Internal Examinations for Mucus

It is not necessary to do internal examinations for cervical mucus, and more often than note internal examinations create confusion. Cervical mucus is a hydrogel – a colloidal suspension that is more than 80% water. So when Type E cervical mucus is present it flows as easily and quickly as water would down from the cervical canals to the entrance to the vagina where you will unmistakably notice it. Along its journey it may mix with some vaginal cell slough, which will lend it a white or cloudy appearance and make it a little thicker. When cervical mucus is present in abundance it overpowers the presence of vaginal cell slough and you will notice a sensation of lubrication when you wipe, and you will finger test it as clear and stretchy.  The presence of cervical mucus is obvious at the vulva. It is not necessary to search internally for cervical mucus, and to do so often leads to confusion.

The common misunderstanding that occurs among women who do internal examinations for cervical mucus is that they confuse vaginal cell slough for cervical mucus. Any time a woman does an internal examination she will find vaginal cell slough – a whitish, pasty, sticky discharge that has a mildly pleasant yeasty smell (like yogurt) which is part of a healthy vaginal ecosystem.

On occasion a HRHP may recommend that a woman use internal examinations, but that would be done only in the context of an individualized approach to understanding her particular patterns of fertility and infertility.