It was a quiet afternoon inside the San Francisco headquarters of Frog, the renowned design firm best known for helping craft the iconic look of Apple’s original Macintosh computers. Gathered around a large conference table, Hailey Stewart, an industrial designer at the firm, surveyed an array of unconventional prototypes she had spent weeks assembling. On one end of the table sat cylinders of foam resembling slender wellness devices, featuring handles projecting at various angles alongside rough sketches of levers and screw mechanisms. On the other end lay the standard speculum—the ubiquitous medical device utilized daily in routine gynecological examinations to inspect the cervix.
Stewart picked up a traditional speculum and cranked it open, demonstrating the harsh mechanics. "You’re literally in the stirrups with that sound," she remarked, noting the loud, alarming click the device makes, adding, "and it’s like, excuse my language, but what the fuck?"
For most of the designers gathered in the room, it was their first time interacting with a physical speculum. Several of the male designers admitted they had never truly considered the multifaceted realities of a pelvic examination: the vulnerability of stripping off one’s clothes, lying flat on a cold examination table, and strapping feet into metal stirrups while a practitioner pries open the vaginal canal with a rigid, ice-cold metal instrument. However, Stewart had not called the meeting merely to educate her colleagues on the standard hurdles of an annual wellness exam. She had convened them to tackle a far more ambitious objective.
Over the preceding several months, largely during personal downtime and on weekends, Stewart and interaction designer Sahana Kumar had immersed themselves in studying the instrument. They had repeatedly wrenched it open and closed, analyzed the precise curvature of its bills, and pored over its long, complex history. Now, Stewart informed her fellow designers at Frog, they were officially taking on a project that was rapidly evolving into a comprehensive quest to redesign the speculum for the 21st century.
The structural foundation of the contemporary speculum dates back to the 1840s, engineered by American physician James Marion Sims. That original iteration utilized two pewter blades designed to separate the vaginal walls, hinged together with a screw mechanism that allowed them to open and close. Sims, frequently designated in medical history texts as the "father of modern gynecology," leveraged the speculum to pioneer breakthrough surgical treatments for vesicovaginal fistula and other severe complications stemming from childbirth.
Yet, those pioneering medical experiments were conducted primarily on enslaved women without the benefit of anesthesia. To state that the speculum was originally engineered without patient comfort as a primary consideration would be an egregious understatement.
More than 150 years later, the speculum utilized in modern medical offices looks virtually identical to the tool Sims deployed in the 19th century. The most significant material evolution is that modern specula are typically manufactured from stainless steel or medical-grade plastic rather than pewter.
The mere age of the device is not inherently problematic. The core issue is that the architecture of the tool is fundamentally suboptimal for both patients and clinicians. Physicians are routinely forced to stretch the speculum’s bills unnaturally wide to secure an adequate line of sight to the cervix, located deep within the body. Even with these forceful adjustments, achieving a clear and comprehensive view is rarely guaranteed. While certain specula feature integrated lighting elements, the primary visual obstruction is typically caused by surrounding tissue collapsing into the field of view rather than simple darkness within the vaginal canal.
The resulting physical pressure routinely causes significant discomfort. In fact, a comprehensive review of medical literature published in the National Center for Biotechnology Information highlighted that a measurable demographic of women actively avoid scheduling routine gynecological visits altogether out of apprehension regarding the feared examination tool.
The psychological and physical tolls did not go unnoticed by the broader medical community. In 2014, the American College of Physicians took the extraordinary step of formally 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 examinations.
These adverse side effects inevitably impact gynecologists and clinical providers as well. "The more comfortable a patient is, the faster they can do their job, the more patients they can see," Stewart observed, emphasizing that patient comfort carries tangible operational value for busy medical practices.
Attempts at modernizing the experience are not entirely unprecedented. Back in 2005, a San Francisco-based enterprise successfully secured a patent for an inflatable alternative known as FemSpec. Constructed from polyurethane—the identical material utilized in the manufacturing of condoms—the device allowed a physician to insert it much like a traditional tampon and subsequently inflate it using air like a miniature balloon. Despite launching with considerable industry fanfare, the product ultimately failed to gain commercial traction. As a retrospective feature in The Chicago Times pointed out at the time, the vast majority of women never even had the opportunity to experience the innovative speculum because it was so novel to the market that mainstream physicians simply were not adopting it.
Other conceptual redesigns have focused on more modest, incremental adjustments. A student prototype titled the Lotus, developed by a designer at the Pratt Institute, preserved the traditional bill shape while applying a slight ergonomic curve intended to facilitate smoother insertion. That design also incorporated a rotating handle engineered to open the speculum bills vertically, alongside a concealed internal lever mechanism designed to eliminate the risk of pinching sensitive tissue. While the prototype generated considerable interest after appearing in a student showcase, it never transitioned into a commercially viable medical product.
Meanwhile, in Oregon, a dedicated medical device startup named Ceek Women’s Health initiated clinical trials for an expanded suite of novel gynecological products. Their lineup included a specialized protective sleeve, a speculum featuring significantly narrower bills, and an alternative designed for patient self-insertion. The organization’s overarching philosophy focused on providing a diverse product ecosystem tailored to varied patient anatomies rather than perpetuating the traditional one-size-fits-all model.
"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 Fathi Khosrow, co-founder and CEO of Ceek. By equipping physicians with an expanded toolkit, she argued, practitioners can far better serve the diverse needs of their patients.
Perhaps the most radical departure from traditional hardware comes out of Duke University, where researchers have explored a technological pathway that bypasses the speculum entirely. Mercy Asiedu, a biomedical engineering doctoral candidate at Duke, spearheaded the development of a compact, tampon-sized device outfitted with a high-resolution 2-megapixel camera at the terminal end.
"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 study involving 15 volunteer participants, with the findings subsequently published in the peer-reviewed open-access journal PLOS One. Every single participating patient reported that the significantly smaller, camera-equipped device provided a markedly superior clinical experience compared to the traditional speculum.
While the Duke study focused heavily on patient satisfaction, Asiedu readily acknowledged that clinical practitioners might offer more constructive criticism regarding workflow integration. The primary design tenets prioritized patient comfort, personal modesty, and bodily autonomy over immediate procedural convenience for the doctor.
"With a speculum, you just shove it in and expand it as wide as you want to get the visualization you want," Asiedu noted. "With this, you have to put it in and gently move it around, kind of like a joystick."
When Stewart and her multidisciplinary team at Frog set out on their own redesign journey, they were keenly aware of the historical challenges ahead of them. Compounding the challenge, Stewart admitted, was the stark reality that before embarking on the project, she had rarely interacted with the device personally.
Consequently, before initiating deep research or putting pencil to paper for final sketches, Stewart and Kumar compiled a comprehensive inventory of the precise elements that consistently troubled them during routine gynecological visits. They documented the jarring auditory disruption resembling a kitchen can opener, the uncomfortably freezing metal temperature, and the internal physical sensation akin to having internal tissues stretched taut like a rubber band. Once they acquired a representative set of standard specula—one plastic and one metal—they realized that an aesthetic overhaul was equally mandatory. In their view, the standard tools visually resembled medieval instruments of torture rather than modern healthcare implements.
First, Stewart investigated potential engineering solutions to silence the characteristic ratcheting sound. Collaborating with Fran Wang, a mechanical engineer at Frog, they explored entirely novel opening mechanisms. No conceptual avenue was dismissed as too eccentric. They pondered whether they could utilize saline solution to inflate the device internally much like a defensive pufferfish, or if compressed air could expand it like a recreational air mattress. They sought inspiration across diverse domains—studying the natural expansion of cobra hoods, the mechanical precision of milling chucks, and the functional mechanics of everyday items like bicycle pumps. They closely analyzed how camera tripods clamp open and shut, and how athletic ski bindings clip securely in and out, searching for functional motifs that might successfully replace the archaic screw mechanism.
Next, the team evaluated alternative material compositions. Rather than relying solely on rigid plastics or cold metals, they elected to encase the entire structural assembly in autoclavable medical-grade silicone. This material choice promised a neutral temperature upon contact, simplified sterilization protocols, and a softer tactile experience during insertion.
"On the metal speculum, there are pokey bits," Wang explained. "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."
Further experimentation involved testing a three-pronged configuration instead of the traditional two-blade setup, allowing the device to expand into a gentle triangular geometry. They explored scaling down the overall profile to roughly the dimensions of a tampon, while simultaneously borrowing ergonomic design cues from the contemporary consumer wellness and vibrator manufacturing industries. They adjusted the handle angle relative to the body, experimenting with inclinations ranging from 90 degrees to 120 degrees to identify the optimal physiological positioning for examining physicians. Following these rapid iterations, they utilized 3D-printing technology to fabricate physical prototypes, placing them directly into the hands of practicing OB/GYNs and clinical healthcare providers for real-world feedback.
"The one they were really excited about was the one that opened up using three bills, rather than just two," Stewart reported.
The triangular expansion geometry offered practitioners an equivalent or superior field of view without necessitating the wide, forceful separation required by traditional two-blade models, thereby rendering the procedure significantly less stretching for the patient. Furthermore, the OB/GYNs responded favorably to the handle positioned at a 110-degree angle, which established sufficient spatial clearance between the clinician’s hand and the patient’s body, effectively eliminating the awkward physical adjustments often required during the final stages of the examination.
The medical-grade silicone coating proved to be an overwhelming success. A dedicated push-button mechanism allowed for effortless, one-handed locking and unlocking of the device, freeing the clinician’s alternate hand for procedural tasks, while a streamlined push-handle eliminated the need for legacy screw adjustments. Perhaps most importantly for patient apprehension, the mechanical operation was entirely silent.
However, continuous consultations with practicing OB/GYNs highlighted a critical realization: the initiative could not succeed through hardware innovation alone. Stewart reflected on why she consistently felt psychologically more at ease undergoing a cosmetic procedure like a bikini wax than attending her annual preventative gynecological exam. The definitive answer ultimately centered on the surrounding environmental context. One clinical setting felt sterile, clinical, and inherently intimidating, whereas the alternative prioritized personal comfort and relaxation, despite carrying a higher degree of physical sensation. If they genuinely intended to redesign the speculum, they recognized they would need to redesign the entire patient journey.
Within half a year, the internal project had evolved into a holistic reimagining of the modern pelvic examination experience. Alongside the evolving physical speculum—refined continuously through direct insights from partnering OB/GYNs—the team formulated a comprehensive set of operational guidelines for clinical practices. These recommendations included simple yet impactful practices, such as providing dedicated spaces for patients to hang garments and ensuring clinicians thoroughly explain each procedural step before initiating contact.
"It’s never going to be perfect," Kumar noted. "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 conceptual ecosystem also encompassed a fully realized app mockup designed to streamline administrative intake forms, facilitate secure pre-visit inquiries, and offer guided relaxation exercises prior to the appointment. Additionally, Kumar conceptualized a patient comfort kit containing items like a stress ball and specialized socks designed to cover bare feet while resting in stirrups. To solidify the initiative’s identity, visual designer Rachel Hobart joined the Frog team to spearhead comprehensive brand development. The resulting comprehensive project was officially named Yona.
Presently, the Yona project remains in an early-stage design concept phase. Stewart and Wang continue refining successive physical prototypes of the speculum, while Kumar and Hobart polish the supporting digital application and patient experience touchpoints. The team works in tandem with an advisory board of medical professionals to iteratively evaluate feasibility and ensure clinical viability. Simultaneously, they are actively pursuing strategic partnerships with progressive healthcare organizations—such as the technology-forward primary care service provider One Medical—to help translate the Yona concept into a commercial reality.
The most formidable hurdle ahead remains securing genuine adoption within traditional medical practices. The designers at Frog are acutely aware that numerous well-intentioned prototypes have previously faltered after encountering clinical resistance, driven either by the financial expenditure required to procure novel equipment or the cognitive investment demanded of practitioners learning to integrate new tools into established workflows. Gynecologists have relied on the standard speculum design for well over a century, and from a strictly functional perspective, it has persisted. The lingering question remains: why alter a functional system now?
"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.
Nevertheless, Wang remains optimistic that widespread adoption is fundamentally a matter of demonstrating clear, tangible value to clinicians and their patients alike. She acknowledges that the traditional speculum remains functionally acceptable for the majority of practitioners.
"It passes, but it’s not great," Wang said. "लेकिन we’re working on making it better. When you give [physicians] 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."
