What is colposcopy?

Colposcopy lets a doctor look at your vulva, vagina, and cervix. If the doctor sees a possible problem, they can take a small sample of tissue. This is called a biopsy. Then another doctor studies the tissue under a microscope.

Most people have this procedure after they have abnormal results from a Pap or human papillomavirus (HPV) test.

During the test, your doctor puts a lubricated tool into your vagina. This is called a speculum. It opens the vagina a little bit. This allows your doctor to see inside your vagina and the cervix. The doctor also uses a magnifying device to help see better. This device does not go inside your vagina.

The doctor may put vinegar or iodine on your cervix. This can help the doctor to see any areas that are not normal. Sometimes the doctor also takes photos or videos.

When the speculum goes in, it can feel a little uncomfortable. If the doctor does a biopsy, you may feel a pinch and have some cramping.

Activity

• You can return to work and most daily activities right after the test.

Exercise

• Do not exercise for 1 day after the test.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Be safe with medicines. Read and follow all instructions on the label. Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.

Other instructions

• Some vaginal bleeding or discharge after a biopsy is normal. The discharge may be dark-colored. Use a pad if you have some bleeding.
• If you had a biopsy, do not have vaginal sex or place anything in your vagina for 1 week or until your doctor tells you it is okay. Do not douche.
• You can take a bath or shower anytime after the test.

A colposcopy usually takes about 15 minutes.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Tell your doctor if:
  • You are having your menstrual period. This procedure usually isn't done during your period. This is because blood makes it harder to see your cervix.
  • You are or might be pregnant. A blood or urine test may be done to see if you are pregnant.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Colposcopy has few risks. In rare cases, a cervical biopsy can cause an infection or bleeding. Bleeding can usually be stopped by using a special liquid or swab on the area. If you are pregnant, you may have more bleeding from a biopsy.

Your doctor will talk to you about what they see at the time of the test. If you had a biopsy, getting your lab results may take several days or more.

You may feel some discomfort when the speculum is put in. You may feel a pinch and have some cramping if a tissue sample is taken.

You may feel some soreness in your vagina for a day or two if you had a biopsy. Some vaginal bleeding or discharge for about a week after a biopsy is normal. The discharge may be dark-colored. You may also have some spotting for about 3 weeks. You can use a sanitary pad for the bleeding.

It may take a week or two for you to get the test results.

• You may want to take a pain reliever 30 to 60 minutes before the test. This can help reduce any cramping pain from a biopsy. Ibuprofen (Advil or Motrin) is a good choice.

At the doctor's office

• Bring a picture ID.
• The procedure will take about 15 to 30 minutes.

This test can be done in your doctor's office.

You will need to take off your clothes below the waist. You will be given a covering to drape around your waist. You will then lie on your back on an exam table. Your feet will be supported by footrests.

The doctor will place a lubricated tool called a speculum into your vagina. It opens the vagina a little bit so your doctor can see inside the vagina and the cervix.

The colposcope is moved near your vagina. Your doctor looks through it at the vagina and cervix. Vinegar (acetic acid) or iodine may be used on your cervix to make abnormal areas easier to see. Photos or videos of the vagina and cervix may be taken.

If areas of abnormal tissue are found on the cervix, your doctor will take a small sample of the tissue. This is called a cervical biopsy. Usually several samples are taken. The samples are looked at under a microscope for changes in the cells that may mean cancer may be present or is likely to develop. If bleeding occurs, a special liquid (Monsel's) or silver nitrate swab may be used on the area to stop the bleeding.

If a sample of tissue is needed from inside the opening of the cervix, a test called endocervical curettage (ECC) will be done. This area can't be seen by the colposcope. So a small brush or tool called a curette is gently put into the area to take a sample. ECC takes less than a minute to do. It may cause mild cramping. An ECC is not done during pregnancy.

Colposcopy is done to:

• Look at the cervix for problem areas when a Pap test was abnormal. If an area of abnormal tissue is found, a biopsy is often done.
• Check a sore or other problem (such as genital warts) found on or around the vagina and cervix.
• Follow up on abnormal areas seen on a previous colposcopy. It can also be done to see if treatment for a problem worked.
• Look at the cervix for problem areas if an HPV test shows a high-risk type of HPV.