A device for gynecological examination has an imaging unit, which may include an illumination source, an imaging unit and an optical system, positioned within a speculum type device, typically between the blades thereof. The imaging unit is positioned at the end of an elongated rod that is positioned within a guide tube, both of which pass from between the blades down through the speculum handle, where they can be manipulated by a user to push the unit upward and forward for better viewing. A transmitter for transmitting sensed data to an external or remote receiver may be part of or may be separate from the device. The device may have non-imaging sensors, such as a pH sensor, a sensor to sense electrical impedance of tissues, a temperature sensor, etc., either by itself or in addition to an imager. A system may further include a remote receiver, a processor for processing data and a monitor for presenting images to the user in real time.