Overview of the Colposcopy Procedure

What to Expect During This Common and Painless Gynecological Procedure

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It may be unsettling when your gynecologist calls to tell you that your Pap smear results were abnormal and that you need a colposcopy, an in-office procedure in which your doctor examines your cervix more closely with a magnifying instrument.

The good news is that this procedure is simple and can be rapidly performed within the comforts of a patient room in your doctor's office. That being said, understanding what a colposcopy entails can lessen any anxiety you may feel going into one.

Why Am I Getting a Colposcopy?

Your doctor may advise a colposcopy if your Pap smear results indicate abnormal cervical changes. According to the American Congress of Obstetrics and Gynecologists (ACOG), it may also be performed to evaluate for:

  • An inflamed cervix (this is called cervicitis)
  • Non-cancerous growths on the cervix (polyps)
  • Genital warts on the cervix

These abnormalities may have been noted by your doctor during your pelvic exam and Pap smear.

In addition, your doctor may also perform a colposcopy if you report abnormal symptoms like pain or bleeding.

How to Prepare for Your Colposcopy

It's best to undergo your colposcopy when you are not menstruating. It's also important to not place anything into your vagina for at least one day prior to the procedure -- this means not using any vaginal creams, having sex, douching, or using tampons. 

It's also important to let your doctor know if you are taking any blood-thinning medications like aspirin or warfarin. These medications can increase your risk of bleeding with a cervical biopsy, which is a tiny sample of cervical tissue sometimes taken during a colposcopy. Tell your doctor too if you are pregnant. While colposcopies are generally considered safe during pregnancy, your doctor will want to refrain from taking a biopsy.

What to Expect During a Colposcopy

A colposcopy is a simple 10- to 15-minute procedure that is painless and performed in a gynecologist's office. In fact, you can expect your colposcopy appointment to be similar to your Pap smear appointment. 

You'll start by laying down on the examination table and placing your feet in footrests. Your doctor will then place a speculum into your vagina. Once the speculum is in position, your healthcare provider will place a vinegar solution on your cervix to make the abnormal areas easier to see.

Next, your doctor will properly position the colposcope (it looks like a large microscope that sits on a stand and has a bright light) close to your vaginal opening, so the light is shining on the vagina and cervix.  

During a colposcopy, your doctor may see white areas on the cervix, which signal abnormal cervical changes. Any abnormal vascular (blood vessel) changes are also visible through the colposcope.

Finally, your healthcare provider will take a tissue sample or biopsy, if necessary, from the abnormal areas and send it to a lab for further evaluation. You should get the results back within one to two weeks. Be sure to call your doctor's office if you do not hear back within that time frame.

What to Expect After a Colposcopy

Women who don't require a cervical biopsy usually feel fine after a colposcopy, although they may have very mild spotting. 

If you had a colposcopy with a biopsy, you should wear a sanitary pad, as you will experience some vaginal bleeding. You may also experience mild cramping for the next 24 to 48 hours. Usually, this pain is treatable with over-the-counter pain medications such as Tylenol (acetaminophen) or Motrin (ibuprofen). 

In addition to some light vaginal bleeding, you may notice a dark discharge, which is likely due to a solution your doctor applied to the cervical biopsy site. This vaginal discharge should not be bad smelling, so call your doctor if it is. While your cervix heals, your doctor may recommend that you refrain from putting anything into your vagina like tampons or having sex. 

If your pain does not improve with over-the-counter medication or your bleeding last for longer than seven days, contact your healthcare provider for follow-up advice. 

In addition, according to ACOG, it's important to call your doctor right away if you experience significant bleeding (like more than one sanitary pad per hour), severe lower abdominal pain, fever, and/or chills after a colposcopy.

A Word From Verywell

While it's normal to be anxious before your colposcopy, knowing what to expect during the procedure and after can hopefully calm your nerves.

Finally, one tidbit to remember is that "no news, doesn't necessarily mean good news." Remain an advocate for your health and call to follow up on test results if you do not hear back.

Ask questions too if you are worried or do not understand your results -- that's what your medical team is for, and they want to guide and care for you. 

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