Being referred for a colposcopy can understandably feel worrying, particularly if you have been told that your cervical screening result is abnormal.
However, being referred for a colposcopy does not mean that you have cervical cancer. A colposcopy is a detailed examination of the cervix that allows a specialist to look more closely at the cells and identify whether any further investigation or treatment is needed. Most people who attend a colposcopy do not have cervical cancer.
At Gynae Solution, Mr Jafaru Abu provides specialist assessment and colposcopy for women who require further investigation following cervical screening or because of symptoms affecting the cervix.
What Is a Colposcopy?
A colposcopy is a specialist examination used to look closely at the cervix, which is the lower part of the womb that opens into the vagina.
During the procedure, a specialist uses a colposcope, a microscope with a light, to magnify the cervix and identify any areas of abnormal tissue.
The colposcope remains outside the body. A speculum is gently inserted into the vagina, in a similar way to a cervical screening examination, allowing the cervix to be seen clearly.
A colposcopy may also involve taking a small sample of tissue, known as a biopsy, if an area needs closer examination.
The purpose of the procedure is to establish whether there are abnormal changes to the cells of the cervix and, if so, determine whether they need monitoring or treatment.
Why Might I Need a Colposcopy?
There are several reasons why you may be referred for a colposcopy.
An Abnormal Cervical Screening Result
One of the most common reasons is a cervical screening result showing high-risk HPV alongside abnormal cell changes.
HPV is extremely common, and most people will have an HPV infection at some point in their lives. In most cases, the immune system clears the infection naturally.
However, if certain high-risk types of HPV persist, they can cause changes to the cells of the cervix. Over time, some untreated cell changes can develop into cervical cancer.
Cervical screening is designed to identify these changes early, before cancer develops. A colposcopy allows the cervix to be examined in more detail.
Persistent HPV
You may also be referred if high-risk HPV continues to be detected over several screening appointments, even if no abnormal cell changes have been identified.
For example, under the NHS screening programme, persistent HPV without abnormal cell changes can result in referral for colposcopy after two years.
Symptoms
A colposcopy may sometimes be recommended because you have symptoms that could be associated with a cervical abnormality.
These can include:
- Bleeding after sex
- Bleeding between periods
- Unusual vaginal bleeding
- Unusual vaginal discharge
- Changes to the appearance of the cervix
Importantly, cervical screening is not intended to investigate symptoms. If you have symptoms such as unexplained postcoital or abnormal vaginal bleeding, you should seek medical assessment rather than waiting for your next screening appointment.
What Are Abnormal Cervical Cells?
An abnormal cervical screening result does not necessarily mean that anything serious is wrong.
Changes to cervical cells are often caused by HPV.
The cells can be described according to the degree of abnormality. You may hear terms such as:
- CIN1, low-grade cell changes
- CIN2, moderate-grade cell changes
- CIN3, high-grade cell changes
- CGIN, abnormal changes affecting glandular cells
These changes are not the same as cervical cancer.
Some low-grade changes can return to normal without treatment. Higher-grade changes are more likely to require treatment because they have a greater chance of progressing if left untreated.
The purpose of colposcopy is to establish exactly what is happening and determine whether monitoring or treatment is appropriate.
What Happens During a Colposcopy?
Before the examination begins, Mr Abu will explain what will happen and give you the opportunity to ask questions.
You will normally be asked to undress from the waist down and will be given privacy and a covering.
You will then lie on an examination couch, usually with your knees bent and your legs supported.
The Speculum
A smooth speculum is gently inserted into the vagina.
This is similar to the instrument used during cervical screening and allows the cervix to be seen.
Some women find this uncomfortable, particularly if they are anxious or have experienced discomfort with previous examinations. Let Mr Abu know if you are uncomfortable so that adjustments can be made.
Looking at the Cervix
The colposcope is positioned just outside the vagina.
It provides a magnified view of the cervix so that areas of abnormal tissue can be identified.
A small amount of liquid is applied to the cervix. This can cause a mild tingling or stinging sensation and helps highlight abnormal areas.
Cervical Biopsy
If an area looks unusual, a small sample of tissue may be taken.
This is called a biopsy.
The sample is very small and may feel like a brief pinch, scratch or cramp. It is then sent to a laboratory for detailed examination.
You may not need a biopsy if the cervix appears normal and the specialist is satisfied with the examination.
Does a Colposcopy Hurt?
Everyone experiences a colposcopy differently.
The insertion of the speculum can feel uncomfortable or cause pressure, particularly if you are nervous.
The solutions applied to the cervix may cause a mild stinging or tingling sensation, while a biopsy can cause a brief pinching or scratching feeling.
You should always tell your specialist if you are experiencing pain or significant discomfort.
You are in control of the examination and can ask for it to stop at any time.
If you have previously found cervical screening or intimate examinations difficult, it is worth discussing this with your specialist before the procedure so that appropriate adjustments can be made.
Can I Have a Colposcopy If I Am Pregnant?
If you are pregnant or think you may be pregnant, tell your specialist before your appointment.
A colposcopy can be performed during pregnancy when necessary, although some procedures and treatments may be delayed until after your baby is born depending on your individual circumstances.
Your specialist will explain what is appropriate for you.
What Happens If Abnormal Cells Are Found?
If abnormal cells are identified during your colposcopy, the next step depends on their appearance and the results of any biopsy.
You may be advised to:
- Have no immediate treatment
- Have a repeat cervical screening test
- Have another colposcopy
- Have treatment to remove the abnormal cells
The appropriate approach depends on the grade and extent of the abnormality.
CIN1
CIN1 represents low-grade changes.
These changes often return to normal naturally and treatment is not usually required immediately. You may instead be offered follow-up screening or another colposcopy to monitor the cells.
CIN2
CIN2 represents moderate-grade changes.
Depending on your individual circumstances, your specialist may recommend careful monitoring or treatment to remove the abnormal cells.
CIN3
CIN3 represents high-grade changes.
Treatment to remove the abnormal cells is generally recommended because these changes have a higher risk of progressing to cervical cancer if left untreated.
Treatment During or After Colposcopy
If treatment is required, this may sometimes be carried out during the same appointment or arranged for a later date.
The most common treatment is LLETZ.
What Is LLETZ?
LLETZ stands for Large Loop Excision of the Transformation Zone.
It involves using a thin heated wire loop to remove the area of abnormal cells from the cervix.
A local anaesthetic is used to numb the cervix, so you should not feel pain during the procedure, although you may experience some pressure or cramping.
The procedure is usually performed as an outpatient procedure and the tissue removed is sent to a laboratory for further examination.
LLETZ is designed to remove abnormal cells while preserving as much healthy cervical tissue as possible.
Cone Biopsy
In some circumstances, a larger area of tissue needs to be removed.
A cone biopsy involves removing a cone-shaped section of the cervix and is usually performed under a general anaesthetic.
It may be recommended when a larger or more deeply situated area needs to be examined or treated.
Does Treatment Affect Fertility?
If you need treatment to remove abnormal cervical cells, your fertility and future pregnancy plans should be taken into consideration.
Most women who have treatment for abnormal cervical cells are able to become pregnant in the future.
However, treatments that remove cervical tissue can have an impact on future pregnancies, particularly where a larger amount of cervical tissue needs to be removed.
Your specialist will discuss the benefits and potential risks of treatment with you before proceeding.
If you are hoping to become pregnant in the future, make sure your specialist knows this so that it can be considered when planning your care.
What Happens After a Colposcopy?
Most women are able to go home shortly after a colposcopy.
If you have had a colposcopy without a biopsy, you may experience mild discomfort or light bleeding for a few days.
If you have had a biopsy or LLETZ, bleeding and discharge may last longer. After LLETZ, some women experience bleeding for up to around four weeks.
You may be advised to:
- Use sanitary pads rather than tampons while bleeding
- Avoid penetrative sex for the recommended period
- Avoid putting anything into the vagina while the cervix heals
- Avoid strenuous activity if it increases bleeding or discomfort
Your specialist will provide specific aftercare instructions depending on the procedure you have had.
When Should I Seek Medical Advice After Colposcopy?
Some light bleeding, discharge and mild cramping can be expected.
However, you should seek medical advice if you experience:
- Heavy vaginal bleeding
- Foul-smelling vaginal discharge
- Severe or persistent abdominal pain
- Pain that does not improve with recommended pain relief
- Other symptoms that concern you
Heavy bleeding, unpleasant-smelling discharge or persistent abdominal pain can sometimes indicate a complication such as infection and should be assessed.
When Will I Get My Colposcopy Results?
If no biopsy is taken and the specialist can provide an immediate assessment, you may be given information about what was seen during your appointment.
If a biopsy is taken, the tissue needs to be examined by a laboratory. Results can therefore take several weeks. The NHS advises that biopsy results may take around 4 to 8 weeks.
Your results will determine whether you need further treatment, monitoring or routine cervical screening.
Waiting for results can understandably be an anxious time, but remember that being referred for colposcopy or having abnormal cervical cells does not mean that you have cancer.
What If Cervical Cancer Is Found?
In a small number of cases, a colposcopy and biopsy may identify cervical cancer.
If this happens, you will be referred to a specialist team for further assessment and treatment planning.
Further tests may be recommended to establish the size and extent of the cancer and whether it has spread.
Treatment depends on the type and stage of cervical cancer and may include surgery, radiotherapy, chemotherapy or a combination of treatments.
The important purpose of cervical screening and colposcopy is to identify abnormal changes before they develop into cancer wherever possible.
Risks and Benefits of Colposcopy
A colposcopy is an important diagnostic procedure that allows the cervix to be examined in much greater detail than during routine cervical screening.
Benefits may include:
- Identifying abnormal cervical cells
- Establishing the severity of cell changes
- Identifying areas that require treatment
- Providing reassurance when no significant abnormality is found
- Allowing treatment to be offered before abnormal cells develop into cancer
- Investigating symptoms such as unexplained bleeding
Most colposcopies are straightforward and do not result in a diagnosis of cancer.
Potential risks include:
- Temporary discomfort or cramping
- Light vaginal bleeding
- Vaginal discharge
- Discomfort following a biopsy
- Infection
- Heavier bleeding following treatment
If treatment such as LLETZ is required, there are additional considerations, including a small potential impact on future pregnancy depending on the amount of cervical tissue removed.
Mr Abu will explain the potential benefits, risks and alternatives before any treatment is undertaken, allowing you to make an informed decision about your care.
Specialist Colposcopy Care
Being referred for a colposcopy can understandably cause anxiety, particularly when the referral follows an abnormal cervical screening result.
However, an abnormal screening result is not the same as a cancer diagnosis. The majority of women referred for colposcopy will not have cervical cancer.
A colposcopy is an important opportunity to look more closely at the cervix, establish whether abnormal cells are present and determine whether monitoring or treatment is appropriate.
At Gynae Solution, Mr Jafaru Abu provides a thorough and reassuring approach to colposcopy, taking the time to explain the procedure, discuss your results and answer any questions you may have.
Whether you have been referred because of an abnormal cervical screening result, persistent HPV or symptoms such as bleeding after sex, your assessment will be tailored to your individual circumstances.
If you have been advised that you need a colposcopy and would like specialist assessment and advice, contact Gynae Solution to arrange a consultation with Mr Jafaru Abu.
Common questions
How soon can I be seen?
Daily appointments are available at The Park Hospital. Call the secretary on 0115 966 2049, or send an enquiry below and we will reply within 24 hours on business days.
Do I need a GP referral?
Referrals from GPs are welcome, and you can also enquire directly. If you are using private medical insurance, check with your insurer whether a referral is required for your policy. See GP referrals and fees and insurance.
What does a consultation cost?
A new consultation is £250 and a follow-up consultation is £150. The cost of any tests, procedures or surgery is quoted individually after your consultation. See fees and insurance.
Enquiries
Send us a message
Enquiries from patients and referring clinicians are both welcome. We endeavour to answer all enquiries within 24 hours on business days. If your case is urgent, please say so in your message or call the secretary directly.