Colposcope in a medical examination room

Colposcopy

Colposcopy is a specialist procedure used to look closely at your cervix (the neck of the womb). It helps check for any changes in the cells that might need treatment, and is an important step in preventing cervical cancer.

About colposcopy

Being referred for colposcopy does not mean you have cancer.

  • Even if abnormal cells are found, most are not cancer.
  • The purpose of colposcopy is to check for early changes so they can be treated before they develop into anything serious.

During the procedure, the cervix is viewed using a microscope called a colposcope. The colposcope looks like a pair of binoculars on a stand — it doesn’t touch you. It magnifies the cervix so that cell changes can be seen more clearly.

A colposcopy usually takes about 15 minutes, but expect to be at the clinic for around 30 minutes.

Sometimes a small sample of tissue (biopsy) is taken. This only takes a couple of seconds and may feel briefly uncomfortable, like a cramp or pinch.

Why you may need colposcopy

You may be referred for colposcopy if:

  • Your cervical screening test shows an abnormal result
  • Your smear detects HPV or abnormal cells
  • Your healthcare provider notices changes on your cervix, or you have ongoing symptoms

It’s important to attend even if you feel well and have no symptoms. Abnormal cells often cause no symptoms but may develop into cancer if left untreated.

Preparing for your appointment

  • Tell the clinic if you have any special needs, or if you are pregnant.
    • Colposcopy is safe in pregnancy.
    • Biopsies or treatment are usually avoided during pregnancy unless absolutely necessary.
  • You are welcome to bring a support person with you — a partner, friend, or whānau member.
  • If your appointment will fall during your period, that’s okay. You may wish to reschedule so the cervix can be seen clearly, but this isn’t necessary.

What happens during colposcopy

  1. You will be asked focused questions about your health and periods.
  2. The procedure is explained and any questions answered.
  3. You change in a private space.
  4. You lie on a bed with leg supports, which makes it easier to see the cervix.
  5. A speculum (the same instrument used for a smear test) is gently placed into the vagina.
  6. The colposcope is positioned just outside, magnifying the cervix. It does not touch you.
  7. A liquid is applied to the cervix to highlight any abnormal cells.
  8. If needed, a small biopsy may be taken. This can cause brief pain.
  9. I will explain what I saw and what will happen next.

After colposcopy

  • You may feel some cramping, similar to period pain.
  • If you had a biopsy, you might notice some light bleeding or reddish discharge for a few days (up to a week).

While healing after a biopsy

To help the cervix heal, until the bleeding stops (around one week):

  • Use sanitary pads (not tampons)
  • Avoid sex, swimming, spa pools and baths
  • Stick to showers

When to call the clinic

Phone your colposcopy clinic if:

  • Bleeding is heavier than a period
  • Bleeding continues longer than a week
  • Pain is not improving

Getting your results

  • Biopsy samples are sent to the laboratory.
  • Results usually take up to a month.
  • The clinic will explain your results once they’re ready, and your GP or smear-taker will also receive a copy.
  • Your results are also recorded in the National Cervical Screening Programme Register, which helps keep track of your follow-up care.

Sometimes a repeat colposcopy may be needed if results are not conclusive.

Understanding your results

Results may show:

  • Normal cells — no further treatment is needed
  • HPV present but no abnormal cells — follow-up cervical screening or colposcopy may be recommended
  • Low-grade changes — these often clear naturally, but follow-up or treatment may be advised
  • High-grade changes — treatment is recommended to remove the abnormal area

Treatment if needed

If abnormal cells are found, I will discuss the best treatment options:

LLETZ (Large Loop Excision of the Transformation Zone)

  • The most common treatment.
  • A fine heated wire loop removes the affected area.
  • Usually done under local anaesthetic.
  • Quick recovery, with mild bleeding or discharge for 1–2 weeks.

Cone biopsy

  • Sometimes a larger or deeper piece of tissue needs to be removed.
  • This is usually done in hospital under general anaesthetic.
  • Recommended if there are higher-grade or unclear changes, or concern about early cancer.

Colposcopy of the vulva

Colposcopy is not only used for the cervix. It can also be used to examine the vulva if you have:

  • Persistent itching
  • Visible skin changes
  • Concerns about precancerous or cancerous conditions

A biopsy can be taken under local anaesthetic if needed. This can help diagnose conditions like:

  • Lichen sclerosus
  • VIN (vulval intraepithelial neoplasia)
  • Vulval cancer
Dr Sam Holford

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In Auckland, I offer expert colposcopy to investigate & provide clear answers. I'll guide you through with gentle care & support.

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FAQs

Is colposcopy painful?
Most people experience only mild discomfort, similar to a period cramp, especially if a small tissue sample (biopsy) is taken. The procedure itself is not usually painful. I will talk you through every step and ensure you are as comfortable as possible.
Does a referral for colposcopy mean I have cancer?
Not at all. It's very important to know that a referral for colposcopy is a preventative measure. It means your cervical screening test showed some cell changes or the presence of HPV that needs a closer look. Most of the time, these changes are not cancer and can be easily treated to prevent any future problems.
Can I bring a support person with me?
Yes, absolutely. You are welcome to bring a partner, friend, or whānau member to support you during your appointment. Having someone with you can make the experience much more comfortable.
How long will it take to get my results?
If a biopsy is taken, the results are typically available within two to four weeks. I will contact you to explain the results clearly and discuss any next steps that might be needed.
What happens if the colposcopy finds abnormal cells?
If high-grade abnormal cells are found, a simple treatment called LLETZ is usually recommended to remove them. This is a very effective procedure that prevents the cells from developing into cancer. We will discuss all findings and treatment options with you in detail.

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Please note: This information is general in nature and not a substitute for medical advice tailored to your specific situation.