Designing Medicine Around Patients: Rethinking Gynecologic Care

Writer: Julia Lalla

Editor: Kimberly Arinton

Introduction

Gynecologic tools and services have not changed for over a century, despite major advances in medical technology [1]. Many patients experience fear, discomfort, and anxiety during routine reproductive health screenings, such as Pap smears, due to the uncomfortable processes and equipment; the use of a speculum, and overall examination, can especially be traumatic for transgender people and victims of sexual assault [1]. A study shows that feelings of anxiety and shame prevent about 35% of women from receiving proper preventative care [2]. As medicine moves toward more equitable healthcare options, there is a growing recognition of the need for gynecologic services with the patient’s needs in mind, such as a redesigned speculum and simpler diagnostic methods utilizing menstrual blood, leading to patient-centered design that improves both the comfort and health outcomes for all.

The Lilium Speculum and Patient-Centered Engineering

The Lilium speculum was designed by Ariadna Izcara Gual, a graduate student in the industrial engineering department at TU Delft, who recognized the issue of the common speculum preventing many women from receiving Pap smears [2]. The speculum was originally designed for visibility and efficiency rather than patient comfort, which has become increasingly evident over the years as many women report feeling pain and discomfort when this traditional tool is used [1].

Through patient-centered design research, the Lilium was created using soft rubber instead of cold metal, which feels better and appears less scary. It also has a flower-inspired structure that opens gradually rather than forcing sensitive tissue apart with strong pressure. This structure is similar to a tampon, which is already used by about 48% of women in the United States [3]. Its familiar, tampon-like structure may feel less foreign and intimidating than the typical speculum. Doctors and nurses were consulted during the designing process, leading to beneficial developments in the structure, such as improving cervix visualization and making the device easier to use for healthcare providers. A small trial has even been completed, with the participants’ feedback showing increases in confidence and comfortability with the Lilium’s design and versatility [2]. Therefore, designing medical devices around familiar bodily experiences can reduce anxiety, improve patient reception, and prevent more cases of cervical cancer-related fatalities.

Menstrual Blood as a Diagnostic Tool

For centuries, menstrual blood has been treated as a waste product. However, new research has shown its great potential as a diagnostic tool for a multitude of diseases. Menstrual blood contains endometrial cells, immune cells, proteins, microbes, and genetic material, each of which can act as biomarkers and provide information about a person’s health. It can be used to detect hormonal imbalances, endometriosis, diabetes, and cervical cancer [4].

One of the most promising applications is cervical cancer screening, which would reduce the need for invasive Pap smears. Human papillomavirus, which causes 99.7% of cervical cancer cases, can be detected in menstrual blood [4]. Early research shows a strong correlation between menstrual blood testing and Pap smears, with one study reporting a 94% agreement of results and a strong patient preference for the menstrual blood collection method [4]. In addition to accuracy, the use of menstrual blood can be much more accessible and less stressful for many women than a Pap smear since the collection is done at home via a specialized menstrual pad; this removes barriers of anxiety, scheduling conflicts, and discomfort.

The ability to detect endometriosis using menstrual blood is also a significant advancement in medical technology. Endometriosis is typically diagnosed through laparoscopic surgery, which can be unrealistic for many patients due to costs, recovery periods, and general risks of surgery. Through examining certain proteins found in their menstrual blood, patients can simply send in a collection rather than have a surgery in order to reach a diagnosis [4]. If this menstrual blood collection process becomes standardized, preventative medicine will be greatly improved for all people who menstruate.

Looking Towards the Future

The move toward patient-centered medicine reflects a larger shift to designing healthcare tools with patient input and needs based on their lived experiences, including the Lilium speculum and menstrual blood diagnostic options. It also corrects the long-term inequalities where women’s comfort in healthcare is overlooked. Combining engineering innovations, clinical research, and patient experience will improve reproductive healthcare accessibility for everyone who requires gynecologic care.

References:

1. Chaney, P. (2020, March 18). Speculum Speculations: History of the Gynecology Instrument. GE HealthCare. https://www.volusonclub.net/empowered-womens-health/speculum-speculations-the-past-and-future-of-an-iconic-gynecology-instrument/.

2. Hoveling, T. (2025, January 16). New Vaginal Speculum Design Might Motivate Women to Go for Health Checkups. Tu Delft. https://www.tudelft.nl/en/ide/delft-design-stories/new-vaginal-speculum-design-might-motivate-women-to-go-for-health-checkups.

3. Wang, Z., Peebles, E., Baird, D. D., Jukic, A. M. Z., Wilcox, A. J., Curry, C. L., Fischer-Colbrie, T., Onnela, J.-P., Williams, M. A., Hauser, R., Coull, B. A., & Mahalingaiah, S. (2025). Menstrual Product Use Patterns in a Large Digital Cohort in the United States: Variations by Sociodemographic, Health, and Menstrual Characteristics. American Journal of Obstetrics and Gynecology, 233(3), 184.e1–184.e15. https://doi.org/10.1016/j.ajog.2025.03.002.

4. Zaheer, A., Komel, A., Abu Bakr, M. B., Singh, A. K., Saji, A. S., Kharal, M. M., Ahsan, A., Khan, M. H., & Akbar, A. (2024). Potential for and Challenges of Menstrual Blood as a Non-Invasive Diagnostic Specimen: Current Status and Future Directions. Annals of Medicine and Surgery (2012), 86(8), 4591–4600. https://doi.org/10.1097/MS9.0000000000002261.