What Is Colposcopy?

What to expect when undergoing this test

A colposcopy is an in-office diagnostic procedure that a healthcare provider uses to examine the inside of the vagina, vulva, and cervix for concerns such as cell changes, growths, and inflammation. An illuminated magnifying instrument called a colposcope is used to access and view the areas.

You may need a colposcopy for investigation of your symptoms or as a follow-up evaluation after an abnormal pelvic exam or Pap smear.

what to expect during a colposcopy

Verywell / Emily Roberts

Purpose of Test

A colposcopy allows your healthcare provider to see inside these areas so they can carefully look for and examine lesions or abnormalities with the aid of magnification.

Solutions are applied to help your healthcare provider assess the cervical lining during this procedure. Your practitioner might take a sample of tissue (biopsy) for examination during your colposcopy as well.

According to the American College of Obstetricians and Gynecologists, a colposcopy is recommended if a pelvic examination showed:

  • Cancer or precancer: These changes can be detected on a routine Pap smear and require further investigation and, perhaps, treatment.
  • Cervicitis: Inflammation of the cervix can be caused by illness, infection, irritation, or physical abrasion.
  • Polyps: Growths on the cervix often need to be removed but are typically not cancerous.
  • Genital warts: Warts, typically caused by human papillomavirus (HPV) infection, can be present on the vagina or cervix and may lead to serious problems, such as cancer.
  • Painful or irregular bleeding: These can be signs of conditions and diseases involving the cervix.

Limitations of Colposcopy

A colposcopy does not extend all the way to the uterus, and it only provides a view of some areas of the cervix and some surrounding tissue.

Risks and Contraindications

In general, colposcopy is considered safe. With that said, if you are pregnant, a biopsy is usually avoided because it can cause cramping and may increase the risk of complications, such as premature labor or miscarriage.

If you are prone to bleeding or take an anticoagulant (blood thinner), you may experience heavy bleeding after a biopsy.

Before the Test

If you need to have a colposcopy, your healthcare provider will schedule it for a time when you are not having your period, as this can change the appearance of the cervix and the bleeding may interfere with optimal visualization.

It's also important to not place anything into your vagina for at least one day prior to the procedure, so you will be instructed to abstain from sexual intercourse, using vaginal creams, douching, or using tampons. 

Tell your healthcare provider if you are pregnant or taking any blood-thinning medications like aspirin or warfarin (but do not stop taking the drugs unless your medical professional tells you to).

Timing

You might have your colposcopy in your healthcare provider's office as part of your gynecologic examination. If this is the case, you should expect the procedure to last for about 10 to 20 minutes.

Location

A colposcopy is done in the healthcare provider's examination room.

What to Wear

You can wear whatever is comfortable on your way to the test. You will be asked to undress from the waist down and may be asked to change into a gown.

Food and Drink

There are no food or drink restrictions associated with colposcopy.

Cost and Health Insurance

If you are having a colposcopy, your health insurance company may require a pre-authorization, which your healthcare provider's office should take care of. You may also need to pay a co-pay, and your health insurance company and healthcare provider's office will be able to tell you the amount.

If you are paying out of pocket, you should expect to pay between $200 and $600 depending on the facility and where you live. The amount will be on the higher end if a biopsy is needed.

What to Bring

You should be sure to bring your test order form, your health insurance card, a form of identification, and a method of payment if you need it.

During the Test

Your test is typically performed by a gynecologist or other healthcare provider. An assistant or nurse may be on hand to assist.

Pre-Test

You will need to fill out some paperwork, including a consent form for the procedure, authorization for payment, and patient privacy forms.

You may be asked to change into a gown, and your nurse may ask you if you need to empty your bladder so that the test will be more comfortable. Once on the examination table, you will be asked to lie down and place your feet in stirrups.

Throughout the Test

Your healthcare provider will place a speculum into your vagina. Once the device is in position, your healthcare provider may gently cleanse your cervix with saline, either using a spray bottle or a cotton swab.

Typically, your practitioner will also place a 3% to 5% dilute acetic acid solution on your cervix to better visualize the area and distinguish between normal and abnormal tissue.

Next, the colposcope will be positioned close to your vaginal opening, so that the light is shining on the vagina and cervix. Your healthcare provider will then take careful note of what they can see. Blood vessel enlargement, bleeding, or irregularities are often visible through the colposcope.

When swabbed with acetic acid, areas of abnormal cervical tissues will immediately turn white and opaque.

Your healthcare provider may insert Lugol's solution, which is composed of iodine and potassium iodide. Normal cervical tissue usually appears brown when it comes in contact with Lugol's solution, and pre-cancerous cells usually appear yellow.

Finally, your healthcare provider may take a tissue sample, if necessary, from the abnormal areas, You may feel mild discomfort or cramping during the biopsy, but this should only last a few minutes.

Be sure to tell your healthcare provider if you experience severe pain or discomfort as this can be a sign of cervical inflammation or infection.

Post-Test

Once your healthcare provider removes the speculum, you may need a few minutes to rest. If a sample was collected, it will be prepared to be sent to a lab.

Your healthcare provider might discuss some of the test results with you right away or a couple of weeks later. You can empty your bladder if you need to, and your nurse may give you a sanitary pad if you have any bleeding.

Normally, you can be discharged to go home at that time.

After the Test

If you have a colposcopy without a biopsy, you may have very mild spotting. If you had a colposcopy with a biopsy, you are likely to experience some vaginal bleeding and mild cramping for 24 to 48 hours after the procedure.

In addition to some light vaginal bleeding, you may notice a dark discharge from the solution that your healthcare provider used to help visualize your cervix. 

You should use a sanitary pad and not a tampon for the bleeding and discharge. Pain is typically treatable with over-the-counter pain medications such as Tylenol (acetaminophen) or Motrin (ibuprofen). 

After your procedure, your healthcare provider may recommend that you refrain from putting anything into your vagina for about 48 hours. This includes abstaining from sexual intercourse.

Managing Side Effects

You should contact your healthcare provider if your symptoms are worse than expected or you develop any symptoms of infection. Both are uncommon but can occur.

When to Call a Healthcare Provider

Call your healthcare provider if you experience any of the following after undergoing a colposcopy:

  • Heavy vaginal bleeding or bleeding that soaks more than one sanitary pad per hour for two hours
  • Severe or worsening pelvic pain
  • High fever with chills
  • Pus-like vaginal discharge with a bad odor

Interpreting Results

Your colposcopy results are based on your healthcare provider's observations during the procedure as well as the results of the biopsy if you had one. Your healthcare provider may discuss some preliminary results during or immediately after the procedure or may schedule an appointment at a later time after your biopsy results return, which is usually within one to two weeks.

A colposcopy may help identify:

Follow-Up

If you have a medical condition diagnosed by colposcopy, your next step is either treatment or further evaluation. For example, if you have an infection, you may need to be treated with an antibiotic.

A pre-cancerous lesion may prompt the need for further evaluation such as a repeat biopsy, a larger biopsy, or close monitoring with more frequent Pap smears or colposcopies. A cancer diagnosis will require further tests and treatments.

In general, it is not typical to have routine follow-up colposcopy at regular intervals, but you may need to have another colposcopy if you have an abnormal Pap smear in the future or other concerning findings.

A Word From Verywell

A colposcopy is a diagnostic test that can provide your healthcare provider with some results while you are having the test. It is generally easy to tolerate with few side effects.

However, you may be anxious or worried about the results if your symptoms are unusual or severe, or you are at risk of cervical cancer. In general, most medical conditions diagnosed by colposcopy are treatable. Even cervical cancer, in fact, has a good prognosis when it is diagnosed early and treated promptly.

Was this page helpful?
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Nam K. Colposcopy at a turning pointObstet Gynecol Sci. 2018;61(1):1-6. doi:10.5468/ogs.2018.61.1.1

  2. American College of Obstetricians and Gynecologists. Colposcopy. Updated May 2019.

  3. Beharee N, Shi Z, Wu D, Wang J. Diagnosis and treatment of cervical cancer in pregnant women. Cancer Med. 2019 Sep;8(12):5425-30. doi:10.1002/cam4.2435

  4. University of California San Francisco. Colposcopy-directed biopsy. Updated January 14, 2018.

  5. American Society of Clinical Oncologists. Colposcopy: How to prepare and what to know. Updated June 13, 2019.

  6. Mayeaux EJ, Cox JT. Modern Colposcopy Textbook and Atlas (Third Edition). LWW Publishing; 2021.

  7. Gutiérrez-Fragoso K, Acosta-Mesa HG, Cruz-Ramírez N, Hernández-Jiménez R. Optimization of classification strategies of acetowhite temporal patterns towards improving diagnostic performance of colposcopy. Comput Math Methods Med. 2017;2017:5989105. doi:10.1155/2017/5989105

  8. Jay N, Berry M, Miaskowski C, et al. Colposcopic characteristics and Lugol׳s staining differentiate anal high-grade and low-grade squamous intraepithelial lesions during high resolution anoscopy. Papillomavirus Res. 2015 Dec;1:101-8. doi:10.1016/j.pvr.2015.06.004