What is a colposcopy?

A colposcopy allows your doctor to examine your vulva, vagina and cervix very closely.

The doctor uses a colposcope, which looks like a pair of binoculars, with a bright light. It gives your doctor a magnified view of the surface of your vulva, vagina and cervix.

When is a colposcopy used?

A colposcopy is usually done to assess the health of your lower reproductive tract. It can check for abnormal cells or growths in your:

• cervix (the neck of the womb)
• vagina
• vulva

You might need a colposcopy if you have:

• abnormal results from a cervical screening test (which has replaced the old Pap smear test)
• unusual or unexplained vaginal bleeding, such as after sex
• an abnormal lump or growth on your cervix, vagina or vulva

The procedure can help diagnose conditions such as:

• cervical cancer or precancer
• benign growths such as polyps
• inflammation of the cervix

Is a colposcopy safe?

A colposcopy is a safe procedure. There is a small risk of complications, such as infection or heavy bleeding, in some cases.

After having a colposcopy, you should contact your doctor if you have:

• a fever
• a bad-smelling vaginal discharge
• severe pelvic pain
• heavy bleeding that lasts longer than 5 days

You can ask your gynaecologist to explain the benefits and risks of a colposcopy.

Can I have a colposcopy if I am pregnant?

Colposcopy can be safely performed during pregnancy if it is needed. If you have a high chance of getting cervical cancer, you may need an urgent colposcopy during pregnancy. In some cases, you may be able to postpone the procedure until after your baby is born.

Pregnancy can cause changes to your cervix, which can make colposcopy more challenging. So, it should be performed by a doctor with a lot of experience. Your referring doctor will help you find the right person to do your colposcopy.

Your doctor can discuss the benefits and disadvantages of a colposcopy with or without a biopsy in your situation.

How do I prepare myself for a colposcopy?

If you are pregnant, let your doctor know before your colposcopy. The procedure is usually done when you are not menstruating. For 24 to 48 hours beforehand, you should also not:

• have sex
• use tampons
• use vaginal medicines
• douche

Your doctor may suggest that you use vaginal oestrogen cream in the weeks before your colposcopy.

Some people experience abdominal cramping after the procedure. You might like to take a pain-relieving medicine, such as paracetamol, about an hour before the procedure.

What happens during a colposcopy?

A colposcopy takes about 5 to 10 minutes. It can feel awkward and uncomfortable, but it is not usually painful.

It will most likely be done in your gynaecologist's rooms or a sexual health clinic. Colposcopies do not usually need an anaesthetic. A local anaesthetic may be used if you need a biopsy.

For a colposcopy, you will be asked to lie on your back. Your legs might be raised and supported in stirrups.

Your gynaecologist will insert a speculum, an instrument that opens the vagina so the doctor can see your cervix. Then they will dab the area with a mild vinegar solution, which may sting a little. Your doctor may also apply iodine, which is a brown dye. This can help identify any unhealthy cells.

Your gynaecologist will place the colposcope just outside the entrance to your vagina. They will look through the colposcope to look for any areas that are abnormal.

If an area needs further investigation, your doctor can do a biopsy. This involves removing a small sample of tissue to send to the laboratory. This may cause a little discomfort. It might take up to 2 weeks for the biopsy results to come back.

How soon will I recover from a colposcopy?

After a colposcopy without a biopsy, you can carry on with your normal activities right away.

If you have had a biopsy, you might have cramps for a day or so. If so, paracetamol can help. It’s normal to have a slight vaginal discharge or spotting for around 5 days.

After a colposcopy or biopsy, it's best to avoid:

• sex and heavy physical exercise for 1 to 2 days
• tampons for 4 weeks
• swimming for 10 to 14 days

Your doctor might also advise you to avoid baths.

Depending on what the biopsy shows, you might need treatment to remove any abnormal cells. If the results are unclear, you might need to have more tests. Often, no further action is required.

Resources and support

The Cancer Council website has resources on cervical cancer, vaginal cancer and vulvar cancer. Call the Cancer Council on 13 11 20.

The Jean Hailes website has information on colposcopy and cervical cancer.

The Royal Women’s Hospital has a fact sheet on colposcopy, which is available in different languages.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.