Colposcopy is a procedure used to detect abnormal cells and tissues of the cervix, vagina, and vulva. It is done with a colposcope -- an instrument that looks like binoculars on a tripod. The colposcope has a magnifying glass that lets the clinician examine the surface cells on the cervix. It is impossible to diagnose conditions of the cervix and vagina with the naked eye. With magnification, a clinician can better tell whether more tests are needed, or if there is no need for concern.

A biopsy is the removal of a small piece of tissue. The tissue is sent to a lab to be examined under a microscope. Biopsy is often done during colposcopy

Colposcopy is a simple procedure. It does not require an anesthetic, and can be done in a clinician's office. The procedure takes about 10 minutes.

A woman lies down on the exam table in the same position used in the Pap test.

A speculum is inserted into the vagina to separate the walls.

The clinician 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. The clinician may also apply iodine to make the abnormal cells easier to see.

The clinician 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 cells. This is done in two ways:
-by taking 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

Collected tissue is sent to a lab for examination.

Colposcopy 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.

Schedule your colposcopy for when you will not have your period.

Your clinician will let you know whether or not to take an over the counter pain medication prior to the procedure.

Do not douche, use tampons, put medications in your vagina, or have vaginal intercourse for at least 24 hours before the test.

Your vagina may feel slightly sore for a couple of days. You may also spot or have a dark-colored vaginal discharge -- use a maxi pad or panty liner. Ask your clinician whether it is safe for you to use tampons. You may shower or bathe as soon as you want after the procedure.

Complications are rare, but may require medical attention. Call your clinician if you have

fever or chills

heavy bleeding at a time when you are not having your period

heavy, yellow-colored, or bad smelling discharge from your vagina

severe pain in the lower abdomen

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

If a biopsy is taken, you should wait one week 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.

Yes. Continue taking your medications as usual -- including the birth control pill. You can also continue to use any other method of birth control.

Colposcopy is safe during pregnancy. The risk of biopsy during pregnancy is small, but your clinician 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.

Your need for treatment depends on the severity of cell abnormality.

Your clinician 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 clinician may be able to remove all of the abnormal cells during the colposcopy procedure. If so, no further treatment is needed but your clinician will request you have Pap tests more often to check the cervix.

Another procedure may be prescribed if further treatment is needed. Cryotherapy, LEEP, laser removal, and cone biopsy are all very effective at removing the abnormal areas and preventing cervical cancer:

Very rarely, a hysterectomy -- removal of the uterus -- is used to treat abnormal cells.