Colposcopy information sheet

A colposcopy is a close examination of a woman’s cervix (or neck of womb) using a special microscope called a colposcope.  The colposcope can also be used to examine for abnormal cells in the woman’s genital tract, either inside or on the outside of the vagina.

Your health care provider may recommend you have a colposcopy after an abnormal Cervical Smear teat (CST) or due to symptoms such as bleeding from the cervix. A colposcopy is more accurate diagnostic test because the doctor can have a closer look at the cervix to assess whether further treatment is required.

What preparation is needed before colposcopy?

Colposcopy cannot be performed while you are having your period.  Some women experience cramping (like period pains) during colposcopy.  You may find it helpful to take a painkiller an hour before the procedure to minimise discomfort.

How is a colposcopy done?

Having a colposcopy is like having a CST (Cervical Screening Test) but will take about 15 minutes.

• First a speculum is inserted into the vagina.
• Often the doctor will take a CST.
• The colposcope is placed at the entrance to the vagina. The doctor then looks at the cervix through the colposcope.  The colposcope magnifies the cervix 15- 30 times.
• A weak vinegar solution is then applied to the cervix. When the cervix is painted like this, areas where there are changes in the cells turns white.  Health cells stay pink.
• If the cervical tissue stains white, then the doctor may perform a biopsy (the removal of a tiny pieces of tissue) from areas of concern.
• Biopsies generally are not painful. The tissue collected is sent to the laboratory for testing to determine if treatment is necessary.
• Sometimes a brown solution (iodine) is applied to view your cervix under different light. During this examination healthy cells turn brown.  This brown solution (iodine), may produce a brown vaginal discharge for a few days after the procedure.  You need to tell the doctor or nurse if you are allergic to iodine.

What should I do after the procedure?

• You may want to wear a pad for a few days to prevent staining of your underwear by the iodine solution.
• It is best to avoid heavy physical exercise for 24 hours after biopsy and it is best not to have penetrative sexual intercourse for about a week. To prevent infection, avoid swimming, bathing and spas for 3 days.
• If a biopsy is taken, some extra discomfort may be experienced for a short time.
• In general, you will not need time off after a colposcopy.

These precautions are to reduce the risk of bleeding or infection. Please contact your doctor if you have any heavy bleeding, fever or offensive vaginal discharge.

Obtaining results, follow up care and referral

It is important that you see your doctor for follow up care after colposcopy.  At this visit the doctor will explain what was seen and how you will get your results.  Depending on your results and after discussing the result with you, the doctor may recommend:

• More frequent Cervical screening tests
• Repeating the colposcopy for follow-up, or
• Other treatment

What treatments are available?

Your treatment will depend on whether an abnormality was detected and if so, the type of abnormality detected.  Changes in the cells are treated by removing them.  Sometimes the doctor may treat the abnormality while you are having your colposcopy.  In other cases, another follow-up appointment will be arranged and the doctor will discuss treatment options with you.

Common types of treatment

• LLETZ (large loop excision of the transformation zone): this treatment uses a wire loop to remove the abnormal cells from the cervix.
• Cone biopsy: this is where a small cone shaped are of the cervix containing the abnormal cells is removed surgically in hospital under general anaesthetic.
• Laser, Diathermy and Cryosurgery: these are less common treatments which use hot or cold to remove abnormal cells. Your doctor will discuss these in more detail if recommended for you.

Looking after yourself

• It is important that you discuss your follow up with the doctor before going home.
• You will have some bloodstained discharge for a couple of days, followed by spotting which may last for a couple of weeks. It is best to wait until the spotting has stopped before you resume sexual intercourse.
• Follow up after treatment will be 12 monthly CST for 2 years. A colposcopy will only be required if the CST is abnormal.
• Taking time to look after yourself includes a healthy diet, doing some regular exercise, getting enough sleep and not smoking. These basic lifestyle modifications are the best way to stay healthy and well.

For more information and advice

• Talk to you General Practioner or Mobile Women’s Health Nurse.
• Gynaecological Outpatients as your local hospital
• Cancer information and Support Service (Queensland Cancer Fund) – 1300 361 366
• National Cervical Screening Program