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Colposcopy examination

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A colposcopy is a simple procedure used to look at the cervix. This is the lower part of the womb at the top of the vagina.

It is often done if cervical screening (a smear test) finds abnormal cells in your cervix.

You might have been referred because of bleeding after sex, or bleeding when your cervix was touched at your cervical screening. 

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If you are worried about coming to your appointment

We understand that you might be anxious about your appointment, and could need extra support. Please call us on 020 7188 3691 and speak to one of the nurses.

Jo's Cervical Cancer Trust has cervical screening information

  • after sexual violence
  • for people with a learning disability
  • for trans men and/or non-binary people

While these resources are for smear tests, rather than colposcopy, it gives useful information about who to talk to and how to get support.

This website is run by a cancer charity, but this does not mean you have cancer.



Getting an abnormal cervical screening result

About 1 in 10 people have a test result which shows some abnormality.

An abnormal result means that changes have happened to the cells that were taken from your cervix.

In many cases the changes shown on your cervical screening test will return to normal on their own. Some of the changes might, in time, develop into cancer.

Macmillan has more information about cervical screening results.

The colposcopy shows the abnormal areas of the cervix and how abnormal the cells are. We might take a biopsy (small tissue sample) if we need to look at the cells in more detail.

We might offer you treatment to remove the cells. Treating the cells early means we can stop the abnormality from becoming cancer. 

Treatment is very simple and is over 90% effective.

Before your appointment

If you have your period

You should still come for your first colposcopy appointment even if you have your period.

We can still do your colposcopy examination at this time.

If you have your period when you are coming back for a follow-up appointment, please call us on 020 7188 3691 so that we can tell you if you should still attend your appointment.

If you are pregnant

If you are pregnant and have had an abnormal cervical screening result, we would still like to see you. The colposcopy examination is safe, but we may wait until you are more than 12 weeks pregnant.

Please bring your antenatal notes with you to your appointment. You should call us for further advice on 020 7188 3691.

If you need treatment to remove abnormal cells, we will wait until after you have had your baby. Please let us know your expected date of delivery when you come to see us.

The doctor or nurse looking after you might want to monitor the abnormal cells throughout your pregnancy. They will do this by asking you to come for another colposcopy while you are pregnant. This does not harm your baby.

You will be asked to come back to the colposcopy unit 12 weeks after the birth of your baby so that we can have another look at your cervix. We may also perform the treatment at this time.

If you have a coil (IUS/IUCD) fitted

You should still come for your appointment.

If you need treatment, the colposcopist will take it out when you have your treatment.

You should use an extra method of contraception (such as a condom) as well as the coil, or not have sex, for 7 days before your colposcopy appointment.

Having sex before the examination

You can still have sex while waiting for your colposcopy appointment.

If you have had abnormal cervical screening results, it is very important that you do not get pregnant until you have been assessed.

If you can get pregnant from sex, please use protection until you have been seen for your first appointment.

Where to go for your appointment

You will be seen in the Colposcopy Unit at Guy's Hospital. This is in the Gynaecology Outpatients Department (McNair Centre)

You should allow 2 hours from your appointment time. 

You will probably not be in the department for the whole 2 hours, but we would rather you do not feel rushed after your appointment.

Lots of people like to bring someone so that they have someone to talk to in the waiting room and take them home after the procedure if they are feeling unwell. It is unlikely that you’ll feel unwell, but it can happen.

Please remember to bring a sanitary pad with you to your appointment. 

It is important you eat and drink before you come to the clinic. Do not fast.

Who you will see at your appointment

As Guy’s and St Thomas’ is a teaching hospital, a medical or nursing professional may wish to observe the clinic on the day that you are there.

We will always ask for your permission before allowing observations to take place.

You can say no at any time, even if you have said yes before, and this will not affect your care in any way.

What happens at the colposcopy

Medical history

  • Before the examination, the colposcopist (the doctor or nurse performing the colposcopy) will ask you about your medical history.

Preparing for the examination

  • After the consultation with the colposcopist, you will be taken to the examination area where you will be asked to undress from the waist down (a loose skirt does not need to be removed).
  • The nurse who is looking after you and assisting the colposcopist will then help you to get into a comfortable position on the examination couch.

During the examination

  • The colposcopy examination usually takes 15 to 20 minutes.
  • An smooth, tube shaped tool called a speculum will be inserted into your vagina. This shows your cervix for the clinician to examine.
  • The colposcopist then uses the colposcope, which is a type of magnifying glass, to look closely at the cervix.
  • No part of the colposcope goes inside you. The colposcopist may then take another cervical screening test.
  • A liquid is then applied to the cervix to show the colposcopist any abnormal looking areas.

Taking tissue samples (biopsy)

  • They may then take one or two tiny samples of tissue (called biopsies) from your cervix.
  • Some people say that the biopsy is painless, while others say that it hurts slightly and gives them crampy, period-like pains. This crampy pain often only lasts for a few minutes.
  • You should not have sex or use a tampon for up to 7 days after the procedure.

After the examination

  • After the examination has finished, the speculum will be taken out and you will be asked to stay on the examination couch for a few minutes.
  • The assisting nurse will then tell you when you can get up and get dressed.
  • Once you are dressed you will go back to see the colposcopist who will talk to you about the examination.
  • You will then be able to go home or back to work.

Treatment and what happens if you need it

There are 2 treatments we can offer.

LLETZ

If you are treated in the colposcopy clinic, the most common treatment is a large loop excision of the transformation zone (LLETZ). This can also be called loop diathermy.

This type of treatment will be recommended when we believe it is the best way to get the most accurate diagnosis. It involves taking a larger biopsy of the cervix.

LLETZ happens under local anaesthetic. Medicine is injected into the cervix to numb it.

The abnormal cells are removed using a thin loop of wire, heated with an electric current. 

The whole procedure normally takes approximately 15 minutes.

The biopsy is then sent to the laboratory and a report is produced and sent to the colposcopist, who will then write to you with the result within 4 weeks.

Jo's Cervical Cancer Trust has more information on LLETZ

Cold coagulation

Occasionally, another type of treatment called cold coagulation is used.

This procedure also happens under local anaesthetic.

A probe is used to destroy abnormal cells using heat.

You will not get a written result from this procedure because there is no sample to send to the laboratory.

However, if we have taken a biopsy before performing the cold coagulation, you will get this result in writing.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to go ahead, you will be asked to sign a consent form.

This states that you agree to have the treatment and you understand what it involves.

If you would like more information about our consent process, please speak to a member of staff caring for you.

There are no alternatives to a colposcopy. This is the only way that we can investigate your cervix and any symptoms you have.

Risks with a colposcopy 

There are no risks associated with having a colposcopy.

Most people say that the examination is not painful. Some people say it feels uncomfortable.

This is usually because of the speculum that we use to keep the vaginal walls open.

Risks with a biopsy

Bleeding

Following a small biopsy we would expect you to have some light bleeding for up to 7 days.

If you have heavy bleeding, which is heavier than your normal period, or see clots of blood, go to your nearest Emergency Department (A&E). If you need advice, please call the colposcopy unit on 020 7188 3691.

Infection

If you have a vaginal discharge which has a bad smell, you might have an infection.

Please book an appointment with a GP, who might prescribe you antibiotics.

Pain

You might have some pain. Some people have no pain. Others say it hurts slightly and gives them crampy period-like pains.

This crampy pain often only lasts for a few minutes.

Getting your biopsy results

If you have had samples taken (biopsies, swabs and cervical cytology tests) these are sent to the laboratory where they will be checked.

A report will then be sent back to the colposcopist and they will write to you with the results within 4 weeks.

You will be told whether we want to see you again, or if we are discharging you back to your GP.

Follow-up appointments

Once we have the results back from any samples we have taken, we will write to you.

We will tell you if and when we need to see you again, or if we are discharging you back to the care of your GP.

If you are planning on going abroad soon after your appointment, please tell the colposcopist at your appointment, so we can plan your follow-up and getting your results.

Contact us

If you have any questions or concerns about having your colposcopy examination, please call the colposcopy unit on 020 7188 3691, Monday to Friday, 9am to 5pm.

If you do not attend your appointment, and then change your mind, you will have to wait for another appointment, which could take up to 8 weeks.

If you have any concerns, please:

  • contact or visit a GP
  • call NHS 111 or visit 111 online
  • go to your nearest Emergency Department (A&E)
  • call 999 if it is an emergency

 

 

Ref number: 3099/VER3 and 3089/VER3

Date published: January 2018 | Review date: January 2021

© 2021 Guy’s and St Thomas’ NHS Foundation Trust

A list of sources is available on request

 


Where next?

 Contact us

If you have any questions or concerns about having your colposcopy examination, please call the colposcopy unit

Phone 020 7188 3691

Monday to Friday, 9am to 5pm

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