Colposcopy: How to Prepare and What to Know

June 13, 2019
Sonja Hibbs

Your doctor may want to do a colposcopy to check for changes in the health of your cervix, vagina, and vulva. Here are a few things to know about this important examination before your appointment.share on twitter

1. What’s a colposcopy and why do I need one?

A colposcopy is used to find cancerous cells or abnormal cells that can become cancerous in the cervix, vagina, or vulva. These abnormal cells are sometimes called “precancerous tissue.” A colposcopy also looks for other health conditions, such as genital warts or noncancerous growths called polyps. A special instrument called a colposcope gives your doctor a lighted, highly magnified view of the tissues that make up your cervix, vagina, and vulva. The colposcope is placed close to the body, but it does not enter the body.

2. How is a colposcopy different than a pap test?

A pap test, also called a pap smear, involves gathering a sample of cells from your cervix and testing them for early changes that can lead to cervical cancer. If your pap test showed some abnormal cells and you tested positive for HPV, a colposcopy can help confirm and diagnose potential problems. HPV, or human papillomavirus, is a virus that may raise your risk for certain types of cancer, including cervical, vaginal, and vulvar cancers. Your doctor may also recommend a colposcopy if you have symptoms or signs of cervical, vaginal, or vulvar cancer.

3. What happens during a colposcopy?

A colposcopy can be done in the office of your primary care doctor or your gynecologist. After lying down on the exam table, you’ll place your heels in the stirrups at the end of the table. An instrument called a speculum will be inserted inside your vagina to open it up and give your doctor a clearer view of your cervix. Your cervix, vagina, and vulva will be lightly wiped with a vinegar or iodine solution that helps your doctor better see abnormal areas. The colposcope is positioned between your legs as close to your vagina as possible, but it never goes inside your body.

4. What happens if my doctor sees an abnormal area during the colposcopy?

During the colposcopy, your doctor may perform a biopsy on areas that look unhealthy. A biopsy is the removal of a small amount of tissue for examination by a pathologist. A pathologist can identify abnormal cells by looking at the tissue sample under a microscope. While a colposcopy can suggest that you have cancer or precancerous tissue, only a biopsy can actually make a diagnosis. If an abnormal area is small, your doctor may be able to remove all of it during the biopsy.

The type of biopsy you’ll have will depend on the location of the tissue being biopsied. For example, 1 common biopsy method of cervical tissue uses an instrument to pinch off small pieces of suspicious areas. The doctor may also do an endocervical curettage biopsy to check an area inside the opening of the cervix that can’t be seen during a colposcopy. You may feel pinching or discomfort similar to menstrual cramps during some biopsy types. Sometimes a local anesthetic is used to numb the area before the biopsy. Ask your doctor about the different types of biopsies that could potentially be done during your colposcopy.

5. What should I do before a colposcopy?

Your doctor may suggest that, for 24 to 48 hours before a colposcopy, you stop using vaginal medicines, creams, powders, or foams. During this period, you should also stop having vaginal sex, using tampons, or placing any other products in your vagina. Don’t schedule a colposcopy during the week of your period, and be sure to let your doctor know if you’re pregnant or might be pregnant before your appointment. You may also want ask your doctor if you should take an over-the-counter pain medication before the examination in case you have a biopsy.  

6. Will I have any side effects from the colposcopy?

There are no direct side effects that a colposcopy will cause. However, if you have a biopsy during a colposcopy, then you could have a dark vaginal discharge for a few days. This comes from the solution doctors use to reduce bleeding that can happen with a biopsy. You may also have some bleeding, cramping, or soreness. If these or other symptoms get worse or don’t go away, or you have extremely heavy bleeding, severe pain in your lower abdomen or pelvis, or a fever after the examination, call your doctor immediately. Like before the colposcopy, don’t have vaginal sex or use any type of products or medications that go inside the vagina until your doctor says it’s OK.

7. What happens when the biopsy results come back?

If a biopsy taken during your colposcopy shows that you have precancerous tissue, the tissue may need to be removed to keep cancer from developing. Your doctor will explain the different removal methods that may be right for you. If the biopsy shows that cancer is present, you may need to have more tests before you begin treatment. Your doctor will likely refer you to a gynecologic oncologist, who specializes in treating gynecologic cancer. During treatment for any precancerous tissue or cancer, you may have additional colposcopies to see how well a treatment is working and to look for additional abnormal changes over time.