Your Upcoming Colposcopy: How to Prepare and What to Expect

Three decades ago, cervical cancer was a leading cause of cancer-related deaths among women in the United States. Today, thanks to the HPV vaccine and regular cervical cancer screenings, more women are preventing and surviving cervical cancer than ever before. In fact, the cervical cancer mortality rate has declined by about 40% in the past 30 years. 

At Panhandle Obstetrics and Gynecology in Amarillo, Texas, we take a comprehensive approach to women’s wellness that emphasizes preventive care — including routine Pap testing and, in the event of an abnormal result, a prompt follow-up colposcopy. 

This January, in recognition of Cervical Health Awareness Month, our expert team discusses the ins and outs of a diagnostic colposcopy following abnormal Pap results, including how to prepare for your appointment and what to expect from the procedure.

When you need a diagnostic colposcopy 

During a Pap test, we use a soft, slender brush to gently swab a few cells from your cervix, or the bottom part of your uterus that opens into your vagina. There are three possible results of this test. We may see:

• Cervical cells that look normal and healthy; simply continue with regular Pap testing
• Low-grade cell changes that call for closer monitoring and an earlier follow-up Pap
• High-grade cervical cell changes, or precancers, that require timely investigation 

If your Pap test shows high-grade cervical cell changes, the next step is a follow-up diagnostic colposcopy. This simple, in-office procedure allows your provider to diagnose the nature and extent of cervical cell changes with greater accuracy. The results of your colposcopy determine what next steps — if any — are required to protect your health. 

A colposcopy requires little preparation

A colposcopy uses a special lighted magnifying device called a colposcope to give us a close, high-resolution view of the tissues of your cervix, vagina, and vulva. 

The exam itself is nonsurgical. If we spot suspicious tissue during our up-close inspection, however, we perform a minor surgical procedure called a biopsy to remove a sample of the abnormal tissue for further evaluation in the lab.  

To ensure your colposcopy goes as smoothly as possible, you should: 

• Schedule the procedure when you’re not having your menstrual period
• Avoid any kind of vaginal penetration for 48 hours before your appointment
• Take a pain reliever like acetaminophen or ibuprofen just before your visit

If you’re pregnant, it’s important to share that information with our team prior to your exam. While you can have a colposcopy during pregnancy, you may be at a greater risk of bleeding if we need to perform a biopsy. 

What to expect during your colposcopy

A colposcopy typically takes 10-20 minutes and is much like a routine pelvic exam. Your provider completes the procedure in three basic steps:

1. Cervix access and prep

Once you’re lying comfortably on the exam table with your feet in supports, your provider inserts an instrument called a speculum into your vagina. This instrument allows them to gently open the walls of your vagina, so they can see your cervix. 

Next, they use a cotton swab to apply an acetic acid wash to your cervix. This vinegar-like solution highlights abnormal cells and makes it easier to spot suspicious tissue areas. You may feel a mild tingling or burning sensation when the wash is applied. 

2. Visual cervix inspection

Next, your provider positions the colposcope a few inches from your vulva; the instrument doesn’t go inside you or touch you. They then switch on the instrument’s bright light and look through the binocular-like lenses at your cervix. 

3. Quick tissue sampling 

If your provider sees questionable-looking areas, they perform a quick biopsy of the area by collecting a small tissue sample for in-depth laboratory testing. During the biopsy, you may feel mild pressure, a sharp pinch, or a sensation that’s like a menstrual cramp. 

Next steps after a diagnostic colposcopy

After a cervical biopsy, you may experience mild vaginal pain and light bleeding for a few days. You may also notice a brown or black vaginal discharge from the vinegar solution. While you can resume most activities right away, you should avoid inserting anything into your vagina until the bleeding stops and your cervix has healed. 

About two in five women (40%) who have a colposcopy are found to have no abnormal cells and require no additional follow-up. About three in five women (60%) require treatment to address a diagnosed precancerous abnormality. 

Often, this means taking steps to eliminate remaining abnormal cells before they evolve or spread — usually with the loop electrosurgical excision procedure (LEEP). Removing cervical precancers this way prevents cervical cancer 95% of the time.

Do you have questions or concerns about your upcoming colposcopy procedure? We’re here to help. Schedule a visit at Panhandle Obstetrics and Gynecology by calling our office at 806-359-5468 today.