Understanding a colposcopy

A colposcopy is a simple procedure to find out whether there are abnormal cells on or in the cervix, the vagina or the vulva. It is a lot like having a smear test and usually takes 5 to 10 minutes. The main difference is that your doctor uses a special magnifying instrument called a colposcope to look closely at the cervix. If you have been referred for a colposcopy, try not to worry: it is a routine examination, and most people do not have cancer.

Why do you need a colposcopy?

If your doctor thinks something may not be quite right with your cervix, they may recommend a colposcopy. Common reasons include:

• your smear test showed abnormal cells (see abnormal cervical smears)
• your smear test found human papillomavirus (HPV)
• your cervix looked abnormal during an examination
• you have unexplained bleeding, such as bleeding after sex

A colposcopy can also help to diagnose genital warts and, less often, cervical, vaginal or vulval cancer.

How is a colposcopy performed?

You will lie on an examination couch, and your doctor will gently insert a speculum to hold the vagina open, just as for a smear test. They will then dab a vinegar-like solution onto the cervix and vagina, which makes any abnormal cells easier to see. Next, they will use the colposcope, which stays outside your body, to examine the cervix and vulva closely. You can ask to stop at any point.

Before the procedure, you will have time to ask questions, and you can bring someone with you for support. If you can, avoid booking during your period. Afterwards, most people return to normal activities the same day. If you have had a biopsy or treatment, avoid sex, tampons and swimming for a few days, or for as long as your doctor advises.

Will I need a biopsy?

A biopsy is only taken if your doctor sees an area that does not look normal during the colposcopy. It is usually done straight away, by taking a small sample of tissue from the abnormal area. This can feel like a sharp pinch, and you may have some light bleeding or discharge for a few days afterwards.

What will the results show?

Biopsy samples are sent to a laboratory, and the results help your doctor decide what to do next. If all the abnormal cells were removed during the biopsy, you may not need any further treatment. Otherwise, your doctor may suggest one of the following to remove the cells and prevent cervical cancer:

• LLETZ (also called LEEP): the abnormal cells are removed with a thin wire loop that carries an electric current, usually under local anaesthetic.
• Cone biopsy: a cone-shaped piece of tissue is removed from the cervix.
• Cryotherapy: the abnormal cells are frozen.

Are there any risks with a colposcopy?

A colposcopy is a routine procedure, and complications are rare. However, contact your doctor straight away if you notice signs of infection afterwards, such as:

• a temperature of 38°C or higher
• heavy, yellow or foul-smelling vaginal discharge
• severe pain in your lower tummy that is not eased by over-the-counter painkillers
• vaginal bleeding that lasts more than 7 days

Occasionally, test results can be wrong, and abnormal cells can come back even after treatment. That is why it is so important to keep going for your smear tests and follow-up checks.

Cancer Research UK explains cervical screening and colposcopy, and the World Health Organization describes how treating precancerous changes prevents cervical cancer. Our colposcopy page has more detail. To book a colposcopy with Mr Jafaru Abu, please contact the team.