What is a colposcopy test done for?

Written by: Mr Paul Carter
Published: | Updated: 27/10/2023
Edited by: Emily Lawrenson

Mr Paul Carter is a highly-experienced consultant gynaecologist, consulting at several prestigious clinics in the London area. He also holds the title of Lead Clinician for Colposcopy & Vulval Disorders, and runs a specialist clinic for the treatment of vulval disorders offering expert treatment across a multi-disciplinary team. As an expert in colposcopy, Mr Carter sees over 4000 women a year in the specialised colposcopy unit. Before colposcopy, many women wonder why the test is performed, and how it is done. Here, Mr Carter answers some of the most frequently asked questions surrounding the colposcopy procedure, and tells us what you should keep in mind before going to your appointment.

What is a colposcopy?

Colposcopy is a procedure which allows the cervix (the neck of the womb) to be examined, using a device called a colposcope, which illuminates and magnifies the area. The procedure is actually similar to that of a cervical smear, however it takes longer, as the colposcopy looks for any abnormalities through the application of various solutions to the cervix. Colposcopes can also be used to examine the vagina and vulva.

Why is a colposcopy performed?

Colposcopy is most commonly performed after a cervical smear which has shown some presence of abnormal cells. A cervical smear is a routine procedure offered to women between 25 and 65 years of age, during which a cell sample is taken from the cervix, and is later examined, in order to detect any changes in the cervix and if any abnormal cells are present.

Colposcopy may also be performed if smear results are consistently inadequate, or for other reasons, such as bleeding between periods (inter-menstrual), bleeding experienced after sexual intercourse, or an abnormal or unusual appearance of the cervix.

If the investigation is for abnormal cells, they are generally regarded as being pre-cancerous, which means if they are left untreated, they could become cancerous in the future. However, if the abnormal cells are found at this early stage, the chances of cancer actually developing are very small indeed. They may develop, but usually over a number of years, so they can be treated quickly and easily. Therefore it is important for women to be reassured that there is little need to worry, and in 90% of cases, the pre-cancerous condition is eliminated.  

How is a colposcopy performed?

A colposcopy examination is very similar to that of a cervical smear test. A colposcopist inserts a speculum into the vagina, which dilates it and allows for examination both in the vagina and cervix.

Usually when the colposcopy is performed because of abnormal smear results, the colposcopist will apply a small amount of acetic acid (vinegar) to the cervix using cotton wool. This solution allows them to see any changes in the epithelium, the skin covering the cervix, more clearly. This can be a little uncomfortable, as it may sting, but it should not be more so than a regular smear test.

Occasionally, the colposcopist may wish to take a biopsy (a small sample of tissue) from the cervix, which is usually the size of a grape pip. When the biopsy is taken, it may cause a small amount of bleeding, but this can be controlled by applying silver nitrate to the affected area. This can also cause slight stinging. Once the bleeding has stopped, the examination is over. The biopsy is then sent to be tested and analysed by the pathologist. The procedure usually takes about 15 minutes, so it is not long.

When can I expect the results?

During the test itself, the colposcopist may discuss any changes they might see with you. If you have a biopsy taken, lab tests usually take several days to come back. The doctor will advise you on how long you have to wait.

Before the test:

  • avoid having sexual intercourse the day before your colposcopy
  • do not put anything into your vagina (tampons, medicines, creams) in the 24 hours leading up to the test
  • schedule the test for when you are not due on your period
  • some prefer to wear a panty-liner as they may experience slight bleeding or discharge after the colposcopy
  • contact the clinic if you are pregnant – colposcopy is safe during pregnancy, but biopsy and treatment are usually delayed until after birth 

By Mr Paul Carter
Obstetrics & gynaecology

Mr Paul Carter is an experienced consultant gynaecologist with over 20 years' experience, based in London. also consults at several prestigious clinics in the London area. He possesses expert knowledge in the field of gynaecology and takes a specialist interest in areas such as colposcopyvulval disorders, complex benign surgery, and oncology. He holds specialised private clinics at The Parkside Hospital and the Portland Hospital, alongside his NHS practice at St George’s Hospital.  
Mr Carter commenced his medical studies at St Bartholomew’s Hospital London graduating in 1998. Following this, he undertook specialist training at St Bartholomew's, Queen Charlotte's, Royal Surrey County and Guy's Hospitals. He became a fellow of the Royal College of Surgeons and the Royal College of Gynaecologists in 1991 and 1992 respectively.

Mr Carter takes an active role at the forefront of gynaecology at St George’s Hospital. He currently serves as head cancer surgeon and lead clinician for colposcopy & vulval disorders at St George's Hospital. He leads a specialist clinic for vulval disorders, which offers expert treatment from a multi-disciplinary team, including a dermatologist and a genito-urinary medicine physician. His colposcopy unit sees over 4,000 women per year, and he runs a weekly clinic for suspected cancers of the lower genital tract. Having trained as a cancer surgeon, he is also skilled in taking on surgery for the more complex cases of benign disease. 

Alongside the aforementioned ares, Mr Carter aids women experiencing childbirth, eptopic and high-risk pregnancy, and is skilled at performing procedures such as vulvectomy and hysterectomy.

In addition to his medical practice, Mr Carter enjoys sharing his knowledge with future gynaecologists. He currently holds a senior position at St George’s, University of London as the head of anatomical science and also lectures extensively on human anatomy. Furthermore, he offers teaching sessions at St George's Hospital Medical School Dissection Room and is an examiner for the University of London.
He is a member of several medical associations, including the British Society for Colposcopy & Cervical Pathology, the British Gynaecological Cancer Society and the British Society for the Study of Vulval Disorders.

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