What’s a Colposcopy?

Medically Reviewed by Nivin Todd, MD on November 07, 2022
4 min read

A colposcopy is a simple procedure that lets your doctor get a good look at your cervix. The exam takes 5 to 10 minutes, and is a lot like getting a Pap smear. One of the biggest differences is your doctor uses a special magnifying instrument called a colposcope.

You usually get a colposcopy if you had some sort of abnormal results on your Pap test so your doctor can further diagnose any problems.

If your doctor has reason to believe something may not be quite right with your cervix, they may recommend a colposcopy. Some of these reasons might include:

  • Your Pap results were abnormal.
  • Your cervix looks abnormal during a pelvic exam.
  • Tests show you have the human papillomavirus, or HPV.
  • You have unexplained bleeding or other problems.

Your doctor can use a colposcopy to diagnose cervical cancer, genital warts, vaginal cancer, and vulvar cancer, as well. Once your doctor gets the results from your colposcopy, they’ll know whether or not you need further tests.

Your doctor will have you lie on an exam table, and they’ll use a speculum to keep your vagina open. Next, they’ll dab a cotton swab in a vinegar-like solution and use it to wipe your cervix and vagina. It may burn a little, but it’ll help them see any cells that don’t look normal.

Then, they’ll use the colposcope to examine your cervix and vulva.

Don’t put anything inside your vagina -- like creams. This will make it hard for your doctor to see your cervix. And don’t use tampons or have vaginal intercourse for a few days before.

Call your doctor to reschedule if your period is heavy on the day of your appointment. And let them know if you’re taking medicines that thin your blood. These could cause heavy bleeding during your procedure, especially if you have a biopsy, which is the removal of a tiny piece of tissue for testing.

Lastly, let your doctor know if you’re pregnant. You can still have a colposcopy, but they’ll probably choose not to do a biopsy.

Only if your doctor finds something that doesn’t look normal during your colposcopy. If they find several areas that don’t look right, they’ll biopsy those, too.

Your doctor will do the biopsy during your colposcopy. They’ll use a sharp tool to take a sample of tissue from the abnormal area. It’ll be uncomfortable -- you’ll feel pressure or mild cramps. You will likely feel a sharp pain.

The biopsy samples will be sent off for testing. The results will give your doctor an idea of what steps they should take next.

If they're able to remove all the abnormal cells during the biopsy, you may not need more treatment.

They may also suggest one of the following options to remove the cells and prevent cervical cancer:

Cone biopsy. Your doctor cuts a cone-shaped piece of tissue from your cervix to remove any precancerous cells. The abnormal cells are typically precancerous or cancerous.

Cryotherapy. Your doctor uses liquid gas to freeze abnormal cells from your cervix.

Loop Electrosurgical Excision Procedure (LEEP). Your doctor removes abnormal cells with a wire loop that carries an electric current.

With both the colposcopy and the cervical biopsy, you should be able to go back to work or school right away. But don’t put anything inside your vagina -- tampons, creams, etc. -- and don’t have intercourse for at least 48 hours after your biopsy.

Colposcopy is a routine procedure, and complications are rare, though you might be sore afterwards.

Your doctor may apply a liquid bandage to your cervix after the procedure to stop any bleeding. If they do, you might have brown or black vaginal discharge. It may even look like coffee grounds. Don’t worry—it should clear up in a few days.

But call your doctor right away if you show any signs of infection, such as:

  • Fever of 100.4 F or higher
  • Heavy, yellow, stinky vaginal discharge
  • Severe pain in your lower abdomen that isn’t relieved by over-the-counter pain relievers
  • Vaginal bleeding that lasts more than 7 days

There’s always a risk that test results are incorrect. It’s rare, but it happens. And there’s a chance that abnormal cells can come back, even after your doctor removes them. That’s why it’s important to continue to get regular Pap smears and check-ups.