What is a Colposcopy?

A colposcopy is a procedure in which a doctor is able to examine the cervix, vagina and vulva for signs of disease, and it uses an item called a colposcope with a special magnifying lens.

When might this test be right for you, and what types of conditions can it help identify? Here’s a look at some basic details about colposcopy and what expectations you should carry into your appointment.

Who is Colposcopy For?

The most common use of the colposcopy test is for women who have received an abnormal result on a Pap test. This is often caused by a viral infection, or natural changes to the cervix linked to menopause.

Potential reasons for a colposcopy include:

Viewing the cervix to determine the cause of abnormal Pap tests. If abnormal tissue is found, a biopsy for this tissue is often ordered.
Check for sores, warts or other issues found around the vagina or cervix.
Follow up for abnormalities detected in a previous colposcopy, or to see if a previous treatment has been successful.
If an HPV test shows a high-risk form of HPV is present, colposcopy can be used to check the cervix for problem areas.

Colposcopies can help diagnose several important diseases or conditions:

Cancer: Cervical cancer, vaginal cancer and vulvar cancer can all be detected by this test
Cervicitis: This is a condition involving inflammation of the cervix
Precancerous changes: These can occur in cervical or vaginal tissue, or in the vulva.

Preparation and Risks

A few elements that go into colposcopy preparation include:

• Pregnancy test: A blood or urine test might be done to see if you’re pregnant. Colposcopy is safe for pregnant women, but there are resulting tests that could be slightly more risky.
• Medications: You’ll want to tell your doctor about all medications you take and any allergies you have to medications. If you use any vaginal medications, you shouldn’t use them for a couple days in advance.
• Menstruation and tampons: It’s recommended that you avoid scheduling a colposcopy during your period, and avoid using tampons for a couple days before the procedure.
Sexual intercourse: Avoid intercourse for 24 hours prior to the exam.
Pain relievers: A basic over-the-counter pain reliever like ibuprofen or acetaminophen is recommended before the appointment.
• Anxiety: Many women have anxiety before a colposcopy, and this is normal. There are a few things you can do to help minimize your anxiety, including speaking with your doctor.

Test Expectations

A colposcopy usually takes between 10 and 20 minutes. You’ll lie on your back with your feet in supports, and your doctor will use a tool called a speculum to hold open the walls of the vagina. The doctor then positions the colposcope a few inches from the vulva and uses a bright light with the colposcope’s magnifying instrument to look through the lens.

After the test, your cervix and vagina will be swabbed with cotton and cleaned. The doctor may apply a vinegar or other solution to the vagina, which may tingle but can help highlight any suspicious areas.

If the test reveals any suspicions, your doctor may collect a small sample from these areas for testing, called a biopsy. A biopsy can be one either for the cervix or the vagina. A biopsy may cause minor pain during the procedure, and can lead to pain and light bleeding or dark discharge in the days just after it’s done. Your doctor will discuss all the results of both these potential tests with you, and let you know of treatment plans if any conditions are detected.

If you’ve had an abnormal Pap test, or think you need a colposcopy for any reason, speak to your family doctor.

I practice the full range of family medicine including obstetrics, pediatrics, adolescent medicine and adult medicine. I also practice some orthopedics, remove lumps and bumps, and perform colposcopy, cryotherapy and vasectomies. Due to the volume of deliveries we do, my practice has evolved to be more centered on women and children’s medicine, but I enjoy all aspects of family medicine.