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Colposcopy: What to Expect from a Colposcopy Procedure

After reviewing the results of your most recent Pap smear, your doctor suggests that you get a colposcopy. Naturally, you’ve got a lot of questions: why do I need a colposcopy? What happens in a colposcopy procedure? Does a colposcopy hurt?

Below, you’ll find everything you need to prepare yourself for your first colposcopy. It’s a short, simple process, and knowing what to expect means you can breathe a whole lot easier. 

So exactly what is a colposcopy? It’s an exam relying on the use of a colposcope for viewing your cervix, vagina, and vulva in greater detail.

When you have a Pap smear with abnormal results, your health care provider might want to evaluate the situation a little more closely. A colposcopy procedure offers a lighted, magnified view of tissues in your vaginal area. 

A colposcopy is intended to uncover potential reasons for an abnormal Pap and to catch early signs of cancer. 

Various reasons for having a colposcopy performed include:

A routine Pap provides your doctor with records about your cervical cells, which shouldn’t change very much after you reach adulthood. If they suspect the presence of unusual tissues, however, they’ll need to rule out the possibility of cancer

  • Bleeding after intercourse 

Sometimes, bleeding occurs following intercourse due to rough sex, sex without lube, or a preexisting condition. If none of these apply and you suddenly start bleeding after intercourse or between periods, talk to your doctor right away.

  • A visible growth

While performing your Pap smear, your doctor may notice a growth on your cervix, vagina, or vulva. When this happens, they’ll want to check if the growth is cancerous or an indication of another health condition

Experts recommend getting regular Pap smears to ensure your body’s functioning normally, and as a preventive measure. Precancerous cell growth, for example, can be diagnosed and treated quickly and easily, if discovered in its early stages. The need for a colposcopy is also dependent upon your family history.

A colposcopy only takes 10 to 20 minutes, and doesn’t require anesthesia, so you can certainly drive yourself home. The steps of a colposcopy procedure are as follows:

  • You’ll be asked to lay on a table with your feet in stirrups, just like in a Pap smear or pelvic exam. Remember to take deep, calming breaths and mentally prepare yourself for the procedure.
  • Your doctor places a speculum into your vagina and positions the colposcope a few inches away from your body. Note that a speculum holds your vaginal walls open to provide a clear view of the interior and your cervix. It’s common to experience some discomfort during this step.
  • A long cotton swab is used to cleanse your cervix with a vinegar solution. This clears mucus away from your cervix and allows them to spot any abnormal cell growth. Here, you might notice a slight stinging sensation from the vinegar.
  • With the aid of a colposcope, your doctor views your cervix, vagina, and vulva. They may take pictures or perform a biopsy of any unusual-looking tissues. 
  • Lastly, based on their review of your colposcopy results, your doctor might choose to do a biopsy (if they haven’t already). They’ll apply a special solution at the site to control bleeding. Depending on the location, you could experience a certain degree of pain. Keep in mind that for a few days after your colposcopy procedure, you’ll observe dark discharge resembling coffee grounds. 

This process is rather quick, and not too invasive, since your doctor is simply collecting more data, such as pictures or tissue samples. If it helps, consider asking them to talk you through the colposcopy procedure, letting you know what they’re doing as they’re doing it. 

The general consensus is that a colposcopy procedure is only mildly uncomfortable. Some women do report feeling more discomfort than others. 

As mentioned, the location of a biopsy (should your doctor choose to perform one) is a determining factor. It is, of course, a necessary step to confirm whether or not any abnormal cells are cancerous, and pain should be temporary. The two most common types of biopsies in this situation include: 

  • Cervical biopsy: Your doctor may numb your cervical area beforehand as it’s been known to cause pain, cramping, and bleeding. They could also suggest taking a painkiller up to 30 minutes in advance. Be sure to discuss these options prior to the procedure.
  • Lower vaginal biopsy: Since your lower vaginal area has a lot of nerve endings, your doctor might apply a local anesthetic before getting started to minimize pain.

There isn’t much physical preparation required for a colposcopy procedure, but here are a few things you can do to help alleviate anxiety: 

  • Ask for details: When your doctor schedules the test, ask them to explain it in complete detail. This way, you’ll get a good idea of what’s going to happen and why a colposcopy is needed.
  • Inform your doctor: Think you might be pregnant? This could affect when your doctor performs the procedure in order to keep both you and your baby safe.
  • Steer clear of period days: To make it easy on your doctor, don’t get a colposcopy  when you’re menstruating. Light bleeding at the beginning or end of your period is usually fine, but too much blood interferes with their ability to see clearly. Also, don’t use tampons or douches for two days beforehand. 
  • Don’t have sex: Avoid intercourse for two days prior to your colposcopy. Just like with tampons or douches, intercourse can inflame the tissues in your vagina and reduce visibility.
  • Discuss pain relievers: Consult your doctor in advance regarding the use of pain relievers in the event of a biopsy. 
  • Go to the bathroom: Right before the test starts, be sure to relieve your bowels and bladder, just in case. 
  • Bring a loved one: Having a friend or family member nearby is always comforting. You should be able to drive yourself home, but it’s a great way to soothe your nerves. The process is roughly 20 minutes long, so they can wait outside and accompany you home. 
  • Take it easy: Lastly, try to relax yourself before a colposcopy procedure. Practice meditation and relaxation exercises to clear your mind and prepare your body.

Generally speaking, a colposcopy procedure doesn’t cause any side effects. But if you have certain biopsies done, you might experience pain, cramping, bleeding, and dark discharge for a few days. If bleeding is heavy and cramps are severe, see your doctor right away. 

Wondering what the difference is between a colposcopy, Pap smear, and biopsy?

  • Pap smear: This is the initial test (performed regularly or as advised by your doctor), where they might spot abnormal cells.
  • Colposcopy: It’s basically phase two, in which your doctor takes a closer, more detailed look at those tissues.
  • Biopsy: The third step, when needed, is to extract a sample of abnormal cells and send them away for lab testing.

Note that just because they’re suggesting you get a colposcopy and biopsy doesn’t automatically mean you have cancer. They’re merely precautionary measures to ensure early detection and treatment in case something is actually wrong.  

A colposcopy is a simple, straightforward exam designed to follow up on and clarify unusual Pap results. The most important thing is to stay relaxed and open the lines of communication with your doctor. Being honest about your preferences and medical history allows them to offer you the best possible care.

https://medlineplus.gov/ency/article/003913.htm

https://www.cancer.gov/publications/dictionaries/cancer-terms/def/colposcopy

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5780303/

https://www.ncbi.nlm.nih.gov/pubmed/22611948

https://www.cancer.net/blog/2019-06/colposcopy-how-prepare-and-what-know

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