If you received an abnormal result from your Pap smear, chances are your gynecologist will call and schedule you for a colposcopy. If this happens to you, don’t panic. It’s quite common to have an “abnormal result” from a Pap smear, and it doesn’t automatically mean you have a serious problem or cancer. Therefore, any abnormal Pap smear result requires further testing and diagnosis, and scheduling a colposcopy is the most common “next step.”

What is colposcopy?

This minimally invasive procedure allows your gynecologist to get a closer, more detailed look at your vulva, cervix, and vagina and map out any lesions. It also allows them to take a tissue sample if they notice areas of abnormal cells that need to be biopsied by the lab.

The colposcope

The instrument your gynecologist uses to perform a colposcopy is called a colposcope. It uses a combination of a mirror (to keep your vagina open), a light to provide illumination, magnifying lenses (so your doctor can get a magnified view of your tissue and cells), and a biopsy instrument that is used to take and remove a sample of abnormal or irregular cells to be analyzed by the laboratory.

The process

The first step of the procedure is similar to a standard pelvic exam and Pap smear. You lie on your back on the exam table with your feet in stirrups. Once you are comfortable, the gynecologist places the colposcope between your legs. The procedure usually takes 10 to 15 minutes. The doctor cleans the area and inside your vagina with a cotton swab to make it clearer. He or she may also apply acetic acid or a similar solution designed to highlight irregular cells. Then, the doctor looks through magnifying lenses, carefully examining the tissue of your vulva, cervix, and vagina for any irregular cells, discoloration, or changes that may indicate any abnormalities.

If you need a biopsy

If your doctor notices any abnormalities on your cervix or inside your vagina, they will use a biopsy forceps to cut a small sample of tissue for laboratory analysis. If there is more than one questionable area, they may perform multiple biopsies so that each area can be analyzed separately.

Do biopsies hurt?

Biopsies require cutting a shallow incision through tissue, so it can be uncomfortable – and it’s possible to cause spotting or bleeding until the area heals. Most women find that cervical biopsies cause very little to no actual pain or irritation. However, vulva and lower vaginal biopsies can be more painful. The good news here is that your doctor will use a local anesthetic to numb the area beforehand.

Will I bleed?

If your colposcopy results in a biopsy, you may feel mild pain or discomfort for 1 to 3 days. You may spot blood or have light bleeding for up to two or three days as the area heals. You may have more than usual vaginal discharge for a day or two, and this is completely normal.

When will I get my results?

If your doctor doesn't tell you, be sure to ask when you can expect the results. Always remember that early diagnosis is the key to faster and more effective treatment. Never postpone a colposcopy appointment if your gynecologist has recommended it.