When a smear test or HPV test comes back abnormal, the next step is often an appointment for a colposcopy. The word sounds more alarming than the procedure is. A colposcopy is a closer look at the cervix using a magnifying instrument. It is not surgery, and being referred for one does not mean cancer has been found.
The examination is much like a routine internal check. You lie on the examination couch and a speculum is inserted, as it is for a smear. The colposcope itself stays outside the body — it is a magnifier on a stand, not something that goes inside. A mild solution is applied to the cervix, which makes any area of cell change show up more clearly. Most women describe a cool or slightly stinging sensation as it is applied. The whole appointment usually takes ten to fifteen minutes.
If the doctor sees an area worth examining further, a small tissue sample may be taken. This is the part most women worry about. It is usually felt as a brief pinch or a period-like cramp rather than sharp or lasting pain. Light spotting or dark discharge for a few days afterwards is expected and not a cause for concern.
Biopsy results usually take one to two weeks. Most come back showing low or moderate cell changes, many of which resolve on their own without treatment. Your doctor uses that result to decide with you whether to monitor or to treat. The waiting period is often the hardest part, and knowing in advance that most results are not cancer makes that wait easier.
See a doctor by keeping the colposcopy appointment even if you feel perfectly well, and contact the clinic sooner if afterwards you have bleeding heavier than a normal period, a fever, or lower abdominal pain that keeps worsening.