What Is a Colposcopy and Why Do I Need One?

What To Expect From This Painless Procedure

Woman at the Gynecologist
Keith Brofsky/Photodisc/Getty Images

It can be frightening if your gynecologist calls to tell you that your Pap smear results were abnormal. Rest assure that, although you might think an abnormal Pap smear means that you have cervical cancer, the majority of abnormal Pap smears are not actually caused by this serious condition. The more likely causes are inflammation or a vaginal infection.

Still, your Pap smear results alone won't be able to tell you what's wrong.

Pap smears can only screen for potential problems. It can't diagnose them. So your gynecologist may want to take a closer look at your cervix in order to determine the cause of your abnormal Pap smear results.

In order to do this, she will perform a procedure known as a colposcopy.

Why Am I Getting a Colposcopy?

Your doctor may order this procedure if you have Pap smear results that:

Your gynecologist may also order a colposcopy if your cervix appears abnormal during your pelvic exam and Pap smear, or if you have a history of prenatal DES exposure.

What Can I Expect During a Colposcopy?

A colposcopy is a simple, 10- to 15-minute procedure that is painless and performed in a gynecologist's office or other clinical settings.

You can expect your colposcopy appointment to be similar to your Pap smear appointment.

You'll start by laying down on the examination table and placing your feet in stirrups. Your doctor will then insert a speculum into your vagina. Once the speculum is in position, your healthcare provider will:

  1. Place a solution on your cervix to make the abnormal areas easier to see.
  2. Position the colposcope, which is a large, electric microscope with a bright light, approximately 30 cm from the vagina, so as to better view your cervix. 
  1. Focus on the areas of the cervix where light does not pass through. Abnormal cervical changes are seen as white areas: the whiter the area, the worse the cervical dysplasia. Abnormal vascular (blood vessel) changes are also visible through the colposcope. 
  2. Take a tissue sample or biopsy, if necessary, from the whitest abnormal areas and send it to a lab for further evaluation. 

What Can I Expect After a Colposcopy?

Women who don't require a biopsy usually feel just fine after the procedure. Still, you should probably use a panty liner in case of spotting, which can last for several days after the procedure. 

If you had a colposcopy with a biopsy, you should also use a sanitary pad, and may also experience the following:

  • Pain and discomfort for the next 24 to 48 hours, which you can usually combat with over-the-counter (OTC) pain medication
  • Vaginal bleeding
  • A dark discharge, which is possibly due to the medication your health care provider used during the procedure

Is a Colposcopy Really Painless?

If you experience any pain during the procedure, it won't be from the colposcopy itself.

Rather, it will be the result of other procedures that are sometimes performed during a colposcopy. These other procedures can cause discomfort, vaginal bleeding, or discharge. They include:

If your pain or bleeding lasts for longer than several days after the procedure, contact your doctor immediately.


American Congress of Obstetricians and Gynecologists: Colposcopy (2015)

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