What to expect when undergoing this gynecological test
A colposcopy is an in-office diagnostic procedure used to examine the inside of the vagina, vulva, and cervix. It is performed similarly to a Pap smear but uses an illuminated magnifying instrument (colposcope) to look for cell changes, growths, and inflammation. Urology Ureteroscope
You may need a colposcopy to investigate your symptoms or as a follow-up evaluation after an abnormal pelvic exam or Pap smear. During a colposcopy, your healthcare provider may also take a tissue sample (biopsy) for further examination.
This article details the colposcopy procedure, including why and how it is performed, and what you can expect during the test. It also discusses a colposcopy biopsy and what the results may mean.
Illustration by Emily Roberts for Verywell Health
A colposcopy allows your healthcare provider to get a better look at your cervix and vaginal walls. It is used to examine lesions or abnormalities with the aid of magnification. A biopsy is sometimes taken during a colposcopy.
According to the American College of Obstetricians and Gynecologists, a colposcopy is recommended if a Pap smear of pelvic examination showed the following:
A colposcopy does not extend all the way to the uterus, and it only provides a view of some areas of the cervix and some surrounding tissue.
In general, colposcopy is considered safe. With that said, if you are pregnant, a biopsy is usually avoided because it can cause cramping and may increase the risk of complications, such as premature labor or miscarriage.
If you are prone to bleeding or take an anticoagulant (blood thinner), you may experience heavy bleeding after a biopsy.
If you need to have a colposcopy, your healthcare provider will schedule it for a time when you are not having your period, as this can change the appearance of the cervix and the bleeding may interfere with optimal visualization.
It's also important to not place anything into your vagina for at least one day prior to the procedure, so you will be instructed to abstain from sexual intercourse, using vaginal creams, wearing tampons, or douching.
Tell your healthcare provider if you are pregnant or taking any blood-thinning medications like aspirin or warfarin (but do not stop taking the drugs unless your medical professional tells you to).
You might have your colposcopy in your healthcare provider's office as part of your gynecologic examination. If this is the case, expect the procedure to last about 10 to 20 minutes.
A colposcopy is done in the healthcare provider's examination room.
You can wear whatever is comfortable on your way to the test. You will be asked to undress from the waist down and may be asked to change into a gown.
There are no food or drink restrictions associated with a colposcopy.
If you are having a colposcopy, your health insurance company may require a pre-authorization, which your healthcare provider's office should take care of. You may also need to pay a co-pay, and your health insurance company and healthcare provider's office will be able to tell you the amount.
If you are paying out of pocket, expect to pay between $200 and $600 depending on the facility and where you live. The amount will be on the higher end if a biopsy is needed.
Bring your test order form, health insurance card, a form of identification, and a method of payment if you need it.
A colposcopy is typically performed by a gynecologist or other healthcare provider. An assistant or nurse may be on hand to assist.
You will need to fill out some paperwork, including a consent form for the procedure, authorization for payment, and patient privacy forms.
You may be asked to change into a gown, and your nurse may ask you if you need to empty your bladder so that the test will be more comfortable. Once on the examination table, you will lie down and place your feet in stirrups.
Your healthcare provider will place a speculum into your vagina. Once the device is in position, your healthcare provider may gently cleanse your cervix with saline, either using a spray bottle or a cotton swab.
Typically, your practitioner will also place a 3% to 5% dilute acetic acid solution on your cervix to better visualize the area and distinguish between normal and abnormal tissue.
Next, the colposcope will be positioned close to your vaginal opening, so that the light is shining on the vagina and cervix. Your healthcare provider will then take careful note of what they can see. Blood vessel enlargement, bleeding, or irregularities are often visible through the colposcope.
When swabbed with acetic acid, areas of abnormal cervical tissues will immediately turn white and opaque.
Your healthcare provider may insert Lugol's solution, which is composed of iodine and potassium iodide. Normal cervical tissue usually appears brown when it comes in contact with Lugol's solution, and pre-cancerous cells usually appear yellow.
Finally, your healthcare provider may take a tissue sample, if necessary, from the abnormal areas. You may feel mild discomfort or cramping during the biopsy, but this should only last a few minutes. Be sure to tell your healthcare provider if you experience severe pain or discomfort.
Once your healthcare provider removes the speculum, you may need a few minutes to rest. If a sample was collected, it will be prepared to be sent to a lab.
Your healthcare provider might discuss some of the test results with you right away or a couple of weeks later. You can empty your bladder if you need to, and your nurse may give you a sanitary pad if you have any bleeding.
Normally, you can be discharged to go home at that time.
If you have a colposcopy without a biopsy, you may have very mild spotting. If you had a colposcopy with a biopsy, recovery may include some vaginal bleeding and mild cramping for 24 to 48 hours after the procedure.
In addition to some light vaginal bleeding, you may notice a dark discharge from the solution that your healthcare provider used to help visualize your cervix.
You should use a sanitary pad and not a tampon for the bleeding and discharge. After your procedure, your healthcare provider may recommend that you refrain from putting anything into your vagina for about 48 hours. This includes abstaining from sexual intercourse.
Contact your healthcare provider if your symptoms are worse than expected or you develop any symptoms of infection. Both are uncommon but can occur.
While a colposcopy isn't necessarily a comfortable experience, it should not be painful. If you experience pain, it's often due to cervical inflammation or infection. Tell your provider if the procedure is causing you pain.
If a colposcopy biopsy is also performed, some cramping or pain may be normal for up to 48 hours. Pain is typically treatable with over-the-counter pain medications such as Tylenol (acetaminophen) or Motrin (ibuprofen).
If your pain becomes severe, or you experience it with other symptoms, seek medical care.
Call your healthcare provider if you experience any of the following after undergoing a colposcopy:
Your colposcopy results are based on your healthcare provider's observations during the procedure as well as the results of the biopsy, if you had one.
Your healthcare provider may discuss some preliminary results during or immediately after the procedure or may schedule an appointment at a later time after your biopsy results return, which is usually within one to two weeks.
A colposcopy may help identify:
If you haven't heard any news from your healthcare provider after two weeks, call the office to check on the results.
Some busy gynecological practices only call if the biopsy is positive. In addition, many doctor's offices post online to a patient portal where you can view test results. A negative result means no cancer was detected.
If you have a medical condition diagnosed by colposcopy, your next step is either treatment or further evaluation. For example, if you have an infection, you may need to be treated with an antibiotic.
A pre-cancerous lesion may prompt the need for further evaluation such as a repeat biopsy, a larger biopsy, or close monitoring with more frequent Pap smears or colposcopies. A cancer diagnosis will require further tests and treatments.
In general, it is not typical to have a routine follow-up colposcopy at regular intervals, but you may need to have another colposcopy if you have an abnormal Pap smear in the future or other concerning findings.
A colposcopy is a diagnostic test that can provide your healthcare provider with some results while examining the vagina, vulva, and cervix while you are having the test. It is generally easy to tolerate with few side effects.
However, you may be anxious or worried about the results if your symptoms are unusual or severe, or if you are at risk of cervical cancer. In general, most medical conditions diagnosed by colposcopy are treatable. Even cervical cancer, in fact, has a good prognosis when it is diagnosed early and treated promptly.
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By Tracee Cornforth Tracee Cornforth is a freelance writer who covers menstruation, menstrual disorders, and other women's health issues.
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