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Screening for cervical cancer (either by Pap test and/or human papillomavirus testing) is an important part of staying healthy and avoiding cervical cancer. If the results of your screening test are abnormal, further testing is needed to confirm the result and determine the severity of the abnormality. Colposcopy is the test that is usually recommended in this case. It allows your healthcare provider to look at your cervix using magnification. Biopsies may also be done at the time of the colposcopy. The colposcopy (ie, the visualization of the cervix) and the biopsies (removing small tissue at the time of the colposcopy for examination in a laboratory) may or may not be done at the same time.

Colposcopy can be done at any time during your menstrual cycle, but if you have heavy vaginal bleeding on the day of your appointment, call your healthcare provider to ask if you should reschedule.

If you take any medication to prevent blood clots (aspirin, warfarin, heparin, clopidogrel), notify your healthcare provider in advance. These medications can increase bleeding if you have a biopsy during the colposcopy.

If you know or think you could be pregnant, let your healthcare provider know. Colposcopy is safe during pregnancy, although healthcare providers usually do not perform biopsies of the cervix when you are pregnant.


Colposcopy can be performed by a physician, nurse practitioner, or physician assistant who has had specialized training. Colposcopy takes approximately 5 to 10 minutes, can be performed during an office visit, and causes minimal discomfort.

The provider may repeat a Pap smear and then will look at your cervix using the colposcope. The colposcope is like a microscope on a stand, and it does not touch you.

The provider will apply a solution called acetic acid (vinegar) to your cervix. This solution helps to highlight any abnormal areas, making them easier to see with the colposcope. When this solution is used, you may feel a cold or slight burning sensation, but it does not hurt.

During colposcopy, your healthcare provider may remove a small piece of abnormal tissue (a biopsy) from the cervix or vagina. Having a biopsy does not mean that you have precancerous cells. Anesthesia (numbing medicine) is not usually used before the biopsy because the biopsy causes only mild discomfort or cramping. The tissue sample will be sent to a laboratory and examined with a microscope by pathologists.

Some women also need to have a biopsy of the inner cervix during colposcopy; this is called endocervical curettage (ECC). Pregnant women should not have ECC because it may disturb the pregnancy. The ECC may cause crampy pain, although this resolves quickly in most women.

If you have a biopsy, your provider may apply a yellow-brown solution to your cervix. This acts as a liquid bandage.


If you have a biopsy of your cervix, you may have some vaginal bleeding after the colposcopy. If your provider used the liquid bandage solution, you may have brown or black vaginal discharge that looks like coffee grounds. This should resolve within a few days.

Most women are able to return to work or school immediately after having a colposcopy. Some women have mild pain or cramping, but this usually goes away within one to two hours.

Do not put anything in the vagina (creams, douches, tampons) and do not have sex for 48 hours after having a biopsy.

If you have a biopsy, ask your healthcare provider when your results will be available (usually within 7 to 14 days). In most cases, further testing and treatment will depend on the results of the biopsy.

Do not assume that the biopsy results are normal if you do not hear from your healthcare provider — call and inquire about the results. Most women will need a follow up test (repeat cervical cancer screening (Pap smear) and/or colposcopy) within six months.


Call your healthcare provider if you have any of the following after colposcopy:

  • Heavy vaginal bleeding (soaking through a large menstrual pad in an hour for two hours)
  • Vaginal bleeding for more than 7 days
  • Foul smelling vaginal discharge; remember that the brown/black, coffee-ground discharge is normal for the first few days
  • Pelvic pain or cramps that do not improve with ibuprofen (Advil, Motrin)
  • Temperature greater than 100.4ºF or 38ºC


Your healthcare provider is the best source of information for questions and concerns related to your medical problem.