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Colposcopy

Test Overview

Colposcopy lets a doctor look at your vulva, vagina, and cervix. If the doctor sees a possible problem, they can take a small sample of tissue. Then another doctor studies the tissue under a microscope. This is called a biopsy.

Most women have this procedure after they have abnormal results from a Pap test.

During the test, your doctor puts a lubricated tool into your vagina. This is called a speculum. It gently spreads apart the sides of your vagina. This allows your doctor to see inside your vagina and the cervix. The doctor also uses a magnifying device to help see better. This device does not go inside your vagina.

The doctor may put vinegar or iodine on your cervix. This can help the doctor to see any areas that are not normal. Sometimes the doctor also takes photos or videos.

When the speculum goes in, it can feel a little uncomfortable. If the doctor does a biopsy, you may feel a pinch and have some cramping.

Why It Is Done

Colposcopy is done to:

  • Look at the cervix for problem areas when a Pap test was abnormal. If an area of abnormal tissue is found, a biopsy is often done.
  • Check a sore or other problem (such as genital warts) found on or around the vagina and cervix.
  • Follow up on abnormal areas seen on a previous colposcopy. It can also be done to see if treatment for a problem worked.
  • Look at the cervix for problem areas if an HPV test shows a high-risk type of HPV.

How To Prepare

If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your test. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.

You will empty your bladder just before the test.

You may want to take a pain reliever, such as ibuprofen (Advil or Motrin). It is best to take it 30 to 60 minutes before the test, especially if a biopsy may be done. This can help decrease any cramping pain that you may have.

Schedule your colposcopy for when you are not having your period. Heavy bleeding makes it harder for your doctor to see your cervix. The best time to have this test is during the early part of your menstrual cycle. This is usually 8 to 12 days after the start of your last menstrual period.

How It Is Done

This test can be done in your doctor's office.

You will need to take off your clothes below the waist. You will be given a covering to drape around your waist. You will then lie on your back on an exam table. Your feet will be raised and put in foot rests (stirrups).

The doctor will insert a lubricated tool called a speculum into your vagina. It gently spreads apart the vaginal walls so your doctor can see inside the vagina and the cervix.

The colposcope is moved near your vagina. Your doctor looks through it at the vagina and cervix. Vinegar (acetic acid) or iodine may be used on your cervix to make abnormal areas easier to see. Photos or videos of the vagina and cervix may be taken.

If areas of abnormal tissue are found on the cervix, your doctor will take a small sample of the tissue. This is called a cervical biopsy. Usually several samples are taken. The samples are looked at under a microscope for changes in the cells that may mean cancer may be present or is likely to develop. If bleeding occurs, a special liquid (Monsel's) or silver nitrate swab may be used on the area to stop the bleeding.

If a sample of tissue is needed from inside the opening of the cervix, a test called endocervical curettage (ECC) will be done. This area can't be seen by the colposcope. So a small sharp-edged tool called a curette is gently put into the area to take a sample. ECC takes less than a minute to do. It may cause mild cramping. An ECC is not done during pregnancy.

How long the test takes

A colposcopy usually takes about 15 minutes.

How It Feels

You may feel some discomfort when the speculum is put in. You may feel a pinch and have some cramping if a tissue sample is taken.

Risks

Colposcopy has few risks, even if you're pregnant. If a cervical biopsy is needed during the test, the chance of any harm to the pregnancy (such as miscarriage) is very small. But you may have more bleeding from the biopsy.

In rare cases, a cervical biopsy can cause an infection or bleeding. Bleeding can usually be stopped by using a special liquid or swab on the area.

Results

Your doctor will talk to you about what they see at the time of the test. If you had a biopsy, getting your lab results may take several days or more.

Colposcopy and cervical biopsy

Normal:

The vinegar or iodine does not show any areas of abnormal tissue. The vagina and cervix look normal.

A biopsy sample does not show any abnormal cells.

Abnormal:

The vinegar or iodine shows areas of abnormal tissue. Sores or other problems, such as genital warts or an infection, are found in or around the vagina or cervix.

Results may show minor or serious changes to the cells on your cervix. Minor changes may go away on their own. You may need more testing. And your doctor may recommend treatment to remove the abnormal cells.

Credits

Current as of: April 29, 2020

Author: Healthwise Staff
Medical Review:
Sarah Marshall MD - Family Medicine
Martin J. Gabica MD - Family Medicine
E. Gregory Thompson MD - Internal Medicine
Kathleen Romito MD - Family Medicine
Kevin C. Kiley MD - Obstetrics and Gynecology