What Are the Risks of a Colposcopy?

This otherwise safe procedure can have complications

A woman at the gynecologist having a colposcopy
What are the risks of a colposcopy?. Keith Brofsky/Getty Images

An abnormal pap smear can prompt your doctor to advise that you undergo a colposcopy exam. A colposcopy is a common, follow-up procedure that allows a doctor to view the cervix more closely. It involves the use of a lighted instrument called a colposcope, which functions like a microscope and allows the cervix to be viewed more easily.

During the Colposcopy Exam

A colposcopy exam begins much like a Pap test, wherein the patient lies on her back on an examination table with her feet positioned in stirrups.

The doctor starts by inserting a speculum into the vagina and opens it slightly. After applying a vinegar solution to the cervix and vagina (which turns any abnormal tissue white), the doctor will peer through the colposcope to view the cervical and vaginal walls in detail. In some cases, the doctor will take a small sample of tissue, called a cervical biopsy, to be further examined by a lab.

A colposcopy is a painless procedure usually performed in the doctor's office. On average, it takes 30 minutes or less to complete.

Reasons for a Colposcopy

The doctor uses the colposcope to diagnose any number of gynecological conditions, including:

  • abnormal bleeding
  • yeast infections
  • non-cancerous growths (polyps)
  • genital warts which can be linked to the development of cervical cancer
  • diethylstilbestrol (DES) exposure, also associated with cervical cancer
  • other sexually transmitted infections

Risks Associated With Colposcopy

A colposcopy procedure on its own poses little risk to women.

Complications are more associated with any biopsy performed during the procedure.

These complications can include:

  • vaginal irritation, primarily from the vinegar swab
  • bleeding following a biopsy
  • post-biopsy infection 
  • allergy or sensitivity to iodine, latex, or any medications used to numb the cervix prior to a biopsy

    If you are pregnant, be sure to inform your doctor as repeated cone biopsies have been associated with preterm labor. While the risk is considered small, it's important that you and your doctor weigh the benefits and risk of delaying the procedure should there be any cervical abnormalities.

    Certain Conditions That Can Interfere With a Colposcopy

    There are a number of conditions that can increase the risk of infection following a colonoscopy, including:

    Before the colposcopy is performed, your doctor will provide you a consent form that outlines the risks and indemnifies the doctor and/or clinic from any liability. Be sure to read the information carefully and asks any questions you need to get full information.

    Minimizing the Risk of Complications Following a Colposcopy

    After the procedure is complete, your doctor will send you home with a list of instructions. The instructions will typically advise:

    • no sex for a specific amount of time following the exam 
    • no tampon use
    • no douching or vaginal medications
    • no heavy lifting (particularly for those who have had a cervical biopsy)
    • no tub bathing for first the 24 hours following the exam (possibly more if you've had a biopsy)

      After a colposcopy, it is normal for women to experience spotting. If a biopsy has been performed, a thick, brownish discharge can also be expected. Some women might experience minor cramping, which can usually be relieved with over-the-counter pain medications.

      When a Complication Occurs

      If any of the following occurs when you return home, call you doctor immediately or visit your nearest clinic or emergency room:

      • bleeding through an average sanitary napkin in the span of an hour
      • spotting for more than seven days
      • cramping or lower abdominal pain that is not relieved by over-the-counter pain medications
      • fever of 100 degrees Fahrenheit or more
      • bright red bleeding
      • chills
      • foul smelling discharge
      • any other symptom that seems abnormal or worries you

      Sources:

      The TOMBOLA Group: National Cancer Registry Ireland. "After-effect reported by women following colposcopy, cervical biopsies, and LLETZ: results from the TOMBOLA trial." British Journal of Gynaecology. May 11, 2009; 116(11):1506-1514.

      Cruickshank, M.; Cotton, S.; Sharp, L.; et al. "Management of Women with Low-Grade Cytology: How Reassuring is a Normal Colposcopy Examination?British Journal of Gynaecology. 2015; 122(3):380-386.

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