Colposcopy is an examination of
the cervix (the neck of the womb) using a specially designed
Why do I need colposcopy?
The main reason for performing colposcopy is to detect pre-cancerous
changes of the cervix although other conditions can also be
diagnosed during a colposcopic examination. The most common
indications for colposcopy are;
· An abnormal smear
· Bleeding after intercourse
· An identified abnormality on the cervix
· Persistent vaginal discharge
· Bleeding between periods
· Transplant patients or those with HIV
If your smear test is abnormal, then you should not be alarmed.
One in twelve smear tests are abnormal and this usually means
that small changes have been found in the cells of your cervix.
These changes are known as ‘dyskaryosis’ and act
as an early warning sign that cancer might occur in the future.
It is very rare for an abnormal smear to show cancer.
What should I do before colposcopy? You will be asked to undress from
the waist downwards (though a full skirt need not be removed).
You may wish to wear a skirt to avoid removing all your lower
clothing. It is common to have a small amount of bleeding
after colposcopy. You may want to bring a sanitary towel just
in case. Tampons are best avoided immediately after colposcopy treatment
if a biopsy is performed.
It will be necessary to know the date of your period. You
may wish to note this in advance. Colposcopy can be done safely
during pregnancy, although treatment is usually left until
What actually happens?
You will be asked to lie on a gynaecological examination couch
with your legs in supports. When you are positioned correctly
a speculum will be placed into your vagina just as when you
had a smear. A smear test may then be repeated. The cervix
will then be examined using the colposcope. Special dyes are
often applied to the cervix during the examination.
It is sometimes necessary to take a small sample of tissue
(a biopsy) from the surface of the cervix. The biopsy is the
size of a pinhead. You may feel a slight sting but it should
not be painful.
What happens afterwards?
The findings will be explained to you but the actual results
may not be available until some days afterwards when the biopsy
and smear have been analysed. Colposcopy treatment has no major side-effects.
Very occasionally, women can get a reaction to the iodine
in one of the dyes. If you have a known iodine allergy you
must let the doctor know. There is no effect on future fertility
If you have had a biopsy, you should refrain from intercourse
for five days and use sanitary towels rather than tampons.
(Following treatment you are advised to refrain from intercourse
for a month).
What will the examination
The colposcopy shows the type and extent of an abnormal area
on the cervix. The biopsy will show the severity as well as
the type. The technical term used to defined abnormal cells
detected on biopsy is ‘Cervical
which in layman’s terms means ‘Cervix;
the skin; New
cells’. The abbreviation CIN is often used.
There are three grades of CIN. CIN 1 is when a third of the
cells in the affected area are abnormal; CIN 2 is when two
thirds are abnormal; and CIN 3 is when they are all abnormal.
It is extremely rare for cancer to have already developed.
Not all CIN needs treatment. Sometimes it can can go away
on it’s own and is just watched. However, it is normal
to recommend treatment for CIN 2 or CIN 3.
Treatment is usually performed under local anaesthetic as
an outpatient appointment.
The frequency of follow-up appointments depends on the abnormality
and whether or not you have had treatment. After treatment
for CIN it is normal to require at least one follow-up appointment
after treatment. If you have been discharged from the colposcopy
clinic, you may require smears more frequently than you had
them before. You should always ensure that you know when your next smear
test should be afterwards.