COLPOSCOPY

A colposcopy is a medical procedure performed by a gynaecologist. It is part of the National Cervical Screening Program, which is designed to prevent cervical cancer by detecting and treating precancerous changes. A colposcope (a magnifying tool) is used to closely examine a woman's cervix, vagina, and vulva for any signs of abnormality or disease, such as cervical cancer or precancerous changes.

A colposcopy is recommended for women with abnormal cervical screening test results, if an unusual appearance is noted during an examination or if a woman is experiencing abnormal bleeding (postmenopausal bleeding, bleeding between periods or bleeding after intercourse) or pain.

A colposcopy is typically completed within ten to fifteen minutes. It involves:

• Positioning - During a colposcopy, the woman’s legs are placed in leg supports. These can be adjusted to minimise discomfort.
• General examination - The vulval area is usually inspected first
• Speculum- A speculum is inserted to visalise the cervix
• Use of the colposcope - This device provides a magnified view of the cervix but does not touch the woman
• Application of acetic acid (vinegar) and/or Lugol’s iodine - These solutions can help highlight abnormal areas
• Detailed inspection - The area will be re-examined to inspect for any abnormalities or tissue changes
• Biopsy - This is only performed if needed
• Medication- Silver nitrate or Monsel’s paste may be utilised to stop the bleeding from the biopsy site

During a colposcopy, the woman’s legs are placed in leg supports. These can be adjusted to minimise discomfort. The colposcopy examination can be uncomfortable but should not be painful. If a biopsy is required, this may cause menstrual cramping, which typically resolves within a few hours. Some women require paracetamol and/or ibuprofen.

It is important to disclose any prior negative experiences prior to the procedure so that additional options for pain relief can be discussed as appropriate. These may include methoxyflurane or organising the procedure under general anaesthetic.

A colposcopy can be performed even while taking medications. If a biopsy is required, women taking blood thinners may experience slightly increased bleeding.

Colposcopy is safe in pregnancy, however biopsies are typically avoided unless significant abnormalities are noted.

Most women can return to work or normal activities immediately after their colposcopy.

Some women experience mild cramping, especially if a biopsy is required. This typically resolves within a few hours however paracetamol and/or ibuprofen may be required. Small amounts of bleeding may be present for a few days, especially if a biopsy has been taken. A silver, black or brown discharge may also be present from medication used at the time of the procedure.

If a biopsy is performed, it is not recommended to use tampons, engage in intercourse, swim or take baths/use spas for up to seven days or if bleeding is ongoing.

The results from biopsies will typically be available within two weeks and this will guide decisions regarding the need for further treatment or follow up.

The following resources may provide further information. Please note that online information can change and we accept no responsibility for the accuracy and currency of the information provided on external websites.

• A Guide to Understanding your Cervical Screening Test Results
• RANZCOG Cervical Screening in Australia