What is a colposcopy, and what happens during it?
Colposcopy explained: when it is recommended, what happens during the examination, whether it hurts, when a biopsy is taken and how long results take.
A colposcopy is a short, low-risk examination used to look closely at the cervix after a suspicious smear or HPV result. No instrument enters the body: a magnifying device called a colposcope lights and magnifies the cervix from outside.
What a colposcopy is
The colposcope is an examination device made up of a magnifying lens system and a strong light source. During the examination, 3-5% acetic acid — a diluted vinegar solution — is applied to the cervix. It turns areas containing suspicious cells temporarily white, showing which points need a closer look.
When it is recommended
- a suspicious or abnormal result on a smear or HPV screening test
- a suspicious area on the cervix noticed during a routine examination
- bleeding after sex, or unexplained abnormal vaginal bleeding
- follow-up of women previously treated for a cervical lesion (a change in the tissue)
What happens during and afterwards
As in a routine gynaecological examination, a speculum is placed in the vagina, the solution is applied to the cervix and the cervix is examined. When it is over you can dress and return to your day straight away. Where a biopsy has been taken, a protective solution may be applied to stop light oozing; slight spotting, discharge or mild cramping in the first 24 hours is normal.
Does it hurt?
A colposcopy generally causes no serious pain and is well tolerated. You may feel mild pressure as the speculum is placed, and a passing sting as the vinegar solution is applied. If a biopsy is taken there may be a mild cramp similar to period pain, passing within seconds.
Is a biopsy taken?
That depends on whether a suspicious area is seen during the examination. If there is one, several small targeted biopsies are usually taken — multiple targeted biopsies have been shown to detect precancerous changes better than a single biopsy. In lower-risk women — where the smear result is not high-grade, high-risk HPV types 16/18 are not present and the colposcopy findings are entirely normal — a decision may be made to follow up without taking a biopsy.
When do the results come?
Pathology assessment of the samples usually takes 2 to 10 working days from the moment they reach the laboratory; if additional special testing is needed this can extend by a few days.
Frequently asked questions
Can a colposcopy be done during pregnancy?
The examination itself can generally be carried out, but some additional procedures such as endocervical curettage are not performed in pregnancy. The approach during pregnancy is decided separately by your doctor.
When can I have sex after a colposcopy?
If a biopsy was taken, follow the interval your doctor advises for the healing period; this varies from person to person.
Does an abnormal colposcopy finding mean cancer?
No. The white areas seen at colposcopy are most often changes that are not precancerous and can be managed with follow-up or simple treatment; the definitive assessment comes from the biopsy result.
See also colposcopy and smear and HPV testing.