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Why do I need a colposcopy?

Patient Education / Gynecology
Last reviewed

Why do I need a colposcopy?

  • You had an abnormal Pap smear or HPV (human papilloma virus) test result. This is a sign you need more testing. 

What causes an abnormal Pap smear?

  • Abnormal cells on a Pap smear are caused by HPV. This virus is very common. Almost everyone comes in contact with HPV at some point in their life.
  • Your immune system will need to help get rid of or control the virus. To help your immune system do this, you can:
    • Get the HPV vaccine (Gardasil®).
    • Stay away from tobacco products (such as smoking, vaping, and chewing tobacco).
      • Tobacco makes the HPV virus more aggressive and makes it very hard for your body to fight the virus.
      • Tobacco use is linked with cervical cancer because the immune system cannot fight the HPV virus.
      • Talk to your provider about how we can help you stop smoking or vaping. 

What is a colposcopy?

  • A colposcopy is a procedure to look closely at your cervix, vagina, and vulva.
  • Your provider uses a special tool called a colposcope. It works like a microscope.
  • Your provider puts vinegar to the area of concern. This causes abnormal areas to turn white. Tissue samples (biopsies) are taken of any abnormal areas.
    • If your cervix looks normal, you may not need a biopsy.
    • If a biopsy is needed, it is about the size of a pen tip.
    • Most patients also have a Pap smear done of the inside of their cervix where their provider cannot see with the colposcope. 

What will it feel like?

  • You may have a little discomfort. This procedure is like a Pap smear, but it takes more time.
  • Your provider may put a numbing medicine on your cervix with a cotton swab (like Q-tips®) before taking the biopsies. You may feel a cramping or pinching sensation if you get a biopsy, but it is mild.
  • Everyone experiences pain differently. Most people have mild to moderate pain that feels like menstrual cramping (period cramps).
  • If able, you can take 600 mg (milligrams) of ibuprofen by mouth about 1 hour before your visit. This will help lessen cramping. 

Does an abnormal Pap smear mean I have cancer?

  • In very rare cases, an abnormal Pap smear can lead to cancer.
  • Most abnormal Pap smears mean dysplasia (abnormal cells). These are precancerous cells. Treatment can prevent these abnormal cells from turning into cancerous cells.
  • Dysplasia may go away without treatment. But for some people, it can turn into cervical cancer after about 5 to 10 years, if not treated.
  • It is suggested you get treatment for dysplasia. The treatments we have are very good at preventing cervical cancer.

What should I expect after biopsies?

You may or may not have vaginal bleeding for a few days to 2 weeks.

  • Your provider will use a special liquid, Monsel’s®, to stop bleeding at your biopsy site.
    • Your vaginal discharge may look like coffee grounds.
    • It is normal for your vaginal discharge to be brown, black, red, or pink.
  • Do not have sex, use tampons, or douche for 7 days. Only use sanitary pads.
    • Douching can upset the natural balance of bacteria in your vagina.
  • You may take tub baths and showers.
  • You may go back to work and normal activities the same day as your colposcopy.

When will I get my results? 

  • You will get your Pap smear and biopsy results in 2 to 3 weeks.
    • Call the clinic at 319-356-2294 if you do not have results in 4 weeks.
  • Your care team will call you or send a message in MyChart. Make sure your care team has your phone number. Make sure your MyChart is active.

What are next steps if my results show I need treatment?

  • If your results show you need treatment, your care team will call you to schedule this.
  • Most of the time you can be treated in the clinic.
  • Your treatment depends on where the problem area is and how serious it is.

What are some of the treatments?

Observation

  • Often with mild dysplasia, you will be asked to have a Pap smear or another colposcopy in 6 to 12 months. Mild dysplasia may go away on its own (tissues goes back to normal without treatment).

Laser surgery 

  • A laser machine is used to destroy the abnormal cells. It has a strong, thin beam of light that burns and vaporizes the abnormal cells.

LEEP (Loop electrosurgical excision procedure) 

  • This is a common treatment for dysplasia.
  • A LEEP uses a wire loop to take out abnormal cells.
  • The tissue is sent to Pathology for more testing.
  • You can learn more about a LEEP procedure at uihc.org/services/loop-electrosurgical-excision-procedure-leep

Cryotherapy 

  • Cryotherapy makes the abnormal cells on your cervix freeze and die.

Cone biopsy 

  • A laser beam or surgical blade is used to take a cone-shaped piece of tissue from the cervix.
  • This is done in the operating room under anesthesia.

Fluorouracil or Imiquimod (Aldara®) creams 

  • These are special creams used to treat abnormal cells of the vagina.

Ask us if you would like more information about any of these treatments.

When should I call my care team?

Call if you have:

  • A fever above 100.0° Fahrenheit (or 38.0° Celsius)
  • Heavy vaginal bleeding, such as soaking a maxi pad in 1 hour or less
  • Low abdominal (belly) pain or tenderness that does not get better with over-the-counter pain medicines