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Understanding Colposcopy: A Comprehensive Guide for Patients

In this blog post, I will explore what colposcopy is, why you might need it, how to prepare for the procedure, what to expect during the examination, and what comes after. I aim to provide you with the information you need to feel informed and prepared for this important step in your healthcare journey.

Why Do You Need Colposcopy?

Colposcopy is a procedure used to investigate abnormal findings in cervical cancer screening tests such as the Pap smear and HPV testing. These abnormalities may indicate precancerous or cancerous changes in the cervix, often linked to the human papillomavirus (HPV). The colposcope is an instrument that magnifies the cervix, making it easier for me to identify abnormal areas. To enhance visibility, I apply acetic acid (vinegar) to the cervix, which may cause a mild, temporary sensation but is not painful. By assessing the size, type, and location of abnormal cells, I can determine whether a biopsy is necessary.

Preparing for Colposcopy

Before your colposcopy appointment, it's important not to introduce anything into the vagina, such as creams or tampons. The procedure can be conducted at any point in your menstrual cycle. However, if you experience heavy vaginal bleeding on the day of your appointment, contact your provider to discuss whether rescheduling is necessary.

If you are taking blood-thinning medication like aspirin or warfarin, inform your provider in advance, as these medications can increase bleeding during a biopsy. Additionally, if you suspect you might be pregnant, share this information. While colposcopy is safe during pregnancy, biopsies are typically avoided during this time.

To minimize discomfort during the procedure, you can take ibuprofen (400 to 600 mg) an hour before your appointment, although it is not always required.

The Colposcopy Procedure

Colposcopy is a relatively short and minimally uncomfortable procedure that can be performed during an office visit. An OBGYN who has received specialized training, will conduct the examination, which typically takes 5 to 10 minutes.
During the procedure, you will lie on an examination table, much like during a routine pelvic examination. We will use a speculum to gently open your vagina, followed by an assessment of your cervix using the colposcope. The colposcope is a non-invasive instrument that does not touch your body.

A solution, acetic acid (vinegar), is applied to the cervix to highlight any abnormal areas, making them more visible with the colposcope. This may cause a brief cold or slight burning sensation, but it should not be painful. Sometime we also apply a brown solution called Lugol's solution to your cervix to highlight any additional abnormalities.

In some cases, we may take a small tissue sample (biopsy) from the cervix or vagina during colposcopy. This is done to further assess the severity of any abnormalities. Biopsies typically cause only mild discomfort or cramping and do not require anesthesia. The biopsy takes only a second. The collected tissue samples will be sent to a laboratory for examination by pathologists.

Some individuals may also require an endocervical curettage (ECC) during colposcopy, which involves a biopsy of the inner cervix. ECC may cause crampy pain, which usually subsides quickly. If you receive a biopsy, the provider may apply a yellow-brown solution to your cervix, acting as a liquid bandage.

After Colposcopy

Immediately following the procedure, some individuals may feel slightly dizzy or nauseated. If you experience these sensations, inform your provider and lie down until they subside. Applying a cold compress to your forehead can also help alleviate discomfort. It's essential to inform the doctor if you have a history of fainting or feeling lightheaded after medical procedures.

After a cervical biopsy, you may experience some vaginal bleeding, which is normal. If a liquid bandage solution was used, you may notice brown or black vaginal discharge resembling coffee grounds. This typically resolves within a few days.

Most people can return to work or school immediately after a colposcopy. While some individuals may experience mild pain or cramping, it typically subsides within one to two hours. It's important not to insert anything into the vagina (creams, douches, tampons) or engage in sexual activity for 48 hours after a biopsy.

We will inform you of when to expect the biopsy results, usually within 7 to 14 days. The next steps, including further testing and treatment, will depend on the biopsy findings. If you don't receive results as expected, don't assume they are normal – contact your doctor to inquire. In most cases, a follow-up test such as a repeat cervical cancer screening (Pap smear) or colposcopy will be necessary within six months to one year.

When to Seek Help After Colposcopy

It's essential to stay vigilant about your health after a colposcopy. Contact your doctor if you experience any of the following symptoms:

• Heavy vaginal bleeding (soaking through a large menstrual pad in an hour for two hours)
• Vaginal bleeding lasting more than seven days
• Foul-smelling vaginal discharge (note that brown or black discharge is normal for the first few days)
• Pelvic pain or cramps that do not improve with ibuprofen (Advil, Motrin)
• A temperature greater than 100.4°F or 38°C

Colposcopy is a vital step in assessing and managing abnormal cervical screening test results. While the procedure may involve some discomfort, it is relatively brief and well-tolerated. By following these guidelines and maintaining open communication with your doctor, you can take proactive steps to ensure your cervical health and well-being

Swor Women's Care

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