What is Colposcopy? Purpose, Procedure & Results

A colposcopy is a simple, outpatient procedure that lets your doctor take a closer look at your cervix, vagina, and vulva. Think of it as using a special magnifying glass to examine areas that might need attention after an abnormal Pap smear or other concerns.

This procedure helps doctors spot changes in your cervical cells early, when they're easiest to treat. While the word "colposcopy" might sound intimidating, it's actually a routine diagnostic tool that helps keep you healthy.

What is colposcopy?

Colposcopy is a diagnostic procedure where your doctor uses a special magnifying instrument called a colposcope to examine your cervix and surrounding tissues. The colposcope stays outside your body and works like a powerful magnifying glass with a bright light.

During the procedure, your doctor can see areas that aren't visible during a regular pelvic exam. The magnification helps identify any unusual changes in the cells of your cervix, vagina, or vulva that might need further attention.

This examination typically takes about 10 to 20 minutes and is performed in your doctor's office. You won't need anesthesia, though you might feel some discomfort similar to a Pap smear.

Why is colposcopy done?

Your doctor recommends colposcopy when they need to investigate abnormal results from previous tests or symptoms that require closer examination. Most commonly, this happens after an abnormal Pap smear shows changes in your cervical cells.

The procedure helps your doctor determine whether cell changes are minor and likely to resolve on their own, or if they need treatment. It's essentially a way to get more detailed information before making any treatment decisions.

Here are the main reasons your doctor might recommend colposcopy:

• Abnormal Pap smear results showing atypical or precancerous cells
• Positive HPV test results, especially high-risk HPV types
• Unusual bleeding between periods or after intercourse
• Visible abnormalities on your cervix during a routine exam
• Persistent pelvic pain or unusual discharge
• Follow-up after previous treatment for cervical abnormalities

Remember, having a colposcopy doesn't mean you have cancer. Most women who have this procedure have benign conditions or minor changes that are easily treatable.

What is the procedure for colposcopy?

The colposcopy procedure is straightforward and similar to a regular pelvic exam, just with more detailed examination. You'll lie on an exam table with your feet in stirrups, just like during a Pap smear.

Your doctor will insert a speculum to gently open your vagina so they can see your cervix clearly. Then they'll position the colposcope about 12 inches away from your body - it never actually touches you.

Here's what happens step by step during your colposcopy:

1. You'll undress from the waist down and put on a hospital gown
2. Your doctor will perform a brief pelvic exam first
3. A speculum is inserted to open your vagina
4. Your doctor applies a mild vinegar solution to highlight any abnormal areas
5. The colposcope is positioned to examine your cervix with magnification
6. If needed, a small tissue sample (biopsy) might be taken
7. The speculum is removed, and you can get dressed

The entire process usually takes 10 to 20 minutes. If your doctor takes a biopsy, you might feel a brief pinching sensation, but most women find it tolerable.

How to prepare for your colposcopy?

Preparing for colposcopy is simple, and following these guidelines will help ensure the best possible view of your cervix. The key is avoiding anything that might interfere with the examination for 24 to 48 hours beforehand.

Schedule your appointment for about a week after your menstrual period ends, when your cervix is most visible. Heavy bleeding can make it difficult for your doctor to see clearly during the procedure.

Here's how to prepare in the days leading up to your colposcopy:

• Avoid sexual intercourse for 24 hours before the procedure
• Don't use tampons, vaginal creams, or douches for 24 hours prior
• Skip vaginal medications unless specifically instructed by your doctor
• Take an over-the-counter pain reliever 30 minutes before if you're concerned about discomfort
• Wear comfortable clothing and consider bringing a pad for afterwards
• Arrange for someone to drive you home if you're feeling anxious

It's perfectly normal to feel nervous before the procedure. Many women find it helpful to bring a friend or family member for support, and don't hesitate to ask your doctor any questions you have.

How to read your colposcopy results?

Your colposcopy results will typically be available within a few days to a week, depending on whether a biopsy was performed. Your doctor will explain what they observed and what it means for your health going forward.

Normal results mean your cervical tissue appears healthy with no signs of abnormal cell changes. This usually means you can return to your regular screening schedule without immediate concerns.

If abnormal areas were found, your doctor will classify them based on the severity of cell changes. Here's what different findings typically mean:

• Low-grade changes: Mild cell abnormalities that often resolve on their own with time
• High-grade changes: More significant abnormalities that may require treatment
• Atypical cells: Cells that don't look normal but aren't clearly abnormal either
• Inflammation: Irritation that might be caused by infection or other factors

If a biopsy was taken, those results provide more detailed information about the specific type and extent of any cell changes. Your doctor will discuss whether you need treatment or just more frequent monitoring.

What are the risk factors for abnormal colposcopy results?

Several factors can increase your likelihood of having abnormal colposcopy findings, with HPV infection being the most significant. Understanding these risk factors helps you make informed decisions about your health and screening schedule.

HPV (human papillomavirus) infection causes most cervical cell changes, particularly the high-risk types that can lead to precancerous conditions. However, having risk factors doesn't mean you'll definitely develop problems.

Common risk factors that might lead to abnormal findings include:

• HPV infection, especially high-risk types like HPV 16 and 18
• Having multiple sexual partners or a partner with multiple partners
• Starting sexual activity at a young age
• Smoking, which weakens your immune system's ability to fight HPV
• Weakened immune system from conditions like HIV or immunosuppressive medications
• History of other sexually transmitted infections
• Long-term use of birth control pills (more than 5 years)

Less common risk factors include having multiple pregnancies, being exposed to DES (diethylstilbestrol) in the womb, or having a family history of cervical cancer. Remember, many women with these risk factors never develop serious problems.

What are the possible complications of abnormal colposcopy results?

Most abnormal colposcopy results represent early, treatable changes rather than serious complications. The purpose of colposcopy is to catch problems early, when they're most manageable and before they become more serious.

When left untreated, some high-grade cervical changes can potentially progress to cervical cancer over many years. However, this progression is usually slow, giving you and your doctor plenty of time to address any concerns.

Potential complications from untreated abnormal results may include:

• Progression to precancerous lesions: High-grade changes that require treatment
• Cervical cancer: A rare outcome that develops over many years without treatment
• Fertility concerns: Extensive treatment of severe abnormalities might affect future pregnancies
• Recurrent infections: Ongoing HPV infection that doesn't clear naturally

The good news is that with regular monitoring and appropriate treatment when needed, serious complications are very rare. Most women with abnormal colposcopy results go on to have normal, healthy lives.

When should I see a doctor after colposcopy?

You should contact your doctor if you experience any concerning symptoms after your colposcopy, especially if a biopsy was performed. While most women have no problems after the procedure, it's important to know what to watch for.

Normal symptoms after colposcopy include mild cramping for a few hours and light spotting for a day or two. If you had a biopsy, you might have slightly more bleeding and a dark discharge as the biopsy site heals.

Contact your doctor promptly if you experience any of these symptoms:

• Heavy bleeding that soaks more than one pad per hour
• Severe pelvic pain that doesn't improve with over-the-counter pain relievers
• Fever above 100.4°F (38°C)
• Foul-smelling vaginal discharge
• Bleeding that continues for more than a week
• Signs of infection like increased pain, swelling, or warmth

Also schedule a follow-up appointment as recommended by your doctor, even if you feel fine. This helps ensure proper healing and allows your doctor to discuss your results and any next steps.