It was a quiet afternoon in the San Francisco headquarters of Frog, the renowned global design firm best known for helping shape the iconic look of products like Apple’s original Macintosh computers. Gathered around a conference table was an array of unconventional prototypes meticulously laid out by Hailey Stewart, one of Frog’s industrial designers. On one end of the table sat cylinders of foam resembling sleek modern wellness devices, accompanied by handles protruding at various experimental angles and detailed sketches of levers and screw mechanisms. On the other end rested the standard, ubiquitous speculum—the medical device used in routine gynecological exams to inspect the vaginal walls and cervix.
Stewart picked up a traditional speculum and cranked it open, demonstrating the harsh mechanics. "You’re literally in the stirrups with that sound"—the device produced a loud, sharp, and distressing click—"and it’s like, excuse my language, but what the fuck?"
For most of the designers in the room, the object was entirely unfamiliar. Some of the male team members admitted they had never truly considered the physical and emotional reality of a pelvic examination: the vulnerability of stripping off clothes, lying flat on an examination table, and strapping feet into cold metal stirrups, all while a practitioner uses a rigid metallic instrument to pry open delicate tissue. But Stewart had not gathered her colleagues merely to recount the typical patient experience during an annual exam. She had set her sights on a far more ambitious objective.
Over the preceding several months, largely during their off-hours and weekends, Stewart and interaction designer Sahana Kumar had immersed themselves in studying the century-old medical tool. They had pulled it apart, wrenched it open and closed, analyzed the precise curve of its bills, and read extensively about its complicated history. Now, Stewart informed her fellow designers at Frog, they were officially taking on a project to completely redesign the speculum for the 21st century.
The current design of the speculum, originally fashioned by American physician James Marion Sims, dates all the way back to the 1840s. The historic device utilized two pewter blades designed to separate the vaginal walls, hinged together with a screw mechanism that allowed it to open and close manually. Sims, frequently referred to in medical histories as the "father of modern gynecology," used the speculum to pioneer critical treatments for vesicovaginal fistula and other severe complications resulting from childbirth. However, his experimental procedures were infamously conducted on enslaved women without the benefit of anesthesia. Consequently, stating that the speculum was originally engineered without patient comfort in mind is an egregious understatement.
More than 150 years later, the speculum found in modern clinical practice looks almost identical to the instrument Sims utilized in the 19th century. The most notable evolution from the original Sims design to contemporary medical offices is merely a material shift; modern specula are typically manufactured from stainless steel or medical-grade plastic rather than pewter.
The mere age of the speculum is not, on its face, an inherent problem. The core issue is that the design remains fundamentally suboptimal for both patients and physicians. Doctors are frequently forced to stretch the speculum’s bills excessively wide in order to secure a clear line of sight to the cervix located deep within the body, and even under ideal circumstances, obtaining an unobstructed view is not always possible. While certain specula are manufactured with built-in light sources, the primary obstacle is often not the darkness of the vaginal canal, but rather surrounding tissue collapsing into the field of view. All of that mechanical pressure inevitably causes physical discomfort and pain; one notable review of medical literature found that a significant number of women actively avoid scheduling routine gynecological care altogether due to their dread of the device.
The psychological and emotional toll has drawn institutional scrutiny as well. In 2014, the American College of Physicians took the extraordinary step of formally recommending against routine screening pelvic examinations for average-risk adult women, explicitly citing the "harms, fear, anxiety, embarrassment, pain, and discomfort" historically associated with speculum examinations.
These widespread negative 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 points out, highlighting the practical realities of modern healthcare workflows. "There’s actual monetary value to patient comfort."
Yet, the landscape of medical innovation is littered with past attempts to improve or replace the traditional tool. In 2005, a San Francisco-based enterprise successfully patented the design for an inflatable speculum known as FemSpec. Fabricated from polyurethane—the exact material used in the manufacturing of condoms—the device was intended to be inserted by a physician much like a tampon and then inflated internally like a tiny, gentle balloon. It initially debuted to a measure of media fanfare, but ultimately commercialized poorly and faded from prominence. As an investigative report in The Chicago Times highlighted at the time, the vast majority of patients never even had the opportunity to experience the alternative speculum because it was so novel on the market that most established physicians simply were not utilizing it.
Other attempted redesigns have concentrated on more modest functional adjustments. A student prototype named the Lotus, developed by a designer at the Pratt Institute, retained the classic bill shape but introduced a subtle curve intended to facilitate more ergonomic insertion. That particular design also incorporated a rotating handle designed to open the speculum bills vertically, alongside a concealed lever mechanism intended to prevent accidental pinching of sensitive tissue. Despite appearing in a student showcase, the concept never successfully transitioned into a commercially viable product.
Meanwhile, in Oregon, a specialized enterprise called Ceek Women’s Health has initiated clinical trials for an array of novel medical devices. Their product lineup includes a specialized protective sleeve, a speculum engineered with narrower bills, and an alternative speculum designed specifically for patient self-insertion. The overarching philosophy behind their work is to build a diverse medical toolkit capable of serving a wide variety of individual patients, rather than attempting to force a single, one-size-fits-all instrument onto every body type.
"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," explains Fahti Khosrow, co-founder and CEO of Ceek. By providing physicians with an entirely new toolkit, Khosrow argues, clinics can far better serve the diverse needs of their patient populations.
Perhaps the most radical departure from traditional hardware comes from Duke University, where researchers are currently testing an experimental device capable of circumventing the speculum entirely. Mercy Asiedu, a doctoral candidate in biomedical engineering at Duke, spearheaded the development of a tampon-sized device equipped with a high-resolution 2-megapixel miniature camera affixed to the tip.
"The speculum was originally designed for a physician to view the cervix from outside the body," Asiedu notes, "but with current technology, you can easily view the cervix from inside the body."
Asiedu put her prototype to the test in a pilot study involving 15 volunteer participants, the promising results of which were officially published in the scientific journal PLOS One. Every single participating patient reported that the significantly smaller, camera-equipped device provided a markedly superior experience compared to the traditional speculum.
While the Duke study focused heavily on patient satisfaction, Asiedu readily acknowledges that practicing physicians might offer more operational criticism of the alternative device. The engineering priorities of her prototype centered squarely on comfort, personal modesty, and patient empowerment, rather than maximizing procedural speed or ease of use for the clinician.
"With a speculum, you just shove it in and expand it as wide as you want to get the visualization you want," Asiedu explains. "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 first set out to tackle the speculum, they were acutely aware of the formidable historical and professional precedents standing in their way. Furthermore, Stewart candidly admits, "I hadn’t even seen a speculum."
Consequently, before initiating formal academic research or putting final sketches to paper, Stewart and Kumar compiled a comprehensive inventory of every frustrating, painful, or clinical element they had personally experienced during gynecological examinations. They noted the acoustic trauma of the mechanical noise, which resembled an industrial can opener; the physical shock of the freezing cold metal; and the internal sensation of tissues being stretched taut like a rubber band. Once they acquired a set of physical specula—one plastic and one metal—they realized that the aesthetics demanded an immediate overhaul. Unmodified, the instruments bore an unsettling resemblance to medieval torture equipment.
Stewart’s first major technical challenge was finding a way to silence the jarring ratcheting sound of the opening mechanism. Working alongside Fran Wang, a mechanical engineer at Frog, she investigated entirely new classes of expansion mechanics. No theoretical concept was deemed too unconventional. They asked: What if, much like a pufferfish, they utilized sterile saline to inflate the device from the interior? Or what if they used pneumatic air pressure, blowing the device up like a modern air mattress? They drew design inspiration from disparate sources across nature, such as the protective hood of a cobra, as well as industrial machining techniques like milling chucks and everyday mechanical items like bicycle pumps. They closely studied how photographic tripods clamp open and shut, and how athletic ski bindings clip securely in and out, constantly searching for clever mechanical concepts to replace the antiquated screw mechanism.
Next, the team fundamentally rethought material science choices. Rather than constructing the device out of rigid plastics or cold metals, they decided to encase the entire structural assembly in medical-grade, autoclavable silicone—a material that would naturally remain neutral in temperature, withstand rigorous hospital sterilization protocols, and render the physical insertion process significantly more comfortable.
"On the metal speculum, there are pokey bits," Wang observes. "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 designers experimented extensively with alternative structural geometries, moving away from two opposing blades to explore a three-prong configuration that opened the device into a smooth, stable triangle shape. They tested shrinking the physical footprint down to the approximate dimensions of a tampon, and intentionally borrowed clean, approachable design language from the modern consumer wellness and vibrator industries. They adjusted the angle of the device’s handle, testing positions ranging from 90 degrees to 120 degrees in order to determine the absolute most ergonomic posture for examining physicians. Utilizing rapid prototyping technology, they 3-D printed multiple iterations and placed 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 reports. That geometric, triangle-shaped opening successfully provided physicians with an equivalent field of view without requiring the bills to be forced open as widely, thereby dramatically reducing the uncomfortable stretching sensation for the patient.
Furthermore, practicing OB/GYNs responded enthusiastically to the handle angled at 110 degrees, which created sufficient clearance between the clinician’s hand and the patient’s body to eliminate the awkward physical adjustments traditionally required during the exam. The silicone exterior coating was an immediate success, and the incorporation of a simple push-button mechanism to lock and unlock the device with a single hand freed up the clinician’s other hand for procedural tasks. The elimination of traditional screws removed pinching hazards, and perhaps most importantly for patient peace of mind, the entire mechanical operation was completely silent.
However, consultations with clinical OB/GYNs made one critical reality starkly apparent: redesigning the hardware alone would not guarantee systemic success. Stewart reflected on why she personally felt significantly more comfortable undergoing routine cosmetic procedures like a bikini wax than visiting her gynecologist once a year, concluding that the disparity boiled down to the entire environment. One clinical setting felt sterile, cold, and intimidating, while the other felt relatively relaxing and personal, despite carrying a higher degree of physical pain. If they truly intended to fix the speculum, they realized they had to redesign the entire patient experience from the ground up.
Half a year later, the initiative has evolved far beyond a simple hardware modification into a comprehensive reimagining of the modern pelvic exam. The physical speculum itself remains in active development, continually refined through ongoing consultations with a dedicated panel of OB/GYNs who have signed on to provide clinical guidance. Alongside the hardware, the team drafted a comprehensive set of operational guidelines for medical practices, featuring simple yet impactful recommendations such as ensuring patients are provided with a dedicated place to hang their clothing and having clinicians clearly explain each component of the physical exam before it begins.
"It’s never going to be perfect," Kumar acknowledges. "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 ecosystem now includes a fully realized mock-up of a companion mobile application designed to let patients complete intake paperwork, submit personal questions, or listen to guided meditation audio prior to stepping into the exam room. To complement the physical hardware, Kumar also engineered a comprehensive patient comfort kit featuring tactile stress balls and specialized soft socks designed to cover bare feet in the stirrups. To establish a cohesive brand identity, the team integrated visual designer Rachel Hobart into the project. The resulting integrated ecosystem has been officially named Yona.
At present, the Yona project remains an early-stage design concept. Stewart and Wang continue to iterate on new generations of physical speculum prototypes in the workshop, while Kumar and Hobart polish the companion app and overall service experience. They collaborate closely with an advisory board of medical doctors to fine-tune the concept, carefully balancing visionary design with practical clinical feasibility. Collectively, they are actively looking for forward-thinking healthcare partners—such as tech-enabled primary care networks like One Medical—with the shared ambition required to transition Yona from a visionary concept into a commercial reality.
The single greatest hurdle facing the team, however, is developing a product that established medical professionals will actually choose to adopt. The designers at Frog are acutely aware that numerous previous medical prototypes have ultimately failed after encountering professional resistance from physicians hesitant to invest in unfamiliar tools, whether due to financial considerations involving the cost of purchasing new equipment or the cognitive investment required to learn a new procedural workflow. Gynecologists have relied on the traditional speculum design for over a century, and by standard metrics, it continues to function. Why disrupt the status quo 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 notes.
Nevertheless, Wang remains optimistic, emphasizing that widespread adoption is ultimately a matter of introducing the product to the market and demonstrating its tangible benefits to both doctors and patients alike. She acknowledges that the traditional speculum functions well enough for the daily demands of most gynecologists.
"It passes, but it’s not great," Wang says. "लेकिन (But) 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."
