A colposcopy is a test in which the provider uses a multi-lens instrument (colposcope) to magnify the external genital area, vagina and cervix. This magnified view allows the provider to easily examine and identify abnormal areas. The colposcope is not inserted into the vagina but stands outside the area, like a free standing microscope. The provider may take samples of tissue (biopsy) from the area for laboratory examination as well.

When is it used?

A colposcopy is recommended for women who have an abnormal appearing cervix or have had abnormal pap test results, meaning that abnormal size and shaped cells have shown up on the pap smear. There are different categories of abnormal pap test results and they indicate possible infection, a precancerous growth, or cancer. The pap test is only a screening test and the colposcopy is a diagnostic test.

How can I prepare for a colposcopy?

If you are not allergic to ibuprofen (Motrin, Advil, etc.), it is suggested that you take 400-600 mg one hour before the procedure. Do not make your appointment during your menstrual period as a colposcopy cannot be performed while a woman is menstruating. Additionally, refrain from intercourse, the use of spermicidal jelly, vaginal medications, douches, or tampons at least 24 hours before the procedure as these can interfere with the accuracy of the tests.

What happens during the procedure?

You will lie on the examining table just as in a regular pelvic exam with your feet in the stirrups. The provider will use a speculum to separate the walls of the vagina as in a pap smear. The speculum stays in the vagina throughout most of the procedure. The colposcope is placed at the vaginal opening in order to examine the genital area, vagina and cervix. The colposcope does not touch you. The provider will apply a vinegar solution to enable abnormal cells to be more visible. This may sting a bit. If abnormal cells are found during the procedure, the provider will biopsy those areas. In a biopsy, a tiny tissue sample is removed from that area with a tweezer like instrument. The provider may also do an endocervical scraping in which they will take some cells from the os, the opening of the cervix. You may feel pinching or cramping when the provider performs the biopsies. Some providers put a numbing gel on your cervix to lessen this feeling. Your discomfort will go away shortly after the procedure. If the provider has done a biopsy, s/he may put a ‘paste’ on your cervix so that you do not bleed. This ‘paste’ is a yellow-greenish color. The tissue samples from the biopsies will be sent to the lab for examination.

What happens after the procedure?

The provider will explain what he or she saw. Slight bleeding may continue for several days due to the biopsy. You may have vaginal discharge which looks like coffee grounds mixed with blood and the yellow-greenish paste. This is normal. You may use menstrual pads but there should be no sexual intercourse, tampons, or douching for at least 72 hours (3 days) after the procedure. Make sure to rest after the procedure. You may take ibuprofen every four hours if you have cramping or pain.

Benefits of this procedure

The provider should be able to better diagnose the problem in the cervix and vagina and suggest further treatment if necessary.

Risks associated with this procedure

Risks are minimal. Limited cramping and minor bleeding from the biopsy site may occur.

Other less common risks include:

  • heavy bleeding (more than one pad per hour or more bleeding than your menstrual flow)
  • fever
  • infection
  • pelvic or abdominal pain

In the event that any of the above occurs, you should contact your provider immediately.

Revised 10/99 Mary Lee Lobach, M.D., Jordana Brown

Revised 5/03 Maggie Gradison MD