What is a colposcopy?
A colposcopy is a procedure used to examine your cervix and vagina using a medical device called a colposcope. The colposcope brightly illuminates and magnifies the area being examined, which makes it easier to see changes in tissues, identify abnormal cells, and take a biopsy if needed. This exam allows the health care provider to find problems that cannot be seen by the eye alone.
A colposcope is a special microscope your Mesa gynecologist uses to examine your internal tissues more closely than the naked eye alone can detect. Your provider performs a colposcopy when she’s concerned about an abnormal Pap smear test or other abnormalities — such as changes in your vagina, cervix or uterus. A colposcopy may also help your doctor determine if you need to have a test for sexually transmitted diseases (STDs).
Most abnormal Pap smear results are caused by viral infections — such as the human papillomavirus or HPV. Sometimes, abnormal results are from natural changes due to menopause. On rare occasions, the results, an inflamed cervix or symptoms such as pelvic pain or abnormal bleeding point to a more serious condition, including cancer. In these cases, a tissue sample taken at the same time, a colposcopy biopsy, can confirm the suspected condition.
If your gynecologist in Mesa, AZ finds genital warts, inflamed tissue, non-cancerous growths or polyps in your uterus or on your cervix, she can diagnose and treat them right then, during or after your colposcopy. HPV is a common virus that’s most often benign or non-cancerous. If your results show HPV, a colposcopy procedure can rule out more serious health conditions associated with it.
When do you need a colposcopy?
Your provider at Embry Women’s Health may perform a colposcopy if a Pap test or cervical exam revealed:
- Precancerous changes of the cervix
- Precancerous changes of the vagina
- Precancerous changes of the vulva
- Inflammation of the cervix (Cervicitis)
- Genital warts
- Benign (not cancer) growths, such as polyps
What special tests may be done during colposcopy?
Several tests can be done during a colposcopy to help the provider identify potential problems:
- Acetic acid wash: When the cervix is brushed with acetic acid, abnormal cells turn white, which helps the doctor identify any problem areas.
- Color filters: During a colposcopy, filters may be applied to the colposcope that help the provider detect changes in small blood vessels that often develop as a result of precancerous changes.
- Cervical biopsy: If any abnormalities are suspected, a biopsy is performed during the colposcopy. Your provider at Embry Women’s Health will remove a sample of tissue from abnormal areas, which will then be examined under a microscope.
- Cervical biopsies can be done several ways, using a laser, scalpel, or a punch instrument to remove a piece of tissue. In some cases, an instrument called a curette may be used to simply scrape tissue from the cervix.
Preparation for Your Colposcopy
A colposcopy is usually performed by your gynecologist right in her Mesa, Arizona office. Before you arrive, take the following preparatory steps:
- Try to schedule your colposcopy when you are not menstruating.
- Take an over-the counter pain reliever recommended by your provider 30 to 60 minutes before the procedure if you’re worried about mild cramping.
- Do not put anything into your vagina for a full 24 hours before the procedure — including vaginal creams, douches or tampons.
- Do not have sex within 24 hours of your procedure — that includes sex after colposcopy procedures.
- Do not take aspirin or Warfarin before the procedure without your providers knowledge, as these drugs can increase the chances of bleeding after colposcopy biopsy procedures.
- Discuss the possibility that you’re pregnant with your gynecologist. She can possibly do the colposcopy without injury to you or your fetus, but she may decide not to do a biopsy.
- Tell your provider about any medications you are taking or any allergies to medications.
- Discuss any bleeding problems you have had in the past.
- Tell your female gynecologist in Mesa, AZ if you’ve been recently treated for a vaginal, cervical or pelvic infection.
Colposcopy Procedure Details
A colposcopy procedure usually only takes 10 to 20 minutes. It’s primarily an observation test that allows your gynecologist to visually examine your reproductive organs. Your provider only needs to do a colposcopy biopsy procedure if she finds something unusual. Just because you have a colposcopy, HPV infections or other serious complications aren’t always detected. During the procedure:
- You undress from the waist down, but are draped with a sheet.
- You then lie down on the exam table with your feet in stirrups.
- Your provider inserts a speculum into your vagina to keep it open and widen it slightly.
- A swab a vinegar solution or iodine may be used on a particular area to allow your female gynecologist to better see abnormal tissues. This solution may produce a slight burning or tingling sensation.
- Once the colposcope is maneuvered into position. your provider makes her observations.
- Photos or even video may be taken for medical purposes.
Your provider looks for white areas on your cervix, which signal abnormal changes. Genital sores or warts, or vascular changes may also be on your providers agenda to look for. If anything seems unusual or abnormal, she’ll take a very small tissue sample (a colposcopy biopsy) to send to the lab. Results typically take one to two weeks to return.
Because your provider can’t see everywhere with a colposcope, she may decide to take a sample of tissue from inside your cervix. To do this, she performs a test called an endocervical curettage. Gently inserting a small, sharp-edged tool called a curette into your vagina, she takes a small sample of tissue. The test usually takes less than a minute. It may cause some mild cramping and should not be done if you are pregnant.
Aftercare and Colposcopy Side Effects
If your provider didn’t need a biopsy, you should feel fine after your colposcopy. There’s a rare chance of some minimal spotting. Bleeding after colposcopy biopsy procedures, though, is common. It mimics a light period for a day or two.
You may experience some mild cramping for 24 to 48 hours, but you can take over-the-counter pain relievers recommended by your gynecologist. You may also notice some dark discharge after colposcopy procedures, likely due to the solutions used by your provider. This is normal.
Do not douche, use a tampon or have sex after colposcopy procedures for one week. Do not exercise for one day. Contact your provider if you have any of the following:
- The discharge begins to have a strong, foul odor.
- Your pain does not improve with over-the-counter medication.
- Bleeding continues for longer than seven days.
- Significant bleeding occurs, which causes you to use more than one sanitary pad per hour.
- You have severe lower abdominal pain.
- You run a fever or have chills after a colposcopy biopsy.
Special Considerations Regarding a Colposcopy Biopsy
If you test HPV positive, colposcopy may be the first step for your gynecologist in Mesa, AZ. If your Pap smear and colposcopy show very different results, you may need to repeat each test. The results of your biopsy determine if and what further treatment you need.
Since women with HPV are more susceptible to cervical cancer, they may have a colposcopy without an abnormal Pap smear. Your provider wants to be more diligent in screening for cancer. As with any test or procedure, open communication with your doctor about your medical history is essential for the most effective results.
How is a colposcopy performed?
A colposcopy begins just like a regular pelvic exam, with a speculum used to open the vagina and enable the doctor to examine the cervix. The colposcope is positioned near the opening of the vagina, but without touching you, then the doctor apples the acetic acid wash, visually examines the cervix, and performs a biopsy if necessary. The entire procedure typically takes about 15 minutes and usually doesn’t cause any discomfort.
The providers at Embry Women’s Health have extensive experience performing colposcopies. Your team here understands the stress and anxiety caused by even a hint of cancer or other health problems, so we’re here to answer questions and offer support.
As with a pelvic exam, you will lie on your back with your feet raised and placed on foot rests for support. A speculum will be used to hold apart the vaginal walls so that the inside of the vagina and the cervix can be seen. The colposcope is placed just outside the opening of your vagina.
A mild solution will be applied to your cervix and vagina with a cotton swab or cotton ball. This liquid makes abnormal areas on the cervix easier to see. You may feel a slight burning.
When is a biopsy done during colposcopy?
During colposcopy, the health care provider may see abnormal areas. A biopsy of these areas may be done. During a biopsy, a small piece of tissue is removed from the cervix. The sample is removed with a special device.
Cells also may be taken from the canal of the cervix. A special device is used to collect the cells. This is called endocervical curettage (ECC).
If you have a colposcopy without a biopsy, you should feel fine right away. You can do the things you normally do. You may have a little spotting for a couple of days.
If you have a colposcopy with a biopsy, you may have pain and discomfort for 1 or 2 days. Over-the-counter pain medications can be helpful. You may have some vaginal bleeding. You also may have a dark discharge for a few days. This may occur from medication used to help stop bleeding at the biopsy site. You may need to wear a sanitary pad until the discharge stops.
Your health care provider may suggest you limit your activity for a brief time. While the cervix heals, you will be told not to put anything into your vagina for a short time: