If you have recently had a smear test that showed some abnormalities, you will probably have a colposcopy. This is an examination of the cervix (neck of the womb) using a binocular microscope called a colposcope. It’s a routine and painless procedure that is carried out by a specialist doctor or nurse to ensure that there are no signs of cervical cancer.
Why you might need it
A colposcopy is a common procedure that makes sure that you do not have any signs of cervical cancer. It happens to around one in 20 women whose cervical screening test shows some possible abnormalities. Less than one woman in 1,000 who are referred for a colposcopy is found to have cervical cancer needing immediate treatment. (source: NHS Choices)
Possible reasons you may need a colposcopy include:
- abnormal cervical cells - but not necessarily cancerous - following a cervical screening
- you have human papillomavirus (HPV). This is the main cause of the abnormal cell changes and could lead to cancer
- it wasn't possible to get a result despite having several screening tests
- your cervix did not look as healthy as it should when you had your screening test.
This examination can also sometimes be used to investigate:
- unexplained vaginal bleeding, for example, after sex
- inflammation of the cervix
- polyps and cysts - benign (non-cancerous) growths
- genital warts on the cervix.
The aim of having this examination is to spot problems early on before anything more serious develops and to prevent that from happening.
The procedure only takes five minutes and if abnormal areas are spotted, a small tissue sample (biopsy) may be taken.
Further treatment can be carried out immediately after the examination, if necessary. For example, a common procedure called a large loop excision involves your doctor removing abnormal cells with a thin wire loop that is heated with an electric current. This can be carried out using a local anaesthetic.
Find a Spire hospital offering this treatment
Who will do it?
Our patients are at the heart of what we do and we want you to be in control of your care. To us, that means you can choose the consultant you want to see, and when you want. They'll be with you every step of the way.
All of our consultants are of the highest calibre and benefit from working in our modern, well-equipped hospitals or clinics.
Our consultants have high standards to meet, often holding specialist NHS posts and delivering expertise in complex sub-specialty surgeries. Many of our consultants have international reputations for their research in their specialised field.
Before your treatment
You will have a formal consultation with a healthcare professional. During this time you will be able to explain your medical history, symptoms and raise any concerns that you might have.
We will also discuss with you whether any further diagnostic tests, such as scans or blood tests, are needed. Any additional costs will be discussed before further tests are carried out.
Preparing for your treatment
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For more information on visiting hours, our food, what to pack if you're staying with us, parking and all those other important practicalities, please visit our patient information pages.
Our dedicated team will also give you tailored advice to follow in the run up to your visit.
You can’t have this procedure during your period. You should also avoid having sex and not use vaginal medications, lubricants, creams, or tampons for at least 24 hours before treatment.
The procedure
We understand that having an examination can often be a time of anxiety and worry, but our experienced and caring medical staff will be there for you every step of the way.
You will be asked to sit in a special chair with padded supports, where you can rest your legs.
Your specialist, known as a colposcopist, will insert a speculum into your vagina, which is gently opened to allow them to examine your cervix - as happens during a smear test. Your colposcopist will then examine your cervix using a colposcope (a binocular microscope) with a strong light that will remain outside your body. After this, the colposcopist will dab different liquids onto your cervix that will stain abnormal cells a different colour so they can be seen more clearly.
If any abnormal area is identified, a small sample of tissue will be taken from the surface of the cervix.
This biopsy is about the size of a pinhead and you may feel a slight stinging, but it should not be painful. If there is an obvious abnormality, or if you have had a previous positive biopsy result, treatment may be needed. Most often, that treatment is loop excision. This can be done during the same appointment or carried out at a later visit.
For loop excision, a local anaesthetic will be injected into your cervix to numb the area. A loop of fine wire with an electric current flowing through it is then used to remove abnormal cells. If a larger area has to be treated, you might be given a general anaesthetic so you will be asleep during the procedure.
Alternatively, abnormal cells can be destroyed by freezing, heat or laser treatment. Your doctor will discuss these options with you if further treatment is needed.
Aftercare
Colposcopy is carried out as an out-patient or day care procedure depending upon the location and anaesthesia is often not necessary.
If you have had loop excision, freezing, heat or laser treatment, you will have been given either a local or general anaesthetic.
After this, you will be taken to your room or comfortable area where you can rest and recuperate until we feel you’re ready to go home.
If you have had a biopsy, the results will be ready one to two weeks later and will usually be sent to your gynaecologist. He or she will either send you a letter explaining the results, or may discuss them with you at a follow-up appointment.
Pain relief
This procedure should be painless, although a small sample of cervical tissue may be taken and sent for laboratory analysis. A small number of women may have heavy bleeding after the procedure. Occasionally an infection may develop. We will make sure this is treated with antibiotics. If you need them, continue taking painkillers as advised by your healthcare team.
We will provide you with a supply of all the medicines your consultant feels you need to take home with you after you've been discharged up to 14 days. This may be at an additional cost to some patients.
Recovery time
After the procedure, you might experience some vaginal discharge and/or bleeding, similar to a light period. This should clear up after two weeks but may last for up to six weeks. You should be able to return to work the following day.
To help reduce the risk of infection, you should avoid swimming, sexual intercourse and tampons until the discharge has cleared up. Your gynaecologist will give you specific advice.
Healing is usually very rapid. The small area left behind after the abnormal cells are removed fills up quickly and normal tissue grows over.
You may find that your first period following the procedure is heavier or more prolonged than usual and that your periods are irregular for a couple of months.
Looking after you
Even once you’ve been discharged, we’re still here for you. On rare occasions, complications following a colposcopy can occur. If you experience any of the symptoms listed below, please call us straight away:
- heavy bleeding
- severe pain
- pain that lasts more than 48 hours
- fever or high temperature
- vaginal discharge that smells unpleasant.
We will talk to you about the possible risks and complications of having this procedure and how they apply to you.
If you have any questions or concerns, we’re ready to help.
Why choose Spire?
We are committed to delivering excellent individual care and customer service across our network of hospitals, clinics and specialist care centres around the UK. Our dedicated and highly trained team aim to achieve consistently excellent results. For us it's more than just treating patients, it's about looking after people.
Important to note
The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.
Procedures carried out at one of our Spire Healthcare Clinics will be performed under local anaesthetic.
What is a colposcopy?
A colposcopy is an examination of the cervix (the entrance to the womb from the vagina) using a binocular microscope called a colposcope. It’s a routine and painless procedure that’s carried out by a specialist doctor or nurse, usually to check for signs of cervical cancer.
The first step in checking for cervical cancer is a cervical smear test — a way to examine the health of the cells in your cervix. In 1 in 20 women, a cervical smear test may show abnormal cells that need to be investigated or removed in case they become cancerous.
During a colposcopy, if your doctor has found abnormal cells, they may be able to treat them immediately.
How do I know if I need a colposcopy?
Your doctor will recommend you have a colposcopy if:
- You’ve had a cervical smear test that has shown abnormal cells
- You’ve had several cervical smear tests without a clear result
- On examining your cervix during your smear test, your doctor or nurse thought that your cervix didn’t look completely healthy
You may also need a colposcopy if you have:
- Genital warts on the cervix
- Inflammation of the cervix
- Polyps and cysts ie benign (non-cancerous) growths
- Tested positive for human papillomavirus (HPV)
- Unexplained vaginal bleeding eg after sex
Where to get a colposcopy
Many of our hospitals and clinics offer private colposcopies. Some locations also offer a GP service so you can get quick and easy access to a private GP when you need it. Find your nearest Spire hospital or clinic.
Preparing for a colposcopy
You will need to abstain from having sex and stop using vaginal creams, lubricants, medications, menstrual cups or tampons for at least 24 hours before your colposcopy. You can eat and drink normally.
On the day of your colposcopy, bring a panty liner — you may experience some light bleeding or vaginal discharge after your procedure. You can also bring a friend or family member along for moral support.
You should contact your healthcare team before your colposcopy if you think you may have your period on the day of your colposcopy. In most cases, you will still be able to go ahead with the procedure but in some cases, it may be postponed.
You should also contact your healthcare team if you're pregnant during the time of your colposcopy. The procedure is safe during pregnancy but collecting a tissue sample (biopsy) or subsequent treatment will likely be postponed until after you've given birth.
If you want your colposcopy performed by a female doctor or nurse, you will need to inform your healthcare team in advance.
The colposcopy procedure
Before your colposcopy, you will be asked to undress from the waist down. If you’re wearing a loose skirt, you may not need to remove it. You will then lie down in a special chair with padded leg supports.
Your doctor will then gently insert a plastic or metal instrument (called a speculum) into your vagina to expose your cervix (neck of the womb). They’ll use a microscope with a light (a colposcope) to look at your cervix — the colposcope will not enter your vagina. Some colposcopes have a camera attached, which sends images to a screen so you can see inside your cervix.
Special solutions may be applied to your cervix to help identify any abnormal tissue. This may be enough for your doctor to determine whether your smear test was correct and there is abnormal tissue that needs to be removed. However, in some cases, they may need to take a biopsy (sample of cells or tissue) to send to the lab for further analysis.
Your doctor may be able to treat you immediately by removing any abnormal cells. There are a number of procedures to remove abnormal cervical cells. It is most often done using loop excision under local anaesthetic (so your cervix is numb). This involves using a loop of wire with an electrical current passing through it to remove abnormal cells.
Other methods to remove abnormal cells in your cervix include heating, freezing or laser treatment. Your doctor will discuss these options with you if further treatment is needed.
If you feel uncomfortable during your colposcopy, let your doctor know. They may be able to reduce your discomfort or can stop the procedure.
How long does a colposcopy take?
A colposcopy usually takes 15 to 20 minutes.
When do I need a cervical biopsy?
A cervical biopsy involves removing a sample of tissue or cells from your cervix, which is sent to a lab to identify abnormal cells. This can give you a clear diagnosis of cancer or precancerous tissue, while a colposcopy can only suggest that abnormal tissue is present.
You will only need a biopsy if during your colposcopy, your doctor identifies tissue that doesn't look normal. If they find more than one area of abnormal tissue, they will take biopsies from these areas too.
Your cervical biopsy will be performed immediately after your colposcopy using a sharp tool to collect the sample of cells or tissue. This is uncomfortable but not painful. It is often described as a feeling of pressure or mild cramps.
Colposcopy after care
After your colposcopy, you can go home as soon as you feel ready, which is usually immediately after your procedure finishes. You may want to rest for the remainder of the day, however, you can return to your normal activities, such as working and driving.
You may have brownish vaginal discharge or light vaginal bleeding after your colposcopy. Avoid swimming, sex and using vaginal creams, lubricants, medications, menstrual cups or tampons until your vaginal discharge or bleeding has stopped. This should clear up after two weeks but may last for up to six weeks.
Healing is usually very rapid. The small area left behind after the abnormal cells are removed fills up quickly and normal tissue grows over.
You may find that your first period following the procedure is heavier or more prolonged than usual and that your periods are irregular for a couple of months.
Your colposcopy results
Your doctor may be able to tell you about your cells during the procedure. However, if you had a biopsy, we will send your results to the doctor who requested your test in 1–2 weeks. We will try to get your results back to you as soon as possible, as less waiting means less worrying.
You will receive one of two results: normal or abnormal.
Around 4 in 10 women will have a normal result. This means no abnormal cells were found in your cervix and you do not need any treatment. However, you'll still need to keep up with your regular cervical smear tests, as abnormal cells may develop later. The frequency of your cervical smear tests will depend on your age but is usually every three or five years.
Around 6 in 10 women will have an abnormal result. This means abnormal cells were found in your cervix. This is usually due to cervical intra-epithelial neoplasia (CIN) or cervical glandular intra-epithelial neoplasia (CGIN). CIN and CGIN are not cancer but could develop into cancer later.
A biopsy is needed to find out the likelihood of CIN cells becoming cancerous and consequently, whether you need treatment to remove them. CIN is graded according to the likelihood of cancer developing, as follows:
- CIN 1 — the cells are unlikely to become cancerous and may go away by themselves; treatment is not needed but you will need a cervical smear test in 12 months to check the cells have gone away
- CIN 2 — the likelihood of the cells becoming cancerous is moderate and the cells should be removed
- CIN 3 — the cells are highly likely to become cancerous and the cells should be removed
CGIN cells are highly likely to become cancerous and you will need to have them removed.
In rare cases, an abnormal result is due to cervical cancer. In these cases, you will be referred to a specialist cancer care team for treatment. Cervical cancer detected as a result of a smear test and colposcopy is usually in an early stage. This makes treatment much more effective, which is why it’s important to keep up with your regular cervical smear tests.
Treatment to remove abnormal cells
If all the abnormal cells in your cervix were removed during your biopsy, you may not need further treatment. However, if they weren't all removed you may need one of the following treatments to prevent cervical cancer:
- Cone biopsy — a cone-shaped piece of cervical tissue is removed to get rid of any cancerous or precancerous cells
- Cryotherapy — liquid gas is used to freeze and destroy abnormal cells in your cervix
- Loop Electrosurgical Excision Procedure (LEEP) — abnormal cells are removed with a wire loop through which an electric current is passed
Colposcopy side effects and risks
After your colposcopy, you may experience vaginal bleeding, similar to a light period and/or vaginal discharge. You should therefore avoid swimming, sex and using tampons, menstrual cups or vaginal medications, lubricants and creams until any discharge or bleeding has cleared.
On rare occasions, complications following a colposcopy can occur. If you experience any of the symptoms listed below, seek medical attention immediately:
- Fever or high temperature
- Heavy vaginal bleeding
- Pain that lasts more than 48 hours
- Severe pain
- Stomach ache
- Vaginal discharge that smells unpleasant
We’ll talk to you about the possible risks and complications of having this procedure and how they apply to you.
At Spire Healthcare, we’re careful to weigh up the benefits and risks of any procedure and discuss it with you if you have any concerns.
Frequently asked questions
Is a colposcopy serious?
A colposcopy is a procedure to determine whether or not you have any abnormal cells in your cervix that could develop into cancer. The procedure itself is safe and is important to help prevent cervical cancer.
Should I be worried if I need a colposcopy?
Around 4 in 10 women will get a normal result following a colposcopy. The remaining 6 in 10 women will get an abnormal result. However, treatment to remove abnormal cells is highly effective. In rare cases, where cervical cancer is found it is usually in its early stages, which makes treatment more effective.
Is colposcopy considered surgery?
A colposcopy is a procedure to examine your cervix. It does not involve cutting into your tissue. However, if a tissue sample (biopsy) needs to be taken, then after your colposcopy, a sharp surgical tool will be used to collect the tissue — this is uncomfortable but not painful.
Should I shave before a colposcopy?
No, there is no need to shave before a colposcopy. This procedure is used to look inside your cervix and is not hindered by the presence of pubic hair.
The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.