How Painful Is Colposcopy?

Reviewed on 11/5/2020

Colposcopy is a simple procedure that takes less than 10 minutes.
Colposcopy is a simple procedure that takes less than 10 minutes.

The procedure is typically not painful. It does not require local or regional anesthesia. Slight discomfort may be felt when a speculum is inserted into the vagina, which can be minimized by deep breathing during the procedure. You may feel a sting when the cervix is washed with a vinegar solution, but that lasts less than a minute.

If the doctor takes a biopsy from the area, you will feel a momentary sharp pain, such as a period cramp. However, that’s all there is. You must avoid vaginal intercourse for 48 hours after cervical biopsies to minimize trauma to the cervix, which may result in bleeding.

What is the procedure for colposcopy?

Colposcopy is a simple procedure that takes less than 10 minutes. It is done in an outpatient setting by your doctor.

Before the procedure:

  • You must abstain from sexual intercourse, vaginal douching, and inserting tampons 48 hours prior to the procedure.
  • Tell your doctor if you are on blood thinners, have any bleeding disorder, or are pregnant.

During the procedure:

You will be made to undress and lie down on the table, and your legs will be separated. The doctor will examine your private parts for any warts, ulcers, or masses over the vulva. They will ask you to take deep breaths as they insert a lubricated sterile device called a speculum inside the vagina. The insides and corners of the vagina are checked for any abnormal growths. The doctor will adjust the speculum. Next, they will use a colposcope to take a look at your cervix. A colposcope is an instrument that looks like binoculars on a stand. It has a light at one end. The colposcope does not go inside you. The doctor will look at the cervix with the colposcope. Then they will paint the cervix with a vinegar-like solution using a cotton swab. After 30-60 seconds, the solution highlights any abnormal areas over the cervix that may be cancerous. Sometimes, the doctor may also apply Lugol’s iodine or Schiller’s solution to the cervix. The cancerous areas are not stained by iodine.

If nothing abnormal is seen, the procedure will be terminated. If the doctor finds any abnormal areas, they will take a piece of tissue (biopsy) from that area with special instruments and send it for lab examination under a microscope.

Who should not undergo colposcopy?

Although the procedure is largely safe, some people may have a few complications during the procedure. Individuals who may not be suitable for the tests include those with the following conditions:

  • Cervicitis: Any active infection can cause the cells to swell and give false-positive results. They can also make the procedure more painful and increase the risk of spreading the infection deeper. Hence, these must be treated completely before the procedure is undertaken.
  • Bleeding disorders or patients on blood thinners: You must always tell your doctor if you are taking any blood thinners. They may increase the risk of bleeding after the procedure and must be discontinued on the day of the procedure with the advice of your doctor. You must also tell your doctor if you have any bleeding disorder.
  • Pregnancy: A cervix in a pregnant woman tends to bleed heavily on the slightest injury. Additionally, pregnancy changes the cell structure of the cervix making the identification of abnormal cells difficult. Hence, colposcopy must be avoided in pregnancy.
  • Immunosuppression: Patients who have severely compromised immunity and very low white blood levels count are at risk of serious infections during this procedure. This includes patients with acquired immunodeficiency syndrome (AIDS), post-transplant patients, and those on chemotherapy. Colposcopy should be avoided in these patients in most circumstances.

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References
https://www.uptodate.com/contents/colposcopy#H2

https://www.mayoclinic.org/tests-procedures/colposcopy/about/pac-20385036

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