Colposcopy

Medically Reviewed By William C. Lloyd III, MD, FACS

What is colposcopy?

Colposcopy is a procedure to closely examine a woman’s cervix. The cervix is the very lowest portion of the uterus where it narrows into a neck-like structure. It opens into the vagina. The procedure involves using a device called a colposcope. The colposcope lets your doctor see a magnified, lighted view of your cervix to check for precancerous areas of the cervix and vagina. Colposcopy is an important test because it can identify cervical cancer at an early stage.

Other procedures that may be performed

If your doctor finds an abnormal area, she will likely take a biopsy of it. A cervical biopsy involves removing a tissue sample from the cervix and examining it for cancer cells. Sometimes, the biopsy can remove all the abnormal tissue. If this is the case, no further treatment may be necessary.

Why is colposcopy performed?

Your doctor may recommend colposcopy if you have had abnormal results from a Pap test or a positive HPV test. A Pap test is a screening tool for cervical cancer. It involves sweeping the surface of your cervix with small brush to get a sample of cells for testing. The HPV test looks for the virus (human papillomavirus) that causes the vast majority of cervical cancers. A positive result doesn't mean you have cancer or will develop cancer of the cervix, but it increases your risk.

Your doctor may also suggest colposcopy for these symptoms and conditions:

Who performs colposcopy?

An obstetrician-gynecologist (Ob/Gyn) typically performs colposcopy. An Ob/Gyn is a doctor who specializes in the medical and surgical care of women's health and pregnancy.

How is colposcopy performed?

Your colposcopy will be performed in a doctor’s office or clinic. The procedure usually takes less than 30 minutes and generally includes these steps:

  1. You will empty your bladder for your comfort during the procedure.

  2. You will wear a patient gown, lie on an exam table, and put your feet in the stirrups like you would for a pelvic exam.

  3. Your doctor will insert a speculum into your vagina to hold it open.

  4. Your doctor will position the colposcope close to the opening of your vagina to view your cervix. The instrument remains outside your body.

  5. Your doctor will apply a solution to your cervix to help identify any abnormal cells.

  6. If a biopsy is necessary, your doctor will remove a tissue sample and then apply a paste to your cervix to control any bleeding.

Will I feel pain?

Your comfort and relaxation is very important to both you and your care team. You may feel some cramping, burning, stinging or pinching during a colposcopy. You can help yourself and your doctor by relaxing your pelvic muscles as much as possible. Take a few long, deep breaths to help yourself relax. Tell your doctor or a member of your healthcare team if any discomfort does not pass quickly.

What are the risks and potential complications of colposcopy?

Complications after colposcopy are not common, but any medical procedure involves risk and potential complications. Complications may become serious in some cases. Complications can develop during the procedure or your recovery. Risks and potential complications of colposcopy include:

  • Bleeding

  • Cramping

  • Dark discharge if your doctor takes a biopsy

  • Infection

Reducing your risk of complications

You can reduce the risk of certain complications by:

  • Following activity and lifestyle restrictions and recommendations before your procedure and during recovery

  • Informing your doctor if you are nursing or if there is any possibility of pregnancy

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, or increase in pain

  • Taking your medications exactly as directed

  • Telling your care team if you have allergies

How do I prepare for my colposcopy?

The steps you take before your procedure can improve your comfort and outcome. You can prepare for colposcopy by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Not using tampons, douching, using vaginal creams or medicines, or having sex for 24 hours before the procedure.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. 

Questions to ask your doctor

Preparing for colposcopy can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before the colposcopy and between appointments.

It is also a good idea to bring a list of questions to your appointment. Questions can include:

  • Why do I need colposcopy?

  • How long will the procedure take? When can I go home?

  • What kind of restrictions will I have after the procedure? When can I expect to return to work and other activities?

  • What medication plan should I follow before and after the procedure?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

  • When and how will I receive the results?

  • What other tests or treatments might I need?

What can I expect after my colposcopy?

Knowing what to expect after colposcopy can help you get back to your everyday life as soon as possible.

How will I feel after the colposcopy?

You may mild discomfort and cramping after the colposcopy. To reduce discomfort, take slow deep breaths. Your doctor may recommend taking over-the-counter pain relievers.

When can I go home?

You should be able to go home immediately after the procedure. You can usually return to your activities right away. You may have some light spotting for a couple of days, so have a supply of sanitary pads or liners ready.

If your doctor takes a biopsy during colposcopy, your cervix will need time to heal. This generally takes about a week. During this time, you may have some bleeding or dark discharge. While you recover, you should not put anything into your vagina. This includes not using tampons, having sex, or douching. You may also feel sore for a couple of days. Ask your doctor about over-the-counter pain relievers to manage any discomfort.

When should I call my doctor?

It’s important to keep your follow-up appointments after colposcopy. Contact your doctor if you have any concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Fever or chills

  • Foul-smelling discharge

  • Heavy vaginal bleeding

  • Severe pain in your lower abdomen

After colposcopy, your doctor may determine your cervix is normal. Your doctor could also find you have abnormal-looking cells, most often due to human papillomavirus (HPV) infection. The infection usually resolves on its own and the cells heal with time. You may need a repeat Pap smear to check the cells again or an HPV test. If your doctor takes a cervical biopsy to examine the cells more closely, you will get the results within a week or two.

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  1. Colposcopy. American Academy of Family Physicians. http://familydoctor.org/familydoctor/en/diseases-conditions/cervical-cancer/diagnosis-tests/colposcopy.html  
  2. Colposcopy. American College of Obstetricians and Gynecologists. https://www.acog.org/~/media/For%20Patients/faq135.pdf?dmc=1&ts=20140228T1447384445
  3. Colposcopy. Johns Hopkins University. http://www.hopkinsmedicine.org/healthlibrary/test_procedures/gynecology/colposcopy_92,P07770/
  4. Colposcopy. Mayo Foundation for Medical Education and Research. http://www.mayoclinic.org/tests-procedures/colposcopy/basics/definition/prc-20014027
  5. Abnormal Cervical Cancer Screening Test Results. American College of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Abnormal-Cervical-Cancer-Screening-Test-Results
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Sep 16
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