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What is colposcopy?

To understand colposcopy’s meaning, we can simply break the word down into two pieces: “kolpos,” which is Greek for “vagina” and “skopos,” Greek for “to look at.” Thus, a colposcopy is a specialist procedure to examine the vagina and cervix visually.

It involves the use of a tube-shaped tool, called a speculum, to widen the vaginal opening, along with a special lighted microscope, known as a coloscope, to look inside. Colposcopy is most often employed as a follow-up procedure after an initial cervical screening when the doctor feels more information is needed.

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What does it test for?

A cervical colposcopy is most commonly used to check for signs of cervical cancer or to look at abnormal, changing cells that could become cancerous if not treated. It may help a provider spot precancerous conditions, as well as cervical inflammation, noncancerous growths, and other changes to vaginal and cervical tissue.

Why do I have to get a colposcopy?

Healthcare providers may recommend colposcopies to investigate any warning signs or concerns following other diagnostic procedures further. This includes women who have irregular results from Pap tests or pelvic exams, for instance, or those with positive HPV test results.

This is why regular cervical screening is essential, and women should undergo regular smears, HPV, and colposcopy tests as and when advised to minimise their risks of severe long-term conditions.

It is important to note, however, that having a colposcopy is not a sign that you have cervical cancer. Most cervical cell changes are not cancerous. A colposcopy simply provides your doctor with a better look to check any possible warning signs and recommend treatment, if necessary.

What happens at a colposcopy? – Procedure overview

The sections below detail each stage of the procedure – before, during, and after – so you know what to expect.

Before the procedure

Before your colposcopy, your provider may ask you for some information about any medications you are taking and whether you are pregnant. They may also ask about your menstrual cycle to select a suitable date for the procedure. While it is possible to undergo a colposcopy while menstruating, it is easier and more comfortable for both doctor and patient to avoid this.

In the two days before your appointment, avoid any form of vaginal penetration. This includes the use of tampons and insertion of any vaginal medications, as these may alter your colposcopy test results.

On the day of the colposcopy, patients may wish to take a simple pain reliever, such as ibuprofen, to ease their discomfort during the procedure. You can also bring a friend or family member for support.

During the procedure

The procedure should last between 15 and 30 minutes, at the most. You will lie back on an examining table, with your feet supported. To begin, the doctor inserts a speculum to widen the vaginal opening. This may induce mild discomfort.

The doctor then uses the colposcope to examine the vagina and cervix. They will apply a special liquid solution to help highlight any abnormal cells. You may feel a slight burning or tingling sensation at this stage.

In many cases, colposcopy and biopsy are performed together. For the biopsy, a tiny tissue sample will be taken from the cervix to be analysed in a laboratory later. You may experience a pinching or pinprick sensation, accompanied by mild pressure, during this stage. In our clinic we use local anaesthetic prior to taking cervical biopsies to minimise any discomfort.

Colposcopy aftercare

Post-procedure, you should be able to return to your routine for the most part. You may, however, experience some cramping, similar to period pain. Light bleeding after a colposcopy is also possible if you had a biopsy. The bleeding should subside within a few days. If it persists for any longer, please contact your doctor.

Use pads to manage bleeding and discharge and avoid any vaginal penetration for the days following the procedure.

Understanding your colposcopy results

It will take a few days to have the result of the biopsy. We will explain the results to you, and if you need further treatment, we will discuss that with you.

What happens if a colposcopy is abnormal?

If your results are abnormal, the following steps will vary. You might need medication and a repeat colposcopy in 6 months. Possible treatments include a large loop excision, or LLETZ procedure, which uses an electrically-powered wire loop to remove abnormal tissue, or a cone biopsy, in which a cone-shaped tissue sample is taken from the cervix for further analysis.

LLETZ has a brief recovery time, and most patients can return to their normal lives within a day.

FAQ
Is it safe to have a colposcopy while pregnant?

It is safe to perform a colposcopy while pregnant. However, we avoid taking smears as they can be inaccurate, and biopsies are planned only if there are lesions present that are highly suspicious of cancer.

Do I need a colposcopy if I have HPV?

It depends. If you are positive for HPV but have normal smear test results, you may not need a colposcopy right away. Your doctor may prefer to monitor the situation, re-screen you a year later, and then reassess.

Can I get a colposcopy on my period?

Yes, but it is usually better to avoid this, as it will be easier for your doctor to see in and around the vagina if you are not bleeding.

Does a colposcopy hurt?

Experiences vary, but many patients say that colposcopies are mostly painless. You may feel light burning or pinching sensations when the solution is inserted or when your doctor takes the biopsy.

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