Colposcopy (Exam of Vagina and Cervix)

What is colposcopy?

Colposcopy is a way for your healthcare provider to look at the vulva, vagina, and cervix. This exam may be done as part of a pelvic exam. Your provider uses a kind of microscope attached to a stand called a colposcope. It is placed just outside the vagina. It acts like a magnifying glass and makes it easier to examine the skin and cells of the vulva, vagina, and cervix.

During the exam your provider may take a sample of tissue (biopsy) for lab tests.

This exam can help your healthcare provider make a more accurate diagnosis of a possible problem in your vulva, vagina, or cervix and suggest further treatment if needed.

When is it used?

Colposcopy is most often done if you have had an abnormal Pap test result showing:

  • Possible infection
  • Precancerous cells
  • Cells that look like cancer
  • Any other abnormal cells

How do I prepare for this exam?

  • Tell your healthcare provider if you think you may be pregnant. Colposcopy can be done during pregnancy. However, your provider may wait to do a biopsy until after your baby is born.
  • Plan to have the exam when you are not having a menstrual period. These exams are usually not done during your period.
  • Do not douche, have sex, or use any medicines in the vagina for at least 24 hours before the exam.
  • Follow any other instructions your healthcare provider gives you.
  • Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

What happens during the exam?

The exam can be done at your healthcare provider’s office.

Because the cervix doesn’t feel much pain, you will not need an anesthetic to numb the area.

You will lie on your back on the exam table with your knees bent and the heels of your feet in stirrup heel holders, just as you do for a regular pelvic exam. Your healthcare provider will put a small tool called a speculum into your vagina to hold the vaginal walls open during the exam. This is the same tool used during a Pap test. Your provider will use a swab to put a weak vinegar solution on your vulva, vagina, or cervix. You may feel a slight stinging from the liquid.

Your provider will put the colposcope at the opening of your vagina. The vinegar solution will turn abnormal tissue white and show abnormal blood vessels. It helps show where samples of tissue should be taken for a biopsy. Your provider may take photographs and may use a tool to remove 1 or more very small pieces of tissue for lab tests. You may feel a pinch or slight cramp. After the tissue is removed, your provider may put a thick, pasty solution on the area of the biopsy. This will help prevent bleeding.

Tissue that was removed will be sent to the lab for tests.

What happens after the procedure?

Your healthcare provider will tell you what he or she saw. Biopsy results should be ready in 1 to 2 weeks.

A few women feel a little lightheaded right after the exam and need to lie down for a few minutes after the exam is over. You may have some cramping for a short time.

You may have a little dark-colored, sandy discharge from the vagina for a few days after the procedure.

If you had a biopsy:

  • You may have light bleeding or spotting for up to a week.
  • You may have mild cramping.
  • You may notice a thick black discharge caused by blood and the paste put on the biopsied area. This discharge may last for a few days.
  • You should not douche or use tampons for 1 to 2 weeks while the area heals. Use a pad for any bleeding.
  • Don’t have sex for 1 to 2 weeks after the biopsy. Your provider may ask you to wait until you have had a chance to talk about the test results.

Follow your healthcare provider's instructions. Ask your provider:

  • How and when you will hear your test results
  • How long it will take to recover
  • What activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

  • Heavy bleeding (soaking more than 1 pad per hour, or more bleeding than your normal menstrual flow)
  • Infection

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.

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