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 stays outside your body and does not 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
  • You have persistent bleeding after sex or between periods
  • Your healthcare provider notices changes on your cervix

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.

Eating, drinking and the toilet

  • You can eat and drink normally before your appointment – no fasting is required.
  • You will be able to go to the toilet before the examination, which is encouraged so you’re as comfortable as possible.

Medications and pain relief

  • Take your usual medications as normal.
  • Some people choose to take simple pain relief (such as paracetamol or ibuprofen) about an hour beforehand. This is optional.

What to bring

  • A pad or panty liner (we also have these available)
  • Anything that helps you feel calmer while waiting

Important information if you are peri‑ and post‑menopausal

Hormonal changes around peri‑menopause and menopause can affect cervical cells and often make pelvic examinations more uncomfortable. Interpretation of smear and biopsy results can also be affected by these changes.

To improve comfort and the accuracy of your colposcopy, peri‑ and post‑menopausal patients are recommended to use vaginal oestrogen for at least two weeks prior to colposcopy and smears.

Vaginal oestrogen before colposcopy

Please use:

  • Ovestin® cream or an oestrogen ring vaginally EVERY NIGHT for TWO weeks before your colposcopy appointment
  • Do NOT use it the night immediately before your appointment

This helps to:

  • Reduce vaginal dryness and discomfort
  • Improve the accuracy of repeat cervical smears
  • Improve visualisation during colposcopy

In some situations, your colposcopy may be delayed until this course has been completed, as it can make a significant difference to both comfort and diagnostic accuracy.

If you have concerns about using vaginal oestrogen, please make contact before your appointment.

What happens during colposcopy

Getting ready

  • You’ll be shown to a private room and asked to undress from the waist down.
  • You’ll lie on an examination couch similar to a smear test, with your feet supported.

The examination

  • A speculum is gently inserted into the vagina, as for a smear test.
  • The colposcope remains outside the body and magnifies the cervix.
  • Special solutions are applied to the cervix to highlight abnormal cells. These may feel cold or mildly sting for a few seconds.
A patient and doctor performing colposcopy

Biopsies

  • If an area looks abnormal, one or more very small biopsies may be taken.
  • Biopsies are usually only a few millimetres in size.
  • You may feel a brief pinch or period‑like cramp.

Most people describe this as uncomfortable rather than painful. Local anaesthetic can be used in some situations.

The examination usually takes 5-10 minutes.

After colposcopy

Recovery and comfort

  • You’ll have time to sit or lie down afterwards.
  • We have a comfortable area where you can relax, and you’re very welcome to have a cup of tea or coffee before heading home.
  • Most people feel well enough to leave shortly afterwards.

Bleeding and discharge

  • Light bleeding or spotting is common for a few days.
  • You may notice dark or coffee‑ground‑like discharge if a iodine-based solution was used – this is normal.
  • Please use pads rather than tampons for 5 days to avoid infection and disruption to healing.

Pain

  • Mild cramping is common and usually settles within 24 hours.
  • Simple pain relief is usually sufficient if needed.

Activity and sex

  • You can return to normal daily activities straight away.
  • Avoid vaginal sex, tampons and menstrual cups for 5 days.

When to call the clinic

Contact the 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.
  • I 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.
  • Done under local or general 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

Fees and insurance

  • Colposcopy and biopsies are often covered by Southern Cross, nib, and other private insurers, depending on your policy.
  • We recommend checking with your insurer to confirm cover if you have exclusions related to gynaecology.
  • If you are self‑funding, your first visit, colposcopy, biopsies, reporting, and discusion of results are all included in a fixed fee (see Pricing).
  • New Zealand citizens and permanent residents are generally eligible for colposcopy within the public system. Please discuss this with your GP.

Anxiety, trauma, or vaginismus

If you feel anxious, have vaginismus, or have had a difficult or traumatic experience with examinations in the past, please let me know – either when booking or at the start of your appointment.

We can:

  • Go slowly and work at your pace
  • Explain each step before it happens (or keep talking to a minimum if you prefer)
  • Use smaller speculums or alternative positioning
  • Take breaks, or stop completely at any time
  • Avoid biopsies if they are not essential on the day

You remain in control throughout the appointment. Your consent is checked at every stage, and you can change your mind at any time.

Dr Sam Holford

Abnormal smear?

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

Book an appointment

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.

Trusted resources

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