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What is a colposcopy?

A colposcope is a magnifying instrument used to look closely at the surface of the cervix.  A colposcopy is anlarge_colp.jpg easy office procedure, which is performed very much like routine gynecological exam. 

After the speculum is inserted and a mild solution is applied to make the cervix easier to see, your medical provider shines a light on the surface of the cervix with the colposcope. Your doctor or nurse will concentrate on an area of the cervix where two types of cervical cells meet.  If abnormal changes occur, they are most likely to arise in this area.

Based on the appearance of your cervix, your provider may or may not take a small sample of cells, or a biopsy, which may feel like a quick pinch.

Why is colposcopy done?

Most commonly, a colposcopy procedure is recommended when a Pap smear shows abnormal cells from the cervix.  The goal is to determine whether these abnormal cells pose a threat to your health. Usually, the presence of these cells in an indication that you have contracted HPV, the human papillomavirus.

Having an abnormal Pap smear may feel scary. However, abnormal Paps only rarely indicate cancer.  Pap smears can identify pre-cancerous changes years before invasive cancer develops.  Together, Pap smears and colposcopy procedures give your health care provider a more complete sense of whether you are at risk for developing cervical cancer.

Preparations for colposcopy

  1. Schedule your appointment when you are not menstruating.
  2. Do not douche, use tampons or vaginal medication, or have intercourse for 2 days prior to your appointment.
  3. Inform us if you faint easily or bleed readily.
  4. Do a home pregnancy test the morning of your procedure.
  5. We recommend that you take 400-600 milligrams of ibuprofen (with a small amount of food) about an hour before your appointment.

What if the colposcopy shows abnormalities?

If abnormal areas are seen, the location and extent of the abnormalities are considered, along with the Pap smear findings, to make a decision as to what the next step should be.  Sometimes just repeating the Pap at yearly or twice-yearly intervals is all that is necessary.

The presence of abnormal cells may be a sign that you have HPV, the human papillomavirus, which your body is very likely to fight off on its own within two years of infection.  More frequent check-ups are necessary to monitor any abnormal areas for the development of pre-cancerous cell

How are cervical biopsies done?

With the aid of the colposcopy to identify the abnormal areas, a tiny piece of tissue (a biopsy) may be removed from the cervix.  It may also be necessary to sample the cells just inside the cervical canal to make sure there are no hidden abnormalities.  This is called endocervical curettage (ECC).

What will I experience if I have a biopsy?

The degree of discomfort varies from person to person.  Some people feel very little discomfort.  Some people describe cramping like during a period, especially during ECC.  Some people describe a brief pinching sensation during the biopsy. 

A local numbing medication similar to Novocain is often used; it contains epinephrine (also known as Adrenaline) and may briefly cause your heart to race or sweating or jitteriness.

Bleeding from biopsy site can occur, but this is usually minimal.  You will be given a menstrual pad to protect your clothing in case there is spotting.

You may feel faint after the colposcopy, as with any medical procedure, but after resting for a few minutes you should feel better.

What happens after a biopsy?

The cervix heals very quickly and since only very small samples are removed, the surface of the cervix usually returns to normal within several days.

You should abstain from sexual intercourse for 48 hours after the procedure, to allow for healing and to prevent infection.

After the procedure, the biopsy specimens are sent to the laboratory for analysis.  The results are sent to your practitioner in 5-7 days.  Your provider will develop a treatment plan based on the findings.

If the changes are minimal, you and your practitioner may elect simply to monitor the cervix with more frequent Pap smears (every six months) until there are two consecutive normal Pap smears.

If significant cellular changes (dysplasia) are found, treatment will likely be recommended.  (Dysplasia is the term for a kind of cell change that can sometimes be pre-cancerous.)

What kinds of treatment are available for dysplasia?

Treatment choices depend on the particular anatomy of your cervix and the location of the abnormal areas.

If areas of dysplasia are small and do not involve the canal, the abnormal cells can be frozen.  This procedure is called cryocautery, and it takes only minutes during a regular appointment. 

If dysplasia is more extensive, removing the abnormal tissue may be recommended.  This is most commonly done with a LEEP (Loop Electrosurgical Excision Procedure) procedure.  Both cryocautery and LEEP are offered by the Women's Clinic at Hall Health.

Additional resources

Read more about HPV and other STDs.

The American Council of Obstetricians and Gynecologists' FAQ on colposcopy

If you have any questions and are a UW student or established Hall Health patient, you may call one of our Consulting Nurses for further information.


Authored by: Hall Health Center Women's Health Clinic staff

Reviewed by: Hall Health Center Women's Health Clinic staff, January 2014