A medical tool used since the Roman Empire for gynaecological exams just got its first meaningful upgrade, and it’s all thanks to a team of women-led design researchers in the Netherlands.
Despite pelvic exams being key to women’s health, the tools used for them haven’t evolved much. In fact, the vaginal speculum — often described as the ‘duckbill’ — as remained more or less the same since the 1840s.
A big reason? Women’s healthcare is notoriously underfunded. A 2023 Deloitte report found that only 1% of healthcare R&D investment globally goes towards female-specific conditions.
But that might be starting to change.
Ariadna Izcara Gual, a recent graduate, and researcher Tamara Hoveling, both from TU Delft, a technical university in Netherlands, have now developed a completely new speculum design, called Lilium.
It promises better comfort, less anxiety, better visibility, and a more user-friendly experience for both patients and doctors.
FROM ROMAN TIMES TO TU DELFT LABS
The speculum has a long and uncomfortable history. Its earliest versions date back to ancient Rome, where instruments resembling metal spoons were used.
But it was J Marion Sims — the 19th-century “father of gynaecology” — who popularised the duckbill-shaped speculum made of metal, based on a bent spoon.
Sims tested his devices on enslaved Black women without anaesthesia, and the tool’s design remained largely untouched for over a century.
Even today, many women describe it as cold, invasive, and deeply uncomfortable. The shape and sounds can trigger anxiety and embarrassment.
As Ariadna put it, even more than the pain that comes with inserting or removing the device, “It is about the ‘pistol’ shape, the cold and uncomfortable feeling, the emotions.”
That’s what inspired her and Tamara to create Lilium. This speculum that uses soft materials and a flower-inspired design to ease both physical and psychological discomfort.
MEET LILIUM: A FLOWER, NOT A DUCKBILL
The Lilium speculum is made of semi-flexible, medical-grade TPV rubber. It consists of two main parts: a three-petal insert shaped like a flower, and a gentle tube mechanism to push the petals apart for examination.
Patients can either insert it themselves, like a tampon, or have a healthcare provider do it.
Initial testing has shown promising results. Eight patients and seven healthcare professionals (including five nurses and two doctors) tried it out using a pelvic model.
The verdict: better visibility of the cervix — especially in obese patients with a folding wall where traditional duckbill tools struggle — and a much more comfortable experience overall.
All eight patients preferred Lilium over the traditional design.
Lilium is also eco-friendlier than existing tools. With just two parts (compared to nine in many standard speculums), it’s easier to clean, sterilise and reuse.
WHY IT MATTERS: THE PROBLEM WITH TODAY’S TOOLS
Around 35% of women report experiencing pain, fear or shame during vaginal examinations, and around a third cite fear, embarrassment or anxiety.
A Turkish study found that up to 76% of women described pelvic exams as physically uncomfortable, while 80% said they felt emotional distress before them.
These feelings often lead to women avoiding or postponing crucial check-ups, increasing the risk of undetected infections or cervical cancer.
OTHER REDESIGN ATTEMPTS: DID THEY WORK?
Lilium isn’t the first attempt to rethink the speculum, but it might be the most promising.
Back in 2017, a design firm named Frog, led by Hailey Stewart, introduced ‘Yona’, a silicone-based, three-leaf design that aimed to be quieter, warmer, and gentler. But it never reached clinics.
Then came Nella, a startup that created a thinner, sleeker duckbill-style speculum with a silent open-and-close mechanism. While it stuck to the original blade concept, Nella gained more traction, and is now used in some gynaecological clinics.
Yet both these alternatives still largely retained the duckbill structure.
Experts say it’s not always the lack of innovation — it’s the challenge of breaking into a system where medical tools rarely change.
That’s why Lilium, backed by a university and already tested with healthcare professionals, might just succeed where others didn’t.
WHAT’S NEXT FOR LILIUM?
The prototype has already won the Young Medical Delta Thesis Award. Ariadna and Tamara are now seeking partners to help take Lilium from prototype to practice, and distribute it more widely.
“We can make pelvic examinations safer, more pleasant, and the patient more self-confident,” says Tamara.
Given that the duckbill speculum hasn’t really changed in over 150 years, Lilium could be the reset button patients and providers have been waiting for.
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