How to Prepare for a Colposcopy

If you received abnormal results from a Pap test or tested positive for human papillomavirus (HPV), your doctor may recommend a colposcopy. A colposcopy procedure is used to find pre-cancer or cancer in the cervix, vagina, or vulva.

Many people with an abnormal HPV or Pap test receive normal results from a colposcopy. Still, when you’re facing a colposcopy, it’s normal to feel anxious.

“While many people undergoing a colposcopy will not have symptoms, it is a procedure that can help make a diagnosis at the earliest possible point and lead to better outcomes. It is common to feel anxious and nervous about the test, but understanding the procedure and its benefits can relieve some concerns and improve the colposcopy experience,” said Eleonora Teplinsky, MD, American Society of Clinical Oncology (ASCO) expert and head of breast and gynecologic medical oncology at Valley-Mount Sinai Comprehensive Cancer Care.

What happens during a colposcopy

A colposcopy is often done at the doctor’s office. During the procedure, you lie down on the exam table with your heels in stirrups. An instrument called a speculum is inserted into your vagina to open it and give a clearer view of the cervix. Your cervix, vagina, and vulva will be lightly wiped with a solution to help the abnormal areas show up better.

An instrument called a colposcope is then positioned between your legs, near your vagina, to provide a lighted, magnified view of the area. The colposcope never goes inside your body.

A colposcopy should feel like a regular pelvic exam. It may be uncomfortable. You may feel pressure, but it should not be painful.

Preparing for a colposcopy

You should stop using any vaginal medicines or creams for 24 to 48 hours before a colposcopy. In the day or two before your appointment, you should also stop having vaginal sex. Stop using tampons or any other products in your vagina, as well. You do not need to shave before a colposcopy.

If possible, avoid scheduling the procedure during your period. You can still get a colposcopy if you are pregnant, but tell your doctor before your appointment.

What happens if a suspicious area is found

During the colposcopy, a small amount of tissue may be removed if an area looks abnormal. This is called a biopsy. The abnormal cells are sent to a lab to be tested. A diagnosis of pre-cancer or cancer can only be made with a biopsy.

If an abnormal area is small, your doctor may be able to remove all of it during the biopsy. This may cause pinching or discomfort similar to menstrual cramps. Sometimes, a local anesthetic is used to numb the area before a biopsy.

• If the biopsy results show that you have pre-cancer, the area where it was found may need to be removed to keep cancer from developing.
• If the biopsy results show that you have cancer, you may need to have more tests to help know the best treatment options. Your doctor will likely refer you to a gynecologic oncologist, a doctor who treats cancers of the female reproductive system.

Recovering from a colposcopy

A colposcopy should not cause side effects. However, if you received a biopsy, you might have a dark vaginal discharge for a few days. You may also have some bleeding, cramping, or soreness. If your symptoms get worse, call your doctor.

After the colposcopy, do not have vaginal sex or use products that go inside the vagina until your doctor says it is safe to do so.

Dr. Coffman is an Associate Editor on ASCO’s Patient Information Editorial Board.