Colposcopy

A colposcopy is a magnified examination of the cervix. If the results of your pap test are abnormal, your healthcare provider may recommend a colposcopy.

Abnormalities of the cervix are usually caused by HPV exposure. About 80% of sexually active people eventually have some exposure to HPV, but it doesn’t always cause symptoms. Sometimes a colposcopy is done when high-risk HPV is detected or when the cervix looks abnormal, even if the pap smear is normal.

How to Prepare

• Schedule your exam when you do not have your period.
• Avoid douching, having sexual intercourse, or inserting anything into your vagina for 48 hours before the exam.
• You may take ibuprofen 600–800mg, with food, 1 hour before your appointment, to help with cramping during the exam.

Pelvic Exam

First, your history will be reviewed and you will have the opportunity to ask questions. Then the exam will be done. Initially, it is similar to a routine gynecology exam.

What can be uncomfortable about the exam is that the speculum needs to stay in for longer than it usually does with a pap smear. The exam takes 15–30 minutes. If biopsies are done, you may have some cramping or discomfort. Usually this only lasts a short time.

After the Procedure

Take the following steps:

• Rest your vagina for 48 hours. This means no sex, tampons, or soaking in water (such as in a bath or pool). Showering is okay.
• Wear a pad or panty-liner for few days to protect your clothing, because a small amount of spotting or discharge is normal.
• Monitor for signs/symptoms of infection such as fever, pain, or excessive discharge.
• As long as you are feeling well, there are no restrictions to your activities aside from the vaginal rest.

A follow-up appointment will be scheduled for approximately 2 weeks later, but you can return sooner if you have any problems or concerns.

Follow-up

At your follow-up appointment you will review your results with your healthcare provider and decide on a plan for future care. Usually a healthy immune system eventually suppresses the HPV virus and clears up the abnormal cells. However, it may take 2–3 years to completely resolve. Until the abnormalities resolve, the changes to your cervix will need to be monitored with repeat pap smears. In a small percentage of women, the problem may not improve. Some women may require treatment to remove the abnormal cells (but most women do not need treatment). In addition to having follow-up pap smears, sometimes the colposcopy needs to be repeated.

The HPV Vaccine

Most women with abnormal cells on their cervix should still get the HPV vaccine (Gardasil). There are many strains of HPV. Even if you’ve been exposed to several of them, the vaccine can help to protect you against any of the higher-risk strains that you haven’t already been exposed to. The vaccine will not cure the current cervical changes, but it will decrease the risk of having future problems from new HPV exposures.