Understanding Colposcopy: A comprehensive guide

• What is a colposcopy?

A colposcopy is a medical procedure performed by a gynaecologist. It is part of the National Cervical Screening Program, which is designed to prevent cervical cancer by detecting and treating precancerous changes.

It is used to closely examine a woman’s cervix, vagina, and vulva for any signs of abnormality or disease, such as cervical cancer or precancerous changes. During the procedure, a speculum is inserted to visualise the cervix and an instrument called a colposcope is used to magnify the tissues. Acetic acid (vinegar) and/or Lugol’s iodine are applied to the area so that the healthcare provider can visualise abnormal areas. If an abnormal area is found, a cervical biopsy is performed and sent for further testing. Medication will then be applied to stop the bleeding from the biopsy site. This will either be silver nitrate or Monsells paste.

• Why do I need a colposcopy?

A colposcopy is recommended if there are abnormal results following a cervical screening test, if an unusual appearance is noted during an examination or if a woman is experiencing abnormal bleeding (postmenopausal bleeding, bleeding between periods or bleeding after intercourse) or pain.

• Is it uncomfortable?

During a colposcopy, the patient’s legs are placed in leg supports. These can be adjusted for each patient to minimise discomfort. The colposcopy examination can be uncomfortable but should not be painful. The procedure is typically completed within five to fifteen minutes. If a biopsy is required, this may cause menstrual cramping, which typically resolves with paracetamol and/or ibuprofen.

It is important to disclose any prior negative experiences prior to the procedure so that additional options for pain relief can be discussed as appropriate. These may include methoxyflurane or organising the procedure under general anaesthetic.

• Can I still have a colposcopy if I am on medications?

A colposcopy can be performed even on medications however if a biopsy is required, a woman may experience slightly increased bleeding if she is taking blood thinners.

• Can I still have a colposcopy if I am pregnant?

Colposcopy is safe in pregnancy, however biopsies are typically avoided unless significant abnormalities are noted.

• What should I expect afterwards?

Most women can return to work or school immediately after their colposcopy.

Some women experience mild cramping, especially if a biopsy is required. This typically resolves within a few hours however paracetamol and/or ibuprofen may be required. Small amounts of bleeding may be present for a few days, especially if a biopsy has been taken. A silver, black or brown discharge may also be present from medication used at the time of the procedure.

It is not recommended to use tampons, engage in intercourse or swim in public pools or spas for up to seven days or if bleeding is ongoing.

The results from biopsies will typically be available within two weeks and this will guide decisions regarding the need for further treatment or follow up. 

This blog was written by specialist obstetrician and gynaecologist Dr Preethi Nagubandi. Dr. Preethi Nagubandi has a strong belief in patient centred care, individualising treatment and involving women in all aspects of decision making.

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