Colposcopy is a way for your doctor to use a special
magnifying device to look at your
cervix. If a problem is seen during colposcopy, a
small sample of tissue (biopsy) may be taken from the cervix or
from inside the opening of the cervix (endocervical canal). The sample is
looked at under a microscope.
Colposcopy is usually done to look at the vagina and cervix when the result of a
Pap test is abnormal. Most abnormal Pap tests are
caused by viral infections, such as
human papillomavirus (HPV) infection, or other types
of infection, such as those caused by bacteria, fungi (yeast), or protozoa
(Trichomonas). Natural cervical cell changes (atrophic vaginitis) related to
menopause can also cause an abnormal Pap test. In some
cases, untreated cervical cell changes that cause abnormal Pap tests may
progress to precancerous or cancerous changes.
During colposcopy, your doctor uses a lighted magnifying device
that looks like a pair of binoculars (colposcope). The colposcope allows your
doctor to see problems that would be missed by the naked eye. A camera can be
attached to the colposcope to take pictures or videos of the vagina and
Your doctor may put vinegar (acetic acid) and sometimes iodine
(Lugol's solution) on the vagina and cervix with a cotton swab or cotton balls
to see problem areas more clearly.
Colposcopy is done to:
Tell your doctor if you:
Do not have sexual intercourse or put anything into your vagina for 24 hours before a colposcopy. This includes douches, tampons, and vaginal medicines. You will empty your bladder just before your colposcopy.
You may want to take a pain reliever, such as ibuprofen (Advil or
Motrin), 30 to 60 minutes before having a colposcopy, especially if a biopsy
may be done. This can help decrease any cramping pain that can be caused by the
Schedule your colposcopy for when you are not having your period. Heavy bleeding makes it harder for your doctor to see your cervix. The best
time to schedule a colposcopy is during the early part of your
menstrual cycle, 8 to 12 days after the start of your
last menstrual period.
You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.
Talk to your doctor
about any concerns you have regarding the need for the colposcopy, its risks,
how it will be done, or what the results will mean. To help you understand the
importance of this test, fill out the
medical test information form(What is a PDF document?).
Colposcopy is usually done by a
family medicine physician, or a nurse practitioner who has been trained to do the
test. If a biopsy is done, the sample will be looked at by a
pathologist. Colposcopy can be done in your doctor's
You will need to take off your clothes below the waist. You will be
given a covering to drape around your waist. You will then lie on your back on
an examination table with your feet raised and supported by foot rests
The doctor will insert a lubricated tool called a speculum into your vagina. The speculum gently spreads apart the vaginal
walls so your doctor can see inside the vagina and the cervix.
The colposcope is moved near your vagina, and your doctor looks
through the microscope at the vagina and cervix. Vinegar (acetic acid) or
iodine (Lugol's solution) may be used on your cervix to make abnormal areas
more visible. Photographs or videos of the vagina and cervix may be
If areas of abnormal tissue are found on the cervix, your doctor
will take a small sample (cervical biopsy) of the tissue. Usually
several samples are taken. The samples are looked at under a microscope for
changes in the cells that may mean cancer may be present or is likely to
develop. If bleeding occurs, a special liquid (Monsel's) or silver nitrate swab
may be used on the biopsy area to stop the bleeding.
If a sample of tissue is needed from inside the opening of the
cervix (the endocervical canal), a test called endocervical curettage (ECC)
will be done. Since the endocervical canal cannot be seen by the colposcope, a
small sharp-edged tool called a curette is gently put into the endocervical
canal to take a sample. ECC takes less than a minute to do and may cause mild
cramping. An ECC is not done during pregnancy.
Colposcopy and a cervical biopsy usually take about 15
You may feel some discomfort when the vaginal speculum is inserted.
You may feel a pinch and have some cramping if a biopsy sample is taken.
In rare cases, a cervical biopsy can cause an infection or
bleeding. Bleeding can usually be stopped by using a special liquid or swab on
If you have a biopsy, you may feel some soreness in your vagina for a day or two. Some
vaginal bleeding or discharge is normal for up to a week after a biopsy. The
discharge may be dark-colored if Monsel's solution was used. You can use a
sanitary pad for the bleeding. Do not douche, have sex, or use tampons for one
week, to allow time for your cervix to heal. Do not exercise for 1 day after
Follow any instructions your doctor gave you. Call your doctor if
Colposcopy is a way for your doctor to use a special magnifying
device to look at your
Your doctor will talk to you about what he or she sees at the time
of the colposcopy. Lab results from a
biopsy may take several days or more.
The vinegar or iodine does not show any areas of abnormal
tissue. The vagina and cervix look normal.
A biopsy sample does not show any abnormal
The vinegar or iodine shows areas of abnormal tissue. Sores
or other problems, such as
genital warts or an infection, are found in or around
the vagina or cervix.
A biopsy sample shows abnormal cells. This may mean
cervical cancer is present or likely to develop.
Reasons you may not be able to have the colposcopy or why the
results may not be helpful include:
Other Works Consulted
Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.
Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby.
October 22, 2012
Sarah Marshall, MD - Family Medicine
& Kirtly Jones, MD - Obstetrics and Gynecology
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