansion mechanisms. No conceptual avenue was dismissed as too eccentric. They contemplated whether saline fluid could inflate the device from within, much like a biological pufferfish, or if pneumatic air pressure could expand it safely like an air mattress. They drew mechanical inspiration from diverse sources across nature and industry—studying the defensive expansion of cobra hoods, industrial milling chucks, common bicycle pumps, the precise clamping action of photographic tripods, and the quick-release mechanics of ski bindings—in an exhaustive search for alternatives to the century-old screw thread.
Next, the designers reevaluated material science. Abandoning rigid plastics and cold metals, they elected to encase the entire structural assembly in autoclavable medical-grade silicone. This material retains neutral ambient temperatures, withstands rigorous sterilization protocols, and provides a cushioned, frictionless surface for insertion. "On the metal speculum, there are pokey bits," Wang noted. "Those shouldn’t go near your delicate body parts! Having all of that covered in silicon, it prevents tissue from getting damaged. And also when you look at it, it’s nicer."
The team experimented with configuring three distinct prongs instead of two, allowing the instrument to expand symmetrically into a gentle triangular geometry. They tested scaling down the overall profile to tampon dimensions and incorporated ergonomic design principles borrowed from the consumer wellness and vibrator manufacturing industries. By altering the handle angle from 90 degrees to a more natural 110-degree incline, they optimized the posture for practitioners, creating sufficient physical clearance between the clinician’s hand and the patient’s body to eliminate the awkward physical adjustments traditionally required during exams.
After producing multiple iterations via 3D printing, the team placed the functional prototypes directly into the hands of practicing obstetrician-gynecologists and clinical healthcare providers for real-world feedback.
The reception among medical professionals was overwhelmingly positive, particularly regarding the three-bill triangular expansion concept. This geometric configuration afforded physicians an identical field of view to traditional tools without requiring the extreme tissue stretching associated with standard two-bladed models. Clinicians also praised the 110-degree handle orientation and the inclusion of a single-handed push-button locking and unlocking mechanism, which liberates the practitioner’s secondary hand during procedures. Furthermore, the complete elimination of mechanical ratcheting sounds rendered the entire interaction entirely silent.
A Holistic Approach to Modern Care
Consultations with OB/GYNs underscored a vital realization: hardware modifications alone would be insufficient to transform the patient experience. Reflecting on her own clinical visits, Stewart noted a stark contrast in personal comfort levels between undergoing a routine bikini wax versus attending an annual gynecological exam. The discrepancy lay entirely within the environment and psychological framing. One setting felt sterile, clinical, and intimidating, while the other felt personalized and supportive despite involving physical discomfort. Achieving meaningful reform required redesigning the entire clinical ecosystem surrounding the pelvic examination.
Within six months, the internal project at Frog evolved into a comprehensive conceptual overhaul of modern gynecological care. The initiative now encompasses the newly engineered speculum, refined continually through active consultations with participating OB/GYNs, alongside a structured set of clinical guidelines designed for practitioners. These recommendations include simple yet impactful practices, such as providing dedicated spaces for patients to hang their clothing and ensuring clinicians clearly explain each step before initiating the exam. "It’s never going to be perfect," Kumar reflected. "So how do we at least prepare people emotionally for how it’s going to be, and make them feel like they got some value out of it at the end?"
The broader project ecosystem also features a digital application mockup enabling patients to complete administrative intake paperwork, submit inquiries, or listen to guided relaxation exercises prior to their appointment. To further ease patient anxiety, Kumar engineered a complementary comfort kit containing items like a stress ball and specialized socks designed to cover bare feet in stirrups. Bolstered by the addition of visual designer Rachel Hobart to establish cohesive brand identity, the unified initiative has been formally named Yona.
Presently, the Yona project remains positioned as an early-stage design concept. Stewart and Wang continue refining physical speculum prototypes, while Kumar and Hobart polish the digital interface and patient experience architecture. The team collaborates closely with an advisory board of medical professionals to navigate regulatory and practical feasibility, while actively seeking forward-thinking healthcare partners—such as tech-enabled primary care providers like One Medical—to bridge the gap between conceptual design and commercial realization.
The ultimate hurdle remains securing widespread adoption within a conservative medical establishment. The Frog designers are keenly aware that previous medical prototypes have faltered when established practitioners exhibited resistance to change, driven either by the financial expenditure required to procure new equipment or the cognitive investment demanded to master unfamiliar workflows. Gynecologists have relied upon the traditional speculum for well over a century, and by historical metrics, it remains functional. Why alter a routine that appears to work?
"You could create the most beautiful, most unique, most user-friendly device, but if a doctor doesn’t want to learn how to use it, your patient’s never going to see it," Stewart acknowledged.
Yet Wang remains optimistic that demand will surge once clinical providers experience the tangible benefits firsthand. She acknowledges that the legacy speculum fulfills basic clinical requirements, but insists it falls short of modern expectations. "It passes, but it’s not great," Wang said. "Pero we’re working on making it better. When you give them the option to choose a better one or a worse one, then they’re going to choose the better one. But they might not know that until they get that option."
