Why is a colposcopy performed?

A colposcopy is usually done to assess the health of a woman’s cervix, which is the neck of the womb, the vagina and vulva to see whether there are abnormal cells or growths.

The doctor uses a colposcope, which looks like a pair of binoculars with a bright light. It allows the doctor a greatly magnified view of the surface of the vagina and cervix. If an area needs further investigation, the doctor can remove a tiny piece of tissue and send it to a laboratory for a biopsy.

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 bleeding, such as after intercourse
• an abnormal lump or growth on your cervix or vagina

The procedure can help diagnose conditions such as:

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

How to prepare for a colposcopy

Ask your gynaecologist to explain the benefits and risks of a colposcopy. Let them know if you are pregnant.

The procedure is usually done when you are not menstruating. For 24 to 48 hours beforehand, you should also not:

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

What happens during a colposcopy

A colposcopy takes between 10 and 30 minutes. It can feel awkward and uncomfortable, but it is not usually painful. It will most likely be done in the gynaecologist’s rooms or a clinic. There is no need for an anaesthetic for the colposcopy, but a local anaesthetic may be used if the biopsy is in a sensitive area.

If you have a colposcopy, you will be asked to lie on your back, as with a cervical screening test. Your legs might be raised and supported in stirrups.

The gynaecologist will insert a speculum, an instrument that opens the vagina. Then they will clean the surface of your cervix with a mild vinegar solution and might paint it with iodine, an antiseptic that turns healthy cells brown.

The gynaecologist will then place the colposcope just outside the entrance to the vagina and look for any areas of the cervix that are abnormal.

If they need to do a biopsy, they will remove a small sample of tissue to send to the laboratory. This will likely feel like pressure or a slight pinch. It might take up to 2 weeks for the biopsy results to come back.

What to expect after a colposcopy

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

If you have also had tissue removed for a biopsy, then you could have cramps for a day or so. If so, paracetamol can help. It is normal to have a slight vaginal discharge or bleeding for around 5 or 6 days.

After a biopsy, you will be asked to avoid sexual intercourse and heavy exercise, and not use tampons or lubricants for a couple of days. You can shower, but don’t have a bath or a swim.

Depending on what the biopsy shows, you might need treatment, such as freezing abnormal cervical cells with cryosurgery. If the results are unclear, you might need to have more tests. Often no further action is required.

What can go wrong?

There is a very small risk of infection or heavy bleeding. You should contact your doctor if you have:

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

More information

See Cancer Council Australia for information on colposcopy.