What happens at colposcopy?

Colposcopy is an examination to take a closer look at your cervix. It is usually done if cervical screening (a smear test) finds cell changes (abnormal cells).

Read more about what colposcopy is and why it is done > 

You may feel nervous about going to colposcopy, especially if you’re not sure what to expect. The information on this page talks through each step of the appointment, as well as giving some tips that may make your experience better. 

Remember, if you need more support we are here before and after your appointment. Whether you just want to talk things through or have a specific question, one of our support services may be able to help.

Get support > 

Your colposcopy appointment

A colposcopy appointment usually takes between 15 and 30 minutes.

1. At the start of the appointment, your colposcopist invites you into an examination room. They explain why you have been invited and what will happen during the appointment. You can use this time to ask any questions.
2. Your colposcopist gives you a private space to undress from the waist down and ask you to lie on an examination bed. Some colposcopy clinics have an extra screen next to the bed, in case you want to watch the examination. 
3. Like during cervical screening, your colposcopist gently puts a new, clean speculum into your vagina. A speculum is usually a plastic cylinder with a round end – sometimes a metal speculum is used. 
4. Your colposcopist uses a microscope with a light at the end to have a detailed look at your cervix. This is called a colposcope. The microscope stays outside your body.

Someone having colposcopy

Liquid tests

Your colposcopist usually puts some liquid on your cervix. This helps show any areas where there are cell changes. 

Most colposcopists use a combination of acetic acid and Schiller’s iodine tests: 

• Acetic acid is a very weak acidic liquid. It is sometimes called dilute vinegar. The colposcopist gently applies it to your cervix using a cotton wool ball or with a spray. It shows cell changes by turning them white.
• Schiller's iodine test uses an iodine solution. It stains normal cervical tissue dark brown. Cell changes may not stain, so the colposcopist can see them. 

Taking a biopsy

Your colposcopist may take a sample of tissue from your cervix. This is sometimes called a punch biopsy. 

A biopsy only takes a small sample of tissue, so most people don’t have local anaesthetic. If you would like local anaesthetic, ask your colposcopist.

Your colposcopist will explain the biopsy before they take it. Some people find it uncomfortable, but it should not be painful. Remember, you are in control. If it hurts, ask your colposcopist to stop. 

Your colposcopist will take between 1 to 3 biopsies to make sure they have enough tissue from different areas of the cervix. They send the sample of tissue to a laboratory for testing.

Read more about colposcopy results > 

Tips to make colposcopy better for you

Everyone’s experience is different, but knowing these tips before you go to colposcopy may help you feel more comfortable:

• You can ask to see a colposcopist of a particular gender – for example, a female colposcopist. 
• You may want to take someone you trust with you. It could be a friend, family member, partner or someone else. They can be in the waiting room or examination room with you to offer support. They may also be able to speak on your behalf about any worries. 
• If you feel able, it may help to talk to your colposcopist or colposcopy nurse. If it is your first colposcopy, you feel worried, you have had a bad experience before, or you have experienced anything that makes the examination hard for you, telling your colposcopist means they can try to give you the right support. If you don’t feel comfortable saying something, try writing it down.
• If you feel comfortable doing so, wear a skirt or dress. You can keep this on during the examination, which may help you feel more covered. You do get a paper sheet to cover yourself, but check if you can bring a spare shawl or blanket too.
• You can ask for a smaller speculum. Speculums come in different sizes, so if you find the standard size too uncomfortable, you can ask to try another size.
• You may want to ask to lie in a different position. Lying on your back may feel uncomfortable, so you can ask to lie on your left hand side with your knees bent (left lateral position). The examination bed usually moves and tilts so you can find the most comfortable position. 
• If you have gone through or are going through the menopause, you may want to let your GP or practice nurse know before colposcopy. As we get older, the opening of the vagina and vaginal walls become smaller and less able to stretch, which can make the test more uncomfortable. You can ask your GP or practice nurse to give (prescribe) you a vaginal oestrogen cream or pessary about 2 to 4 weeks before your appointment, which may help. 

At the end of your colposcopy appointment

After the examination, your colposcopist will:

• check you feel okay 
• ask whether you have any questions
• let you know when you will get your results.

Sometimes, your colposcopist can tell you if they found anything straight away, but sometimes they need to confirm the result from your biopsy. 

Read about getting colposcopy results > 

If cell changes are treated during the same appointment

Sometimes, your colposcopist can tell that cell changes need treatment during your first colposcopy appointment. If this happens, your colposcopist will explain what the treatment is and why they want to do it, to make sure you are happy with their suggestion. If you are, they will remove areas where there are cell changes.

The most common treatment is a large loop excision of the transformation zone (LLETZ). This removes a small area of the cervix where the cell changes are. You will have a local anaesthetic before LLETZ, which numbs the area being treated. 

Read more about treatment for cell changes > 

More information about your colposcopy appointment

When you are invited for colposcopy, you should be sent a leaflet explaining what will happen at your appointment. If you haven’t been sent a leaflet, we hope the information on this page has helped. But if you feel you have more questions:

• contact the hospital where you are having your appointment and ask for a leaflet
• call our Helpline on 0808 802 8000, so our trained volunteers can talk you through colposcopy >
• visit our online Forum, where you can get more support from others who have been for colposcopy >

We have more information about:

• What is colposcopy and why have I been invited? >
• Getting your colposcopy results > 

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