Gynecologist appointments are about as routine as a dentist visit, but there are a few instances when follow-up is required. One of the most common, but least talked about, procedures regarding our lady parts is a colposcopy. In short, it’s done to evaluate the cervix, vagina, and vulva for cancerous cells.
“A colposcopy is, in essence, a microscope allowing visualization of the cervix under magnification,” says OB/GYN Alyssa Dweck, MD. “While a trained eye can often diagnose a cervix abnormality through visual inspection, oftentimes small tissue samples (biopsies) will be taken to confirm.”
Ahead, she breaks down everything you should know about them and why they’re not always as scary as they seem.
Colposcopy vs. Colonoscopy
A colposcopy is often confused for a colonoscopy. Though their spellings are similar, the two procedures couldn’t be more different. A colposcopy is a microscopic examination of the cervix to evaluate for cancer or pre-cancer.
A colonoscopy is a procedure done to screen for colon cancer or polyps. This is done under anesthesia and requires a “prep”—a cleanse to evacuate the colon. And it’s typically recommended routinely for those 50 years or older and at any age if needed to evaluate a change in bowel habits, pain, or rectal bleeding.
Who Needs a Colposcopy?
The only surefire way to know if you need a colposcopy or not is through your gynecologist, whom you should be seeing once a year or more than that to address specific concerns. If your pap smear comes back abnormal or the doctor identifies an aggressive strain of HPV, he or she will recommend the procedure.
The procedure itself takes about 10–15 minutes, depending on individual circumstances.
“The most uncomfortable part seems to be the speculum—the metal/plastic device that keeps the vagina open,” says Dr. Dweck. “The cervix and upper vagina are swabbed with a dilute acetic solution (like vinegar) to highlight abnormal cells. Tissue samples might be taken from the cervix in various locations.”
Although many doctors administer a numbing gel beforehand, it’s still pretty normal to feel a mild pinch as they gently scrape the cervix canal for samples. Afterward, a brown liquid called Monsel’s solution might be used topically to prevent bleeding. You can also expect increased discharge after the fact for a few days.
Once you’ve made it through the mostly painless procedure, results take approximately one week to arrive. Pelvic rest (no sex) for a few days is usually recommended afterward. As for the results, if your doctor finds anything, there are a number of possible findings, from mild to severe. Typically, the doctor discovers normal HPV changes or precancer cells that can be easily removed. However, Dr. Dweck says to remember that HPV exists in many different strains.
“Some are high risk and linked to cervical cancer. Other strains cause warts, which are a nuisance but not usually dangerous. When a high-risk HPV infection is noted or persistent, a colposcopy might be offered for evaluation. The point is to screen and treat, if needed, well before cervical cancer would ever develop. Keep in mind, as more and more people get vaccinated for HPV, cervical cancer rates should decline significantly.”
All in all, it’s best to take everything one step at a time. The transition from HPV infection or mildly abnormal pap smear to cervical cancer usually takes a very long time to occur. Screening is designed to diagnose problems at a very early/treatable stage.