What is a colposcopy?
A colposcopy is a close examination of your cervix, the opening of the womb. The doctor uses a colposcope, which is a magnifying instrument with a bright light. It stays outside your body. It lets the doctor see changes on the cervix that are too small to see with the naked eye.
If an area looks unusual, the doctor may take a tiny piece of tissue. This is called a biopsy. The sample goes to a laboratory, where a pathologist studies it under a microscope. A colposcopy is a test to find out more. Being asked to have one does not mean you have cancer.
Why you may be asked to have one
Most women are referred after a screening test. Common reasons include:
- An abnormal result on a Pap smear or HPV test
- A cervix that looked unusual during an internal examination
- Bleeding after sex or between periods that has no clear cause
- Genital warts or an unusual growth on the cervix, vagina or vulva
- Follow-up after earlier treatment for cervical cell changes
Most abnormal screening results are caused by cell changes linked to human papillomavirus (HPV), a very common infection. Many of these changes are mild and settle without treatment. The colposcopy helps your doctor decide whether you need treatment, repeat testing or nothing at all.
How to prepare
Choosing the day
Try to book the test for a day when you are not having your period, as heavy bleeding makes the cervix harder to see. If your period starts unexpectedly, call the clinic and ask whether to reschedule.
The day or two before
Doctors usually advise you to avoid sex, tampons, vaginal creams and douching for 24 to 48 hours before the test. Tell the doctor if you are pregnant or might be, if you take blood-thinning medicine, or if you have any allergies. A colposcopy can be done safely in pregnancy, but the doctor decides whether a biopsy is needed or can wait until after delivery.
What happens during the procedure
The test is done in an outpatient room and usually takes 15 to 20 minutes. You can normally go home soon afterwards.
- You undress from the waist down and lie on an examination couch with your legs supported.
- The doctor gently inserts a speculum into the vagina, the same instrument used for a Pap smear.
- The colposcope is placed near the opening of the vagina. It does not go inside.
- A weak vinegar-like solution, and sometimes an iodine solution, is dabbed on the cervix. Abnormal areas change colour. You may feel mild stinging.
- If needed, the doctor takes one or more small biopsies. This can feel like a sharp pinch or a cramp.
- Any bleeding is stopped with pressure or a special paste, and the speculum is removed.
You can ask for the test to be paused at any time. Many clinics allow a family member or a female attendant to stay with you.
Types of biopsy
The type of sample depends on what the doctor sees. Your doctor will explain which one is planned and why.
| Type | What is taken | Anaesthesia |
|---|---|---|
| Punch biopsy | A tiny piece from the surface of the cervix | Often none, sometimes local |
| Endocervical sampling | Cells scraped from the canal of the cervix | Usually none |
| Loop excision (LEEP or LLETZ) | A thin layer removed with a heated wire loop | Local |
| Cone biopsy | A cone-shaped piece of the cervix | Regional or general |
After the test and getting your results
Recovery
If no biopsy was taken, you can return to normal activities straight away. After a biopsy, you may have mild cramps, light spotting or a dark discharge for a few days. The dark colour comes from the paste used to control bleeding. Use a sanitary pad instead of a tampon. Your doctor will tell you how long to avoid sex, swimming and heavy exercise. Recovery takes longer after a loop excision or cone biopsy.
Results
Biopsy reports usually take one to two weeks, though this varies between laboratories. The report may say the tissue is normal, or it may describe cell changes graded as CIN 1, CIN 2 or CIN 3. These are not cancer. They show how much of the lining of the cervix is affected by abnormal cells. Low-grade changes are often simply watched. Higher-grade changes are usually treated to stop them from turning into cancer over time. In a small number of women, the biopsy finds cancer, and the doctor then plans further tests and care.
Costs vary by city, hospital and the type of biopsy. Keep all your reports and take them to your routine gynecological check-up so that follow-up tests are done on time.
When to see a gynecologist
Some bleeding and discomfort are expected after a biopsy. Contact a doctor promptly if you notice any of the following:
- Heavy bleeding that soaks more than one pad an hour or contains large clots
- Bleeding that lasts longer than a week
- Fever or chills
- Vaginal discharge that smells bad
- Strong pain in the lower abdomen that does not ease with the pain relief your doctor suggested
Even if you have not had a colposcopy, see a gynecologist if you have bleeding after sex, bleeding between periods, bleeding after menopause or pelvic pain that does not go away. This article gives general information only. It cannot replace an examination and advice from a qualified doctor.
This page is general information for readers in India. It is not medical advice. Speak to a qualified gynecologist about your own health.