What is a colposcopy?

A colposcopy allows your doctor to examine your vagina and cervix very closely.

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.

Why is a colposcopy performed?

A colposcopy is usually done to assess the health of your cervix (the neck of the womb), the vagina and vulva to see whether there are abnormal cells or growths.

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 vaginal 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

Can I have a colposcopy if I am pregnant?

Colposcopy can be safely performed during pregnancy if it is needed. Pregnancy can make the procedure more challenging, so it should be performed by someone with a lot of experience. Your referring doctor will help you find the right person to do your colposcopy.

Cervical biopsy can be performed during pregnancy, if necessary, but there are risks. In some situations, the potential benefits outweigh these risks.

In some cases, you may be able to postpone the procedure until after your baby is born. In other cases, you may need to have an urgent colposcopy to rule out a serious medical problem, such as cervical cancer.

Your doctor can discuss the benefits and disadvantages of a colposcopy with or without biopsy in your individual situation.

How do I 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:

• have sexual intercourse
• use tampons
• use vaginal medicines
• douche

Some people experience abdominal cramping during the procedure. You might like to take a pain-relieving medicine, such as paracetamol, about an hour before the procedure.

What happens during a colposcopy?

A colposcopy takes about 5 to 10 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, in a similar position to the one used for 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 so the doctor can see your cervix. 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 should I 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 might have cramps for a day or so. If so, paracetamol can help. It is normal to have a slight vaginal discharge or spotting for around 5 days.

After a biopsy, it's best to avoid sexual intercourse, heavy physical exercise and tampons or menstrual cups for 1 to 2 days. Your doctor might also advise you to avoid swimming and baths.

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

What are the complications of a colposcopy?

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

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

Resources and support

See Cancer Council Australia for information on colposcopy.