Colposcopy

Why a colposcopy is done

A colposcopy is often done if a smear test (cervical screening) finds abnormal cells in your cervix caused by human papillomavirus (HPV).

These cells are not cancer, but there's a risk they could eventually turn into cervical cancer if not treated.

You may be offered a colposcopy after getting the results of your smear test if:

• the results of your smear test showed changes to the cells of your cervix
• it was not possible to get a clear result after 2 screening tests in a row

A colposcopy can also be used to find out the cause of other symptoms such as unusual vaginal bleeding (for example, bleeding after sex).

Getting ready for a colposcopy

If your cervical screening results show that abnormal cervical cells linked with human papillomavirus (HPV) were found, you will get a letter inviting you for a colposcopy.

You will be given your appointment time in your letter. You may have to wait up to 6 weeks.

The procedure will usually take place at a colposcopy unit at a local hospital or clinic.

Contact the hospital or clinic before your appointment if:

• you think you will be having your period at the time of your appointment and would prefer to reschedule – it's OK to have a colposcopy during your period
• you're pregnant or think you may be pregnant – it's safe to have a colposcopy when pregnant, but you need to tell the hospital or clinic before you attend your appointment
• you'd like someone to be in the room with you (a chaperone) – for example, someone you know, or a nurse or member of staff
• you need an interpreter

For the 24 hours before your colposcopy:

• do not have penetrative vaginal sex
• do not use any products that you place inside your vagina, such as tampons, vaginal creams or medicines

You might have some minor bleeding after the colposcopy, so it's a good idea to bring a pad or panty liner to the appointment.

If you have a coil (IUD, or Mirena coil) you should avoid sex, or use a barrier method of contraception, for the 7 days before your appointment. This is because sometimes the coil will need to be removed.

What happens during a colposcopy

A colposcopy is usually carried out in a hospital or clinic. It should usually take 15 to 20 minutes to have your colposcopy and you should be able to go home afterwards.

When you arrive at the hospital or clinic, you'll speak with a nurse about what's going to happen during the colposcopy.

They will ask you some questions about your general health and your medical history.

The procedure

A colposcopy is usually done by a specially trained nurse (colposcopist). Sometimes it may be done by a doctor.

Before the procedure you will be asked to remove your clothes, behind a screen, from the waist down. You may be given a sheet to cover yourself.

If you wear a loose skirt or a long jumper, you may be able to keep this on during the procedure.

You will be asked to lie down and put your legs on a padded support.

Further treatment

If the doctor or nurse finds abnormal cells in your cervix, they may recommend removing them. This will reduce your risk of cervical cancer.

They may do this treatment on the same day as your colposcopy, or you might be asked to come back for another appointment.

LLETZ (large loop excision of the transformation zone)

The most common way to remove abnormal cells is using a procedure called large loop excision of the transformation zone (LLETZ).

LLETZ is often done at the same time as your colposcopy. You will not need to stay in hospital and can go home the same day.

You will have an injection of local anaesthetic to numb your cervix first so you should not feel any pain.

A heated loop of wire is then used to remove the tissue. An area of tissue about the size of a fingernail is removed. LLETZ takes around 15 minutes.

Let the doctor or nurse know if you feel any discomfort during the procedure. You may need more local anaesthetic.

Cone biopsy

If the doctor or nurse needs to remove a large piece of tissue, they may recommend a cone biopsy. This involves removing a cone-shaped section of tissue from your cervix.

You will be asked to make a follow-up appointment for this procedure.

You will be asleep (have a general anaesthetic) for the cone biopsy and so may need to spend the night in hospital afterwards.

After a colposcopy

You can often go home to rest soon after the treatment is finished.

After a colposcopy you may have some mild pain, similar to period pain, for a few days. Taking a painkiller such as paracetamol can help.

You are also likely to have some bleeding and discharge from your vagina. If you had a colposcopy only, then the bleeding and discharge may pass after a few days.

If you had a biopsy or LLETZ

If you had a biopsy or LLETZ (large loop excision of the transformation zone) the bleeding can last longer. After LLETZ, some people have bleeding for up to 4 weeks.

If you have any bleeding, discharge and pain:

• do not have penetrative sex or put anything inside your vagina – if you had LLETZ you may be told to avoid sex for 4 weeks
• do not use tampons or menstrual cups – use pads instead
• avoid activities that could make the bleeding or pain worse, such as vigorous exercise that makes you breathe hard and fast

Getting your colposcopy results

If no abnormal cells were found, then you will usually be told straight away by the doctor or nurse.

You will still need to attend routine cervical screening appointments in the future.

If you had a biopsy you may need to wait 4 to 8 weeks to get your results.

Understanding your biopsy results

Your biopsy may not find any abnormal cells. This is known as a normal result. Depending on your age, you'll be invited for a cervical screening appointment in 3 or 5 years if you get a normal result.

Or your biopsy may find abnormal cervical cells. This is known as an abnormal result. It's not cancer, but there is a risk the cells could turn into cancer in the future if not treated.

Doctors use the following terms for abnormal cervical cells:

• cervical intra-epithelial neoplasia (CIN)
• cervical glandular intra-epithelial neoplasia (CGIN)

Abnormal cells are given a grade. The higher the grade, the more likely it is that these cells will grow and spread.

In rare cases, a colposcopy and biopsy will find cervical cancer. If this happens, you'll be referred to a team of specialists to discuss treatment.

Support is available

Most of the time a colposcopy will not find cervical cancer.

But it might help to speak to someone if you're feeling worried about your results or if you're told you have cervical cancer.