Robelle recalls her mother, Bellina Del Rosario, who passed away from cervical cancer almost 20 years ago, a few days after her 47th birthday. When she lost her mother, Robelle was a 20-year-old carefree college student – she had never heard of cervical cancer.

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Her mother’s story is all too familiar.

“As a mom you are so busy taking care of everyone else around you that you forget to take care of yourself. Same with my mom. She was a full-time, working mom, and a single mom to three children on top of it. She never got to take care of herself.”

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Bellina was not alone in these challenges. Recent national data shows that 63% of women, including 75% who have children, struggle to prioritize their own health. Now a mother to a 3-year-old daughter herself, Robelle understands how women – especially mothers – tend to put themselves at the bottom of their to-do list. 

Robelle’s mother immigrated to the United States from the Philippines when she was in her early twenties. Not only did she struggle with access to healthcare due to her non-citizen status, but she was accustomed to a different cultural norm in the Philippines, where healthcare was less accessible and regular preventive screenings were unheard of at the time. In the United States, Bellina continued to feel as though this preventive healthcare was not readily available to her while struggling to find time to prioritize herself. Robelle also tells me that women’s healthcare was almost never discussed in her house growing up, as these topics were culturally taboo in generations past.

After giving birth to her youngest child, Bellina stopped going to the doctor for herself (yet she was diligent with taking her children to all their appointments). As the years went on, she started experiencing vaginal bleeding. She initially dismissed this concern, assuming it was menopause. But as the bleeding worsened, Bellina finally sought a doctor’s appointment. 

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Robelle’s mother was diagnosed with stage 4 cervical cancer at age 46.

Initially, Robelle tells me she did not understand the seriousness of her mother’s situation because her family lacked awareness around cervical cancer at the time.

“If I would have known a little bit more, I could have asked the questions. I would have asked my mom and even pushed her, pushed us together as women, to get screened.”

Unfortunately, Bellina’s condition deteriorated quickly as the cancer spread. While Robelle tried to stay optimistic, she witnessed the toll that the chemotherapy and radiation treatments were taking on her mother. Robelle tells me, “It happened very quickly. She passed away within a year of being diagnosed. This was back in 2006. I had never even heard of cervical cancer, nor did I know anything about it.”

As she coped with her mother’s passing, Robelle stepped in as her younger sister’s caretaker and built her awareness around women’s health. Coincidentally, Bellina passed the same year that the Gardasil shot – a vaccine that protects against high-risk HPV types that cause cervical cancer – was released. Without hesitation, Robelle took herself and her sister to get this shot. “I did not know enough about the vaccine, but I knew enough from the experience that we had with my mom that I was trying to do anything preventive. At 20 years old I was trying to be a mother to a 10-year-old.” 

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Now, Robelle is very informed about preventive care surrounding cervical cancer and other women’s health needs – a concern she has translated to her family in the Philippines. In fact, her mother’s passing prompted Robelle’s aunts in the Philippines to get screened. All three of her aunts were found to have cancer – but, because they were screened and diagnosed early, their treatments were successful.

She tells me that she holds onto her mother’s experience but tries to do things differently now that she is a parent.

“It’s like when the masks fall down in the airplane. You should put the mask on yourself first and then your kid. As a mom you're always coming up with so many excuses as to why you're not taking care of yourself.”

Today, Robelle is particular about attending her annual appointments, women’s wellness visits, and preventive cancer screenings. She stays aware of her body and health needs, advocating for herself to get the care and attention she wants from her providers. Robelle tells me that she often finds herself “trying to break down walls of doctors,” while trying to get providers to take her seriously. In addition to her mother’s struggle, Robelle has also undergone cervical cryosurgery herself after an abnormal Pap smear. Based on her medical history, she insists – despite pushback – on regular preventive care and yearly cervical cancer screenings.

Robelle highlights that the Teal Wand and telehealth platform could fill critical gaps in women’s healthcare. She describes her continued discomfort with the speculum exam. “I always dread it and I always think to myself, ‘you've given birth, you'll be fine.’ It’s quick but it’s not comfortable. And they have that thing (speculum) in you. It kind of sucks.” Beyond the clinical encounter, Robelle notes that scheduling her appointments is painstaking. While she has a good relationship with her ObGyn, it can be frustrating when her appointments are canceled or rescheduled due to her provider’s busy schedule. “Teal would be beneficial because now, I'm rescheduling and canceling a year later. You just lose track of time.” 

Reflecting on how her mother’s story could have been different, Robelle tells me, “I always wonder, if Teal existed back in 2006, would my mom have done it? She wouldn’t have had to make an appointment and sit on hold.” Robelle hopes that people take advantage of the ease and preventive care that Teal’s at-home cervical cancer screening will offer. “Knowing that Teal will be available, women should definitely embrace it. Why not? It’s there for you.”

In Robelle’s words, put your oxygen mask on first.

At Teal, we want to help make sure that happens, starting with your at-home cervical cancer screenings and virtual women’s health providers dedicated to you.

Thank you, Robelle, for generously sharing your experience and your mother’s story. We at Teal Health are incredibly grateful to those who have shared their personal stories about cervical cancer screening with us.

This week, the U.S. moved one step closer to making at-home self-collection cervical cancer screening a reality. The United States Preventive Services Task Force (USPSTF), which is a panel of experts who develop the medical guidelines that providers, insurers, and consumers follow, announced a recommended update to the cervical cancer screening guidelines. 

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The update includes two important changes from the previous published guidelines:

• Primary HPV testing is now the recommended screening test, moving co-test and Pap smear to alternative options:
  From USPSTF proposal: For women 30-65 years, self-collected or clinician-collected HPV testing alone (primary HPV testing) every 5 years provides the optimal balance of benefits and harms. 
• Self-collection was added to the guidelines and stated to have similar accuracy to clinician-collected tests:
  From USPSTF proposal: Self-collection of HPV tests for screening has similar accuracy to clinician-collected tests and is associated with increased screening in underscreened individuals and in historically underscreened populations. The accuracy does not appear to show a difference between home or clinic setting for self-collection. However, most of the evidence for increased rates of screening was for home self-collection of HPV.

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There were no recommended changes to the screening age and screening intervals. For more details, see the current screening guidelines. 

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These recommended updates are currently under review and are open for public comment. Once they are finalized, they will update the 2018 USPSTF screening guidelines. You can see the draft cervical cancer screening recommendation on the USPSTF website.

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How this update supports at-home screening

At Teal Health, we are thrilled to see the USPSTF make these recommended updates to the cervical cancer screening guidelines, acknowledging the accuracy of self-collected samples and following the American Cancer Society’s lead in officially endorsing Primary HPV testing as the recommended screening test. Both of these updates align with the work we have been doing to develop, test, and validate our at-home self-collection device for cervical cancer screening. 

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The Pap smear was revolutionary for its time, but with the overwhelming evidence that HPV causes nearly all cervical cancers, HPV testing is shown to be the most effective screening. Through Primary HPV screening, we can introduce a more comfortable and private at-home self-collection option like the Teal Wand^TM, unlocking access to this critical screening. These updated guidelines will ensure we can get more people screened for cervical cancer - using a preferred method that women want.

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Teal Health, through the FDA Breakthrough Device Designation is on the fast track to be the first FDA approved at-home self-collection kit for Primary HPV testing. We were granted this designation based on the ability of the Teal Wand at-home collection to address a public health need. The USPSTF’s inclusion of this language is another sign of the importance of offering more accessible options to women in the U.S. We are excited by the progress, and honored to play our role in making it a reality in the near term. Our at-home collection kit is currently under review by the FDA.

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Cervical cancer screening guidelines are developed by organizations like the USPSTF as well as other leading organizations, such as the American Cancer Society (ACS), American Society for Colposcopy and Cervical Pathology (ASCCP), and the American College of Obstetricians and Gynecologists. 

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Disclaimer: This article contains references to sexual trauma, which may be distressing. Reader discretion is advised.

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Despite how common it is, human papillomavirus (HPV) remains a stigmatized health issue. Guidance around HPV prevention has focused on encouraging people to manage their sexual practices (e.g., monogamy, protected sex). While safe and consensual sex is important for many reasons, over the years, this emphasis on sexual habits has created a sense of stigma around HPV and blame toward women who test positive for this virus. 

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Aisha, a 40-year-old mother of three, and metastatic cervical cancer survivor describes how this stigma impacted her when she was diagnosed: 

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“Cervical cancer is so taboo. In hindsight, when I was diagnosed, I didn't want to tell anybody I had cervical cancer. I was like ‘Gross, I have a STD.’ I was so misinformed. [...] But I just sat with myself and realized this is actually part of the problem.” 

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Like so many others, stigma added to Aisha’s emotional distress when she was diagnosed. She felt embarrassed and soon realized that this stigma was making it even more challenging to find the information she needed to understand her diagnosis and manage her treatment: 

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“People look at cervical cancer like this (taboo), and this is why nobody talks about it. This is why I'm spending hours trying to find resources and information, having to piecemeal all this because it's not talked about.”

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Almost all cervical cancers are caused by persistent and untreated high-risk HPV infections. According to the Centers for Disease Control, nearly all sexually active adults will get HPV at some point in their lives, making it the most common sexually transmitted infection. In fact, 80% of women will have had an HPV infection by age 50. For 90% of women, HPV clears up on its own within 2 years. However, some HPV infections can persist, and if left untreated may progress into cancerous cell changes. 

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The American Cancer Society notes that certain genetic predispositions, smoking tobacco, and a weakened immune system are among the factors that can make it more likely that an HPV infection persists and progresses. But emerging research is also showing that key social factors can shape the risk for HPV persistence:

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1. Dealing with chronic stress and high-risk coping behaviors
2. Healthcare impacts of living in poverty 
3. Ongoing challenges that sexual trauma or violence has on one’s body and health. 

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These socially driven risk factors are not as uncommon as one may think. Most of us can probably relate to one of the most significant factors – chronic stress. 

• Research shows that among those aged 35-44, long-term sustained stress increased from 48% in 2019 (when the COVID-19 pandemic began) to 58% in 2023. 
• This group also faced the highest increase in mental health diagnoses during these 4 years – from 31% to 45%. 
• When it comes to cervical cancer risk, we also find that this is most frequently diagnosed among women who are between 35-44 years of age.

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Chronic Stress and Related Lifestyle Coping Practices 

Chronic stress (through increased cortisol levels) suppresses one’s immune functions, which compromises the body's ability to clear HPV infections. Stress creates a vicious cycle, leading to an inflammatory response that in turn intensifies stress. This stress cycle compromises immunity, increases DNA damage, and heightens the risk of HPV persisting and progressing into possibly cancerous changes. 

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The accompanying coping behaviors that people at times use to manage stress and mental health (e.g., smoking tobacco, substance use) also damage DNA and weaken one’s immune response, similarly increasing the likelihood that HPV progresses into cervical cancer. 

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Poverty and Healthcare 

Those who are low-income, especially if they also live in residentially segregated spaces, often face healthcare barriers, including limited resources, provider shortages, and less access to preventive care. These barriers contribute to why cervical cancer is steadily increasing, including among those who are low-income in urban and rural areas, where access to the HPV vaccine and routine screening can be challenging. 

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Poverty can also bring overlapping challenges, such as longer or irregular working hours, inconsistent paychecks, immigration hurdles, unsteady housing, and racial and ethnic discrimination. These challenges can lead to chronic stress, making one’s immune system more vulnerable to persistent HPV. 

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Experiences of Trauma and Violence

There is a significant link between experiences of violence or trauma and increased risk of contracting HPV with the infection progressing into cervical cancer. In the United States, over half of all women have experienced sexual violence, and those who are low-income are often continually victimized by intimate partners as they struggle to find the finances to change their living situations. 

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Survivors of sexual violence continually process these experiences psychologically and physically. This represents extreme stress and trauma, which hurts one’s long-term immune response while also increasing vulnerability to social circumstances and behaviors that escalate the risk for persistent HPV infections. 

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A Fuller Framework Around HPV Risk

Today, Aisha is a proud advocate for those going through cervical cancer and has created a platform to support women in a similar position as she was in. But, as Aisha describes, she needed to unlearn the stigma and shame around HPV and cervical cancer before she could move forward: 

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“(The HPV stigma), that's what started me trying to get comfortable because I was uncomfortable.”

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Declining cervical cancer screening rates and rising diagnoses are widespread issues. Shedding light on social determinants behind HPV and cervical cancer risk gives us a fuller framework of how to address this common virus and eliminate a highly preventable cancer – one that goes beyond stigmatizing sexual behavior. With social context in mind, we need more strategies and alternatives that engage people in routine HPV screening, which is the most effective way to eliminate cervical cancer.

Let’s be honest, no one looks forward to getting a pap smear, even if you really like your doctor and think she is amazing.  That experience, coupled with finding an available doctor’s appointment and taking time off work to drive, wait, and have the visit is enough to delay screening for years. And that’s exactly what is happening today; close to 1 in 4 women are currently behind. But we’re going to change that.

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At Teal Health, we’re doing something revolutionary. Today at the Hlth conference, we’ve announced that we’ve submitted to the FDA and shared results from our compiled report on our nationwide study which revealed that 94% of women – across all demographics, backgrounds, and locations – prefer at-home cervical cancer screening over traditional in-office Pap smears. Yes, you read that right—94%! Women across the country overwhelmingly expressed a desire for control, privacy, and comfort in their healthcare. And upon FDA approval you’ll have that option with the Teal Wand™ – we’re coming as fast as we can! 

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Why is This So Important?

Cervical cancer is nearly 100% preventable when caught early. Yet, 1 in 4 women in the US are behind on their screenings. This isn’t because women don’t care about their health—it’s because of the barriers that many of us face, lack of time, discomfort with invasive speculum exams, or simply not having access to a doctor. Did you know that nearly half of U.S. counties don’t have a practicing OB-GYN? The gaps in access to healthcare are real.

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But what do “barriers” mean to you? Personally, I don’t call them barriers…I call them Tommy and Charlie. They are fun, rambunctious, and frequently at the doctors - whether it's for Croup, Strep Throat, stitches, or a concussion. These boys are keeping us happy and busy. But what that also means, is that as a working mother, my care is often falling to the bottom of a very long to-do list. 

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Nancy can also relate. She’s a single mother raising two kids in a rural town, working just to make ends meet. With no OB-GYN nearby, getting time off for her own health feels impossible. She’s missed her last two Pap smears, even though she has insurance and knows how important they are. The Teal Wand could change everything for her—letting her screen at home, on her own time, without needing to travel or take time off work.

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Maria is a woman who has another reason for avoiding the current screening experience. After experiencing traumatic childbirth, the thought of enduring another speculum exam is unbearable. Every visit to the doctor triggers anxiety and pain, making cervical cancer screenings something she avoids at all costs. But with the Teal Wand, Maria could finally take control of her health in a way that feels controlled and comfortable. No speculum, no pain—just an easy self-collection from the comfort of home.

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At Teal Health, we’ve developed a comprehensive alternative that addresses the common reasons women delay their preventative health screenings. Our at-home device, the Teal Wand™, allows women to self-collect a sample in the privacy of their own home, on their schedule with the virtual support of medical experts along the way and through follow-up steps, if needed. 

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No speculums, no waiting rooms, no stress. It’s a seamless end-to-end experience designed by women and for women.

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What the SELF-CERV Study Told Us: A Breakthrough That’s Changing the Game

We recently completed our nationwide SELF-CERV study, enrolling over 600 women from diverse backgrounds. The results were overwhelming:

• 94% of participants said they’d prefer to self-collect at home if they knew it was just as accurate as an in-office exam.
• 93% found the Teal Wand easy or very easy to use—it’s quick, simple, and you’re done in minutes.
• 86% would be more likely to stay up-to-date with routine cervical cancer screening if an at-home self-collecting option was available

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These findings aren’t just statistics—they’re a call to action. Women want a better way, and Teal is delivering. View the full data report here. With the conclusion of the study, we compiled a comprehensive submission of our clinical data for review by the FDA, positioning the Teal Wand™ to become the first FDA-approved at-home cervical cancer screening device. After extensive clinical trials at 16 sites nationwide, we’ve met and exceeded every endpoint. And with the FDA’s Breakthrough Device Designation, we’re on an accelerated path to market.

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This is a huge moment for women’s health. Once approved, the Teal Wand™ will allow women to take control of their cervical health with a convenient, accurate solution.

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Designed for Women, With a Bold Vision for the Future

What sets Teal Health apart? It’s simple: we listened to women. From the very beginning, our mission has been about putting women first—designing a device that’s comfortable, easy to use, and seamlessly fits into their lives. Our commitment to diversity was central to this effort, as we made sure our clinical trials included a representative cross-section of the US population—considering race, ethnicity, gender, income, geography, and more. The result is a solution that works for every woman, no matter her background or access to healthcare. Because healthcare shouldn’t leave anyone behind, and neither will we.

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But this is more than just a product—it’s a movement it's a movement towards designing healthcare for women. For too long, the healthcare system has failed to prioritize women’s unique needs. In fact, it wasn’t until 1993 that women were even required to be included in clinical trials! Teal Health is changing that. We’re working toward a future where every woman is included at every step and has easy access to healthcare and life-saving cervical cancer screenings—whether she’s living in a busy city or a rural community, earning a six-figure salary, or managing on minimum wage.

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And we’re not stopping here. With the momentum of a $1.68 million SBIR grant from the National Cancer Institute, we’re accelerating development and clinical validation to meet the demand and bring the Teal Wand™ to women across the US. This funding strengthens our mission to reach every eligible woman, offering an accurate, accessible screening alternative that drives adherence and improves outcomes for all.

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Join Us in Our Mission Towards Eradicating Cervical Cancer in The US

Teal Health is on a mission to make cervical cancer a thing of the past. It’s bold, but with the innovation of the Teal Wand and the passion of women everywhere, we know it’s within reach.

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So, what’s next for you? Talk about it. Share this with your friends, your sisters, your coworkers. Together, we can start the conversation that will save lives. Follow Teal Health’s journey at getteal.com and sign up to be the first to know when the Teal Wand™ is available.

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Thank you for trusting us with your health. We’re designing for you, and together, we can make history in eradicating cervical cancer in the US. 

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Kara Egan

CEO, Teal Health

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It’s been almost 2 years since I was diagnosed with breast cancer, and a year and a half since my medical team declared me cancer-free.

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I was 29 years old, had just been married, and was in the final stretch of my doctorate program. Life stopped in that moment.

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I vividly remember shriveling up, trying to disappear while my husband held me, as my doctor told us that a clinical trial was my best chance at defeating this stage 3c triple-negative tumor. 

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I was among the many women who delayed their cervical cancer screenings during the pandemic, and finally got an appointment in October 2022. A few days before, I had felt a lump in my breast. I didn’t think much of it. There was no known history of breast cancer in my family and I was young. But, as chance would have, it was a cervical cancer screening appointment that ultimately led to my breast cancer diagnosis.  

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After I pointed out the lump to the Nurse Practitioner conducting my cervical cancer screening, she felt it too and referred me to a breast specialist. I called both my insurance carrier and the specialist clinic, insisting I needed to be seen within the week, and the breast specialist diagnosed the cancer soon after.

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In the weeks to come, an ultrasound, biopsy, MRI, PET scan, and mammogram (although, my dense breast tissue meant the mammogram was not as effective) all confirmed the tumor was there and had spread to a lymph node. During this diagnostic journey, I learned that my cancer was due to a BRCA 2 genetic mutation. The mutation was not as evident in my family, as it was passed down paternally for several generations, with few women to impact along the way (the main effects of BRCA 2 relate to ovarian and breast cancers).

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Had I known, I would have been in specialized hereditary cancer care and surveillance since my early 20s – but that’s the thing about family medical history, often we simply don’t know. 

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Being unaware of family medical history is a common challenge for immigrants. As someone who has moved around several times, and the first in my family to immigrate to the United States, my family history knowledge is scattered. While my doctoral research focused on genetic testing experiences, there is little to no guidance for people of “South Asian” or “Indian” heritage to get tested for cancer genes (unless they are aware of a family history). Anytime I would ask for a breast screening, being frustratingly proactive about preventative healthcare, I was told ‘You’re too young.’ In many ways, I fell through a series of cracks. 

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Within 2 weeks of being diagnosed, I was getting my first chemotherapy infusion as a part of a clinical trial for high-risk breast cancers. I had the option to delay my infusions to freeze my eggs, but chose not to. I was overwhelmed knowing how aggressive my tumor was. I spent the next three months getting infusions and MRIs. Never had I imagined I would spend my 30th birthday or my first wedding anniversary bald, nauseous, in cancer treatment. But my goal was to persevere. I was in fight mode.  

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I was incredibly fortunate that the drugs used in the clinical trial worked – in January 2023, an MRI and biopsy confirmed that the cancer was gone.

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In March 2023, I underwent a day-long surgery, a double mastectomy with reconstruction using tissue from my thighs. For four days, I recovered in the ICU. For five weeks I recovered at home, while my husband helped me re-learn how to move with a walker, emptied my surgical drains, and took care of my every need. 

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The rest of 2023 held five weeks of radiation, 13 rounds of immunotherapy infusions, and a 12-month course of pills – and many, many side effects. My skin endured severe burns from the radiation, which required intense wound care. I remember the nurse who changed my dressings each day saying that everyone missed the early signs of my brown skin burning (they were looking for ‘redness’ that one might expect on lighter complexions). My body was covered in allergic hives, a reaction to ongoing infusions. I ended up in the Emergency Room unable to breathe because the pills had greatly reduced my red blood cell count. But, despite everything, I had been declared “NED” (no evidence of disease), and I wanted to get through treatment to keep it that way.

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I am immensely grateful for my stellar medical team, loving family, and unwavering community of friends and colleagues. My husband never let me feel helpless and took on the weight of my care with grace. Somehow, he made sure I still laughed, enjoyed my hobbies, and drew strength in each moment. Now, in close surveillance care, I still hold my breath before every scan and panic at a slight bodily ache, but knowing I am not alone makes a world of difference. 

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While I may wish breast cancer never happened, it has taught me every day to be grateful, find meaning in what I do, and cherish those around me. It has undeniably shaped me and the decisions I have made since. I joined Teal Health almost right after I completed my treatment, and I do not take for granted the opportunity to help eradicate cervical cancer. 

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This Breast Cancer Awareness Month, I will be celebrating 2 years of my diagnosis – celebrating, because getting screened and identifying the cancer was the start of my journey to get rid of it. If you are behind on your routine cancer screenings, please, get screened. If you don’t know your family medical history, talk to your doctor about testing for your health needs. And if this finds you going through your own diagnosis, know that you are not alone. 

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A traditional cervical cancer screening requires a patient to lay on an exam table and place their feet into stirrups to hold their legs apart, while a provider inserts and expands a speculum into their vagina. This procedure, the status quo for cervical cancer screenings in the United States, can be distressing for many patients. As an at-home self-collected HPV test for cervical cancer, the Teal Wand^TM could offer an alternative to this traditional exam for those who cannot or prefer not to use the speculum. 

While an alternative to the speculum may be a preference for many, it is a necessity for some. Certain health conditions make using a speculum excruciating and at times impossible. These include genitourinary syndromes involving narrowing or tightening of the vaginal tissues, chronic vaginal pain, as well as lichen sclerosus, a chronic autoimmune vulvar skin disease. These conditions can intensify with the physiological changes menopause brings, and make using a speculum very difficult if not intolerable. 

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When the Speculum is Not an Option

We recently spoke to Jennifer and Kristin, both women in their mid-50s, about their health conditions and inability to screen with a speculum. Jennifer experiences pain from a stenotic hymenal band (or, hymenal stenosis and fibrosis), while Kristin was diagnosed with chronic lichen sclerosus. 

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Hymenal stenosis and fibrosis is a rare condition where a fibrous ‘band’ develops on the hymen, making one’s vagina more sensitive and narrow. There is little research on this condition, but medical case studies note that symptoms may include pain with using tampons, intercourse, and recurring urinary infections. In most cases, the condition can only be resolved surgically, with a hymenectomy. 

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Lichen sclerosus affects up to 3% of the population, although prevalence is likely higher, since its symptoms are frequently misdiagnosed. It can cause a patient’s vulvar skin to thin and narrows their vaginal opening, so patients often experience tearing, inability to have sexual intercourse, pain during urination, constipation, itching, and soreness. If left untreated it can cause scarring that may lead to complete loss of one’s vulvar architecture. There is up to a 5% risk that lichen sclerosus evolves into vulvar cancers. 

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Dr. Liz Swenson, an OBGYN and Teal’s Medical Director, tells us, “Unfortunately, these situations are not that uncommon. Despite the range of speculum sizes, it can still be too painful for some women to tolerate. Even if they make it through the speculum exam it can still have a negative impact, causing some to put off that next visit.”

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Unable to tolerate speculums, Jennifer and Kristin describe how an alternative to the current in-person speculum exam experience would make the difference between being able to participate in routine screening or falling behind and facing heightened risks.  

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Jennifer’s Story

Jennifer has been a midwife for almost 25 years and is passionate about her work. As a provider, she conducts cervical cancer screenings and has witnessed women struggle with the speculum time and time again. However, while Jennifer insists her patients should stay up to date on their screenings, she has not been able to do this for herself.

For Jennifer, traditional speculum exams are painful and have led her to delay her own screenings. Her last screening was almost 10 years ago, much longer than the current recommendations. “The advice I give to people as far as when they should have screenings, I am not following it - I'm terrible!” 

Jennifer has seen several providers about her hymenal stenosis and fibrosis. She first began feeling this pain during perimenopause, around her 40s. However, it has worsened in the past several years as her vaginal tissue changed during menopause and she stopped being as sexually active. The various interventions, like estrogen creams, dilators, and surgical procedures, have not been suitable for Jennifer.

“A speculum exam, honestly, it’s somewhat like torture,” she tells me, as she explains that during her last screening she “basically whimpered and cried the whole time.” She dreads (and has thus delayed) her cervical cancer screening because of her vaginal tissue sensitivity.

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“A regular speculum would be really, really uncomfortable, to a point where I don't even know if I would tolerate it.”

Using a self-collection device designed for all body types, with the convenience and comfort of being in one's own home is a critical option for someone like Jennifer.  She not only struggles with the exam, but also with finding time on her days off as a healthcare provider. The added comfort would mean that Jennifer can screen without pain. 

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Kristin’s Story

Kristin was diagnosed with lichen sclerosus in 2009, making it extremely painful to screen with a speculum. She has not been screened for cervical cancer since 2019. Although, she did attempt a screening in 2023, where she tells me, “(My provider) wasn't able to get the speculum in, even the smallest size. So, we had to stop. It was just not going in.” After Kristin exclaimed in pain, the provider stopped and sent Kristin home without offering any screening alternatives. 

Unfortunately, Kristin has often experienced dismissive and unsupportive healthcare. “There's just a lack of empathy [...]. I just feel like I'm just a number. [...] I do tell them about my disease, but I don't feel like there's a lot of information out there.” Her providers insist that her vagina will stretch with the speculum, despite the terrible pain.

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“You know how they're like, ‘Spread your knees apart’? I could never do that. I was just like ‘No, I can't. It hurts. That’s as far as it goes.’ It just feels like I'm ripping!”

Kristin’s vaginal pain and narrowing intensified throughout menopause. She describes the feeling of enduring a speculum as “being stretched,” and that interventions like dilators do not work for the same reason.

Kristin desperately wants to stay on top of her screenings but does not know how, given that she cannot use a speculum. “From here, I'm not sure what to do.”

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She adds, “Before I got diagnosed, I kept up to date with my screenings. […] This is the first time that I’ve let it lapse. [….] I tried. I know it’s still important to get tested. I want to get it done.”

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Paving the Way Forward Requires More Screening Options

For both Jennifer and Kristin, the speculum is out of the question. Here, devices like the Teal Wand* offer a critical solution for engaging in routine cervical cancer screenings. Jennifer tells me, “Honestly, if the Teal device was available now I would do it, and I probably would be good about how often I have to do it.” 

Kristin, in particular, looks forward to self-collecting at-home, where she can feel at-ease and in-control. At the clinic, Kristin says she is immediately “triggered, nervous, and upset.”

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“Even when the doctor just touches me with the speculum, I tense up from my past experiences. But if I could just do it at home and take my time, take a bath and get relaxed, I could just go at my own pace and not feel rushed.” 

While seeing providers in-person is important and needed at times, an in-person pelvic exam is not always called for during routine cervical cancer screenings. For some, like Jennifer and Kristin, self-collection is a necessity and can enable them to stay up to date on cervical cancer screenings. 

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For too long, women and people with cervixes have been made to accept that their healthcare is inevitably painful and a matter of endurance. However, providing alternatives can make all the difference between allowing people to readily participate in – versus indefinitely delaying – their life-saving cervical cancer screenings (when caught early, through screening, cervical cancer can be cured 92% of the time). 

A seasoned midwife, Jennifer highlights, “Especially for women, it can feel like so many things are done to us, so doing it yourself feels great.” She adds, “that feeling that I have just taken charge of my own health and did this on my own? That’s wonderful.” 

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Thank you, Jennifer and Kristin, for being so generous with your time and perspectives. Teal Health is honored to share your stories.

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*The Teal Wand is not yet FDA approved, but has been designated as a Breakthrough Device by the FDA, prioritizing its review

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