A colposcopy is a specialized procedure that allows a healthcare provider to closely examine the cervix, vagina, and vulva using a magnified view. This examination uses an instrument called a colposcope, which acts like a powerful microscope to illuminate the tissues in the lower genital tract. A colposcopy is typically recommended when a routine screening test, such as a Pap test or a human papillomavirus (HPV) test, returns an abnormal result. This inspection evaluates for precancerous changes, or dysplasia, that may not be visible to the naked eye.
Preparing for the Examination
It is recommended to avoid sexual intercourse for 24 to 48 hours before your colposcopy appointment. Recent intercourse can cause minor irritation or bleeding of the cervix, which might obscure the provider’s view during the procedure. Additionally, the presence of semen or other fluids can interfere with the chemical solutions used to highlight abnormal cells, potentially leading to inaccurate results.
You should also refrain from placing anything into the vagina in the days leading up to the examination. This includes douching, using tampons, and applying vaginal creams, suppositories, or medications. These items can alter the appearance of the cervical tissue or introduce foreign substances that affect the clarity of the examination.
If you anticipate having a heavy menstrual flow, contact the clinic, as the procedure may need to be rescheduled. Heavy bleeding makes it difficult to clearly visualize the cervix for an accurate assessment. Taking an over-the-counter pain reliever, such as ibuprofen, about 30 to 60 minutes before the procedure may help minimize discomfort or cramping.
Steps of the Colposcopy Procedure
The colposcopy is performed similarly to a standard pelvic exam, with the patient lying on an examination table. The provider first inserts a speculum into the vagina to gently open the vaginal walls and bring the cervix into full view. The colposcope, a large, lighted magnifying device, is then positioned just outside the vagina and never actually enters the body.
A cotton swab is used to apply a weak solution of acetic acid, commonly known as a vinegar solution, onto the cervix. This solution causes abnormal areas of tissue to temporarily turn white, making them stand out clearly under magnification. The provider then examines the entire surface of the cervix, vagina, and vulva.
If an area of tissue appears abnormal, the provider may take a small tissue sample, known as a biopsy, for laboratory analysis. This is typically done using punch biopsy forceps, which removes a tiny circular piece of tissue, often feeling like a brief pinch or a mild menstrual cramp. For biopsies taken from inside the cervical canal, a thin scraping tool may be used (endocervical curettage).
Immediate Post-Procedure Care
If no biopsy was taken, you can usually resume normal activities immediately. If a biopsy was performed, expect minor side effects, most commonly light vaginal spotting or bleeding for a few days. You may also notice a dark brown or black discharge if the provider used a hemostatic agent, such as Monsel’s solution, to stop bleeding from the biopsy site.
To allow the biopsy site to heal properly and reduce the risk of infection, you must follow temporary post-procedure restrictions. Avoid sexual intercourse, douching, and using tampons for the period specified by your doctor, typically between three and seven days. Use sanitary pads instead of tampons until the spotting or discharge has completely stopped.
Contact your healthcare provider if you experience heavy bleeding, such as soaking through more than one pad per hour, or if you develop signs of infection. These signs include a fever, severe lower abdominal pain, or a heavy, foul-smelling vaginal discharge. Biopsy results are usually available within a week or two, and your doctor will discuss necessary follow-up care.