Colposcopy ~ Information for Women

What is a colposcopy?

A colposcopy is a close examination of a woman’s cervix (neck of the womb) to help identify any abnormalities using a special magnifying instrument called a colposcope.

Why is a colposcopy done?

Your health care provider may recommend you have a colposcopy after an abnormal Pap smear test or because of symptoms such as bleeding from the cervix. Pap smears are screening tests for changes in the cells of the cervix, and an ‘abnormal’ result means microscopic changes were seen in some cells. A colposcopy helps a gynaecologist to make an assessment of the cervix to determine:

• whether there is an abnormality and what type of abnormality (minor or more serious)

•  if a biopsy should be taken and where the biopsy should be taken from

• if further treatment is needed.

How is a colposcopy done?

Having a colposcopy is similar to having a Pap smear but will take between 15 minutes and half an hour. A colposcopy is usually scheduled for a time when you are not having your period but bleeding does not mean a colposcopy cannot be done. (It is important that abnormal or unusual bleeding is investigated.)

• First a speculum is inserted into the vagina.
• The doctor looks at the cervix through the colposcope which is placed at the entrance to the vagina. The colposcope magnifies the cervix 6 – 10 times.
• A cotton swab may be used to remove excess mucous and a weak vinegar solution is applied to the cervix. This makes areas where there are changes in the cells turn white helping the doctor to identify abnormalities.
• Sometimes a brown solution (iodine) is applied to view your cervix. During this examination healthy cells turn brown.  You need to tell the doctor or nurse if you are allergic to iodine.
• Having identified any abnormalities, the doctor may take a biopsy (the removal of a tiny piece of tissue) from any areas of concern.
• A biopsy may be felt as a sharp pinch and there may be some associated cramping pains afterwards. 
• The tissue collected is sent to a laboratory for testing to confirm the diagnosis.

What should I do after the colposcopy?

• Colposcopy is an outpatient or clinic procedure and will not require a hospital stay.
• If a biopsy is taken, some extra discomfort may be experienced for the next 24 hours. It is normal for some slightly blood stained discharge to occur and this may continue for 5 or 6 days. It is best to avoid heavy physical exercise, sexual intercourse, swimming, bathing and spas for 24 – 48 hours after a biopsy.
• Contact your doctor if you have any heavy bleeding, fever or smelly vaginal discharge.

Obtaining results and follow up care

After the colposcopy your doctor will explain what was seen and how you will get your results. Depending on the results of your colposcopy and biopsy, the doctor may recommend:

• No further action (usually where there are minor changes in the smear and no abnormality is seen with the colposcope)
• More frequent Pap smears
• Repeating the colposcopy at a later date
• Active treatment.

It is important to remember that not all abnormalities will require active treatment. Many abnormalities will resolve without any treatment.

What treatments are available?

Your treatment will depend on whether an abnormality was found and what kind it is. The purpose of treatment is to remove or destroy any abnormal cells. Treatments include:

• LLETZ (large loop excision of the transformation zone). This treatment uses a wire loop to remove the abnormal cells. 
• Cone Biopsy - where a small cone shaped area of the cervix containing the abnormal cells is removed either by laser or by traditional surgical knife.
• Other treatments are Laser, Diathermy or Cryosurgery, which use heat or cold to remove abnormal cells.

Looking after yourself after treatment

• It is important that you discuss your follow up with the doctor before treatment.
• You may 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.
• Contact your doctor if you have any heavy bleeding, fever or smelly vaginal discharge.
• You will probably be advised to have a Pap smear and possibly another colposcopy in 3 to 6 months. Having regular Pap smears in the future is very important in maintaining your health.
• Taking time to look after yourself includes a healthy diet, doing some exercise, getting enough sleep and not smoking. These basic lifestyle changes are the best way to stay healthy and well.

For more information and advice

• Speak to your doctor or call the women’s health information line on 1300 882 880.
• For information about Pap smears and screening for cervical cancer you can search on the web at www.cervixscreening.sa.gov.au or contact the SA Cervix Screening Program (contact details below). Country callers can ring 13 15 56 for the cost of a local call.

Acknowledgements
Dr Margaret Davy, Director Gynaecological Oncology
Queensland Cervical Screening Program, Colposcopy Fact Sheet

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Email: cervixscreening@health.sa.gov.au

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