What Is a Colposcopy and Why Do I Need One?

This painless procedure helps diagnose certain cervical conditions

Woman at the Gynecologist
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It can be unsettling when your gynecologist calls to tell you that your Pap smear results were abnormal. Even though it’s the main screening test for cervical cancer, the majority of abnormal Pap smears are caused by inflammation or a vaginal infection.

But if the results of your Pap smear were inconclusive or abnormal, you many need further screening to determine what may be wrong. Your gynecologist may want to take a closer look at your cervix in order to narrow down 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 indicate cervical dysplasia or cervical cancer, show evidence of HPV (human papilloma virus) or show first-time or repeat atypical squamous cells of undetermined significance (ASCUS).

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 health care provider will place a solution on your cervix to make the abnormal areas easier to see.

Next, she’ll position the colposcope, which is a large, electric microscope with a bright light, approximately 30 centimeters from the vagina, to better view your cervix.

This will allow her to 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. An abnormal vascular (blood vessel) changes are also visible through the colposcope.

Finally, your healthcare provider will 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 pain and discomfort for the next 24 to 48 hours. Usually, the pain is treatable with over-the-counter pain medications such as Tylenol or Motrin.

In addition to some light vaginal bleeding, you may notice a dark discharge, which is likely due to the preparation 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.

A cone biopsy is one such example. This surgical procedure is done to remove a cone-shaped piece of tissue from the cervix and cervical canal. Also called conization, this may be used to diagnose or treat a cervical condition such as cervical intraepithelial neoplasia (CIN).

Cryotherapy, a gynecological treatment that freezes a section of the cervix, may be performed to destroy any precancerous cells discovered during the colposcopy.

If your pain or bleeding lasts for longer than several days after the procedure, contact your healthcare provider for follow-up advice.


American Congress of Obstetricians and Gynecologists: Colposcopy (Jan. 2016)


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