Colposcopy is a procedure that involves examining the cervix and vagina using a special magnifying instrument called a colposcope. It is typically performed when an abnormal result is found on a pap smear (cervical cancer screening test), usually related to human papillomavirus (HPV) infection. HPV is a very common sexually transmitted infection (most of us will be infected at some point in our lives!). We care about HPV because we know it can cause cervical cancer.  A colposcopy allows us to get a closer and more detailed view of the cervix to evaluate any abnormalities and perform biopsies if necessary.  The results of these biopsies tell us whether the HPV has caused only mild vs more significant changes in the cells of the cervix.  Mild changes generally resolve on their own.  It is important to detect more significant changes early, as removal of these abnormal cells significantly decreases the risk of developing cervical cancer in the future.

What to expect during a colposcopy:

1. Preparation: It is important not to schedule your colposcopy during your period.  Menstrual efflux makes it difficult to visualize the cervix.  You may take an over the counter pain reliever (ie ibuprofen) 30 minutes prior to the procedure.

2. Once in the office, we will discuss the procedure at length and a consent will be signed.  A pregnancy test is performed to ensure it is negative.  You will then undress from the waist down and position yourself just like when you’ve had your pap smear.  I will be talking you through every step of the way!  A speculum will be inserted into your vagina to visualize your cervix.  A vinegar solution is then applied to your cervix.  Interestingly, this helps to visualize any abnormal cells.  Some people sense a little bit of a tingling sensation, but it is not generally uncomfortable.  Next, I will spend a few minutes looking at your cervix with the colposcope.  

3. If I see abnormal cells (I usually do), I will take a small biopsy.  This biopsy helps us to better identify what type of abnormality the HPV has caused.  The biopsy takes a tiny piece of tissue (maybe the size of a ½ grain of rice) – even though it is so small it gives us much more information than the pap.  The biopsy feels like a “pinchy, crampy” sensation that typically subsides quickly.  Some people do feel mild cramping for a short time afterwards.

4. Some people will spot lightly.  A special solution (“Monsel’s solution”) is usually applied to the biopsy sites afterwards to stop the bleeding.  This solution can cause a dark sometimes fleshy like discharge for the next few days.  It is important not to insert anything vaginally (ie no tampons, no sex) for about the next 5-7 days after the procedure. This helps to decrease the risk of infection and bleeding.  Unless otherwise discussed with you at the end of your visit, all other activities are fine right away.  

5. It generally takes 7-10 days to get results.  Anyone with a “mild abnormality” will get a message from me to follow up in one year.  Anyone with any more significant changes will get BOTH a message and a phone call.