Colposcopy

A colposcopy is a type of examination that helps your doctor take a closer look at the cervix, vagina and vulva. During this procedure, which is typically performed in a gynecologist's office, your doctor can perform a biopsy of areas that appear abnormal and check for precancerous or cancerous lesions. Colposcopies also may be performed to look for lesions on the anus, though this procedure is usually performed by a colorectal specialist.

Your doctor may recommend a colposcopy for several reasons:

• You have symptoms that could indicate cervical cancer.
• Your Pap smear test results were abnormal.
• You have a positive human papillomavirus (HPV) test. A colposcopy is sometimes used to track changes in your cervix and vagina when you have HPV.
• During a pelvic exam, your doctor noticed abnormal growths or other findings.

How to prepare for a colposcopy

Ask your doctor what you should do to prepare for a colposcopy. Most women undergoing this procedure typically follow these guidelines:

• Stop using vaginal medicines, creams or other such products, including tampons, for a day or two before the colposcopy.
• Don’t have vaginal sex for one to two days before your colposcopy.
• Ask if you should take an over-the-counter pain reliever before your appointment.
• Try to schedule the colposcopy when you aren’t menstruating. If you get your period unexpectedly before your appointment, alert the medical office so your doctor can decide whether to proceed with the colposcopy on the scheduled date.
• Let your doctor know if you’re pregnant or could be pregnant.

What to expect during a colposcopy

For a colposcopy, you lie down on the exam table and place your feet in stirrups, just as you would for a pelvic exam. The doctor places a speculum to keep the vagina open and applies acetic acid, a diluted-vinegar solution, to help locate any abnormal areas of the cervix and vagina. Then, the doctor uses a colposcope to examine the cervix area. The colposcope remains outside of your body, but it has special magnifying lenses and a bright light for better visibility. Your doctor may take some images of specific areas.

Many times, a biopsy will be performed during a colposcopy. A biopsy involves removing a small piece of tissue to check for abnormal cells under a microscope.

• Try to take slow, regular breaths during your colposcopy to help cope with any discomfort.
• You may experience some cramping during the biopsy, or bleeding or discharge afterward.
• It’s okay to use sanitary pads for bleeding in the days following your colposcopy. Don’t use tampons.
• It’s normal to have a dark discharge for a couple of days. This is caused by the solution that doctors use to reduce bleeding.
• You'll be advised to avoid intercourse for two to three days following a biopsy.

Benefits and risks of a colposcopy

The benefit of a colposcopy is that you’ll find out if you have any abnormal cells that may indicate precancer or cancer.

In the days after your colposcopy, let your doctor know as soon as possible if you experience any of the following:

• Cramping that persists
• Fever or other signs of infection
• Heavy bleeding that lasts longer than two weeks
• Severe pain in your lower abdomen

Find out from your doctor how soon after your colposcopy you can have vaginal sex or use products or medicines that go inside the vagina.

Even if you’re pregnant, you can still have a colposcopy with external cervical or vaginal biopsies. The colposcopy and the biopsy should not affect your pregnancy or your ability to get pregnant.

Understanding the results of a colposcopy

A pathologist examines the tissue sample taken during the colposcopy under a microscope. It usually takes one to two weeks to get the results of your biopsy. The results from your colposcopy reveal whether there are precancerous cells or cancer.

• A normal result means that no abnormal areas were found.
• If you have precancer, you may need to have some tissue removed to stop cancer from developing.
• If you have cancer, then your doctor will likely order tests to learn more about the cancer before starting treatment. You may also be referred to a doctor who is an expert in gynecologic cancer, called a gynecologic oncologist.
• You may require more colposcopies in the future to determine whether treatments are helping and to check for other abnormalities.

Your care team can also let you know about other noncancer abnormalities seen during a colposcopy such as:

• Cervical or vaginal polyps, which are finger-like growths on the cervix
• Genital warts