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Colposcopy

Planned Parenthood Women's Health: Procedures to Prevent Cervical Cancer: Colposcopy

Colposcopy at a Glance

  • Test to find abnormal cells on the cervix
  • Sometimes performed with biopsy
  • Helps determine if further treatment is necessary

When a health care provider thinks that a woman may have abnormal cells on her cervix, the provider may suggest further testing. One key way to find abnormal cervical cells is to have a colposcopy procedure and, sometimes, a colposcopy and biopsy together.

Many people have heard about colposcopies, but are not sure what they are. Here are the answers to some questions women commonly ask about colposcopy, biopsy, and abnormal cervical cells.

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What Is a Colposcopy?

A colposcopy is a way to get a close-up view of the cervix. It is used to detect abnormal cells on the cervix and the area near the cervix. During a colposcopy procedure, a health care provider uses a colposcope — an instrument that looks like binoculars with a bright light mounted on a stand.

Why Do Women Have Colposcopies?

A colposcopy may be used when

  • you have abnormal Pap or HPV test results
  • your cervix looks abnormal during a GYN exam
  • you need to find the cause of unexplained bleeding or other problems

A colposcopy procedure is used to determine whether more tests or treatments are needed.

What Is a Biopsy?

If a part of the cervix does not look normal, a health care provider will remove a tiny sample of it and send it to a lab. This is called a biopsy. A biopsy is often done during a colposcopy procedure. Sometimes a woman needs to have more than one biopsy.

What Happens During a Colposcopy and Biopsy?

A colposcopy procedure is simple. It does not require an anesthetic, and can be done in a health care provider's office.

  • A woman lies down on an exam table in the same position used to have a Pap test.
  • A speculum — a metal or plastic instrument — is inserted into the vagina to separate the walls. You may feel some pressure when the speculum is put in.
  • The health care provider swabs the walls of the vagina and the cervix with a vinegar-like solution. The solution removes mucus and also turns abnormal cells white — making them more visible. You may feel a little burning from the solution. The health care provider may also apply iodine to make the abnormal cervical cells easier to see.
  • The health care provider looks at the magnified cervix and vagina through the colposcope from outside the vagina — the instrument never enters the body.

 

Biopsies are taken from any areas that appear to have abnormal cervical cells. This is done in two ways:

  • by scraping away cells with a small brush or a small metal loop called a curette
  • by taking a plug of tissue about the size of half a grain of rice with an instrument similar to a paper punch. This is known as a punch biopsy.

 

The tissue that has been collected is then sent to a lab. A doctor in the lab will test them.

A colposcopy and biopsy usually take about 10 minutes.

Colposcope

Are a Colposcopy and Biopsy Painful?

The colposcopy procedure is nearly pain-free — the cervix does not have many nerve endings. Some women feel mild stinging or burning when the solution is applied.

If a biopsy is necessary, you may have some discomfort — most women describe it as feeling like a sharp pinch. To others it feels like a menstrual cramp.

What Should I Do to Prepare for a Colposcopy?

Preparing for a colposcopy is simple.

  • Schedule your colposcopy procedure for when you will not have your period.
  • You may want to take an over-the-counter pain reliever about an hour before the exam to reduce the chance of discomfort. Ask your health care provider in advance to recommend a pain reliever.
  • Do not douche, use tampons, put medications in your vagina, or have vaginal intercourse for at least 24 hours before the procedure.

What Can I Expect After the Procedure?

After you have a colposcopy procedure, your vagina may feel slightly sore for a couple of days. If you also have a biopsy, you may spot or have a dark-colored vaginal discharge. Use a maxi pad, panty liner, or tampon — unless your health care provider tells you not to use tampons.

You may shower or bathe as soon as you want after the procedure.

If a biopsy is not taken, you can resume sexual activity as soon as you like.

If a biopsy is taken, you should wait about three days before having vaginal intercourse. This allows the cervix time to heal. You can enjoy other sex play that does not involve inserting anything into your vagina.

Continue taking your medications as usual — including your birth control.

What Are the Risks of a Colposcopy and Biopsy?

It is rare to have problems after a colposcopy and biopsy. Rare risks include bleeding that needs treatment or an infection that needs treatment.

Call your health care provider if you have

  • bleeding that's heavier than spotting — unless you think it's your period
  • fever or chills
  • heavy, yellow-colored, or bad-smelling discharge from your vagina
  • severe pain in the lower abdomen

 

A colposcopy and biopsy are like many other tests. There is a risk that they can give a wrong result. That's why it's important to continue getting regular Pap tests and follow-up care after your colposcopy.

If You Are Pregnant

The colposcopy procedure is safe during pregnancy. The risk of biopsy during pregnancy is small, but your health care provider may delay performing a biopsy, if possible. Pregnant women may have more bleeding after biopsies than women who are not pregnant. This is because the cervix has an increased blood supply during pregnancy.

Colposcopy and biopsy should not affect your ability to have children in the future.

What Happens If I Have Abnormal Results?

It depends on how abnormal the cervical cells are. Your health care provider simply may recommend waiting to see if the abnormal cells heal themselves. In this case, you will have a repeat Pap test and possibly other tests to monitor the cells.

Sometimes, the biopsy is also the treatment. The health care provider may be able to remove all of the abnormal cells during the colposcopy and biopsy procedure. If so, no further treatment is needed.

Another procedure may be needed for further treatment. The following procedures are very effective at removing the abnormal areas and preventing cervical cancer:

  • Cryotherapy — abnormal tissue is frozen off
  • LEEP — abnormal tissue is removed using a thin wire loop that carries an electrical current
  • Laser — abnormal tissue is destroyed with a laser beam
  • Cone biopsy — a cone-shaped wedge is cut out of the cervix

Pap Tests After Treatment

It is important to continue to get regular pelvic exams and Pap tests after you have been treated for abnormal cells. Even though cryotherapy, LEEP, laser, and cone biopsy are very effective, sometimes abnormal cells reappear or develop after treatment.

Very rarely, a hysterectomy — removal of the uterus — is used to treat abnormal cells. Talk with your health care provider about your options if you would like to become pregnant in the future.

Where Can I Get a Colposcopy?

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Colposcopy