Having a Colposcopy

This information sheet answers some of the questions you may have about having a colposcopy. It explains the risks and the benefits of the procedure and what you can expect when you come to hospital. If you have any other questions or concerns, please do not hesitate to speak to the doctors or nurses at your appointment.

The colposcopy unit is situated in the East Wing, Entrance 1 – in the Maumbury Outpatient Department. Clinics are held in Dorset County Hospital and Blandford Community Hospital.

The information in this leaflet is intended to be a general guide to the colposcopy service, so not all the information may apply to you. You will be given an opportunity to talk to the colposcopist (specialist doctor or nurse) before having your colposcopy examination. You can also get further information and clarification from your GP or practice nurse.

Consent

We must by law obtain your written or verbal consent to any procedures beforehand. Staff will explain all the risks and benefits before they ask you to consent. If you are unsure about any aspect of the treatment proposed, please do not hesitate to ask to speak with a senior member of staff.

What is a colposcopy?

A colposcopy is an examination of the cervix (neck of the womb) using a special microscope (a colposcope) that allows the colposcopist to look more closely at your cervix than during a smear test.

During this examination the colposcopist may also perform the following procedures to diagnose or treat problems:

• taking of cervical biopsies (very small samples of tissue)
• cervical smear
• removal of small part of cervix using LLETZ (large loop excision of the transformation zone).

Why do I need a colposcopy?

There are many reasons why you may have been referred to the colposcopy unit. You might have had an abnormal smear test, or have an unusual looking cervix, or inadequate smears.

Does it mean that I have cancer?

Women who have regular cervical smears are very unlikely to get cervical cancer.  A colposcopy is done to try and detect early abnormal changes of the cervix and to monitor these changes until they return to normal. If more moderate or severe changes are detected, then we will advise you to have a LLETZ procedure to remove the area of the cervix with the abnormality in case it develops into cancer in the future.

What can I and can’t I do before the examination?

• If you have an intrauterine device or coil in place, please use condoms for one week prior to your appointment if you have sexual intercourse as it may be necessary to remove your coil if you need treatment to your cervix, although not everyone needs treatment.
• You will be asked when your last period started so, please keep a record of this date.
• Please do not have sexual intercourse for 24 hours before your appointment.
• If you have any bleeding problems, a heart condition, allergies or you are on medication please bring this information and your tablets/inhalers with you.
• You are welcome to bring your partner or a friend with you.
• There is no need to fast – please eat and drink normally.

It is safe to perform a colposcopy when you are pregnant, however we do not normally take any biopsies at this time.

Will I be treated on my first visit?

In most cases a decision to do a treatment on your first colposcopy visit depends on your smear result and the findings of the colposcopy examination. If there is strong evidence of an area of moderate to severe abnormality at your first colposcopy examination, you may be offered treatment, which is called a LLETZ. In cases where the examination shows less evidence of an abnormality, the colposcopist may repeat the cervical smear and/or do a cervical biopsy before the decision is made to do a treatment at a future visit.

What happens before a colposcopy examination?

The colposcopist will ask you questions about your medical history; answer any questions you may have and will explain the risks and benefits before proceeding with the colposcopy examination.

Before taking a cervical biopsy or doing a treatment (LLETZ or cautery to cervix). You will be asked if you are happy to consent for the colposcopist to go ahead with the procedure.

Please note: Whilst you are undergoing colposcopy you will have two nurses in the procedure room with you, to support and to act as your advocate during the procedure.

There is a small changing area where you can remove your lower garments; you will be given a sheet to cover yourself.

What happens during the examination?

Once you are comfortable on the examination couch a colposcopist will gently insert an instrument into your vagina called a vaginal speculum (the same instrument used for a smear test). This holds open the vaginal walls and allows a good view of the cervix. The colposcopist will look at the cervix through the colposcope (which does not touch you). There is a monitor (television screen) connected to the colposcope so you can watch the examination if you wish. We may take a picture(s) of your cervix.  Another smear may be taken before a liquid is put on the cervix to help find any abnormal area; this liquid may sting a little. The colposcopy examination usually takes about 15 to 20 minutes.

Cervical biopsies may be taken from the cervix to be checked later in the laboratory. Many women say that having a biopsy taken is uncomfortable but not painful.

What care do I need to take afterwards?

• You should not have sexual intercourse or use tampons or a menstrual cup for 7 days. This is to reduce the risk of infection.
• You may experience some pain or bleeding, but it usually goes away within a day.
• If the bleeding or the pain does not go away after a few days, you need to contact your GP.
• You may notice a slight silvery colour to your vaginal discharge if silver nitrate sticks are used to cauterise any bleeding.
• There is a very small risk that the biopsy site may become infected. If you develop a smelly discharge or high temperature you must contact your GP immediately.

What will the biopsy show?

• The medical term used to describe cell changes confirmed by a biopsy is Cervical Intra-epithelial Neoplasia, (CIN). The degree of change is described on a scale of 1 to 3 according to how many of the cells are affected.
• CIN 1- Means that only a third of the cells in the affected area are abnormal. These may be left to return to normal or may be treated.
• CIN 2- Means that up to two-thirds of the cells in the affected area are abnormal, treatment will usually be needed to return the cells to normal.
• CIN 3 – Means that all the cells in the affected area are abnormal.  Treatment will be needed to return the cells to normal.

What is Human Papilloma Virus (HPV)

HPV is an extremely common virus; anybody who has ever been sexually active is at risk of contracting HPV. There are more than 80 human papilloma viruses, a few of which are associated with and increased risk of developing cervical cancer. 

There’s no treatment for the HPV infection. Most HPV infections do not cause any problems and are cleared by your body within two years.

If I need treatment, how will it be done?

A local anaesthetic is then injected into your cervix, where the abnormal cells changes are, this will become numb, you may feel slight discomfort from the insertion of the speculum and some pain when the local anaesthetic is administered. A thin wire loop, which an electric current is running, is then used to remove the area of the cervix where there are cell changes and then cauterised at the same time. This should take around twenty minutes in total. You should not feel any pain during the excision.

Advice following treatment

• We recommend that you do not have sexual intercourse or use tampons or a menstrual cup for a month after treatment.
• We recommend that you do not swim or bath for two weeks, again to avoid infection. Avoid vigorous exercise for up to four weeks as this can cause extra bleeding.
• We also recommend that you have a couple of days off work if it involves heavy lifting.

Who do I contact for queries or advice?

Telephone the colposcopy office directly: 01305 255729, Monday to Friday (8am to 5pm).

If you have any queries about your colposcopy visit, treatment or results please contact the colposcopy nurses on 01305 254239, (Mon-Fri (8am to 5pm) leaving your name, date of birth, hospital number and a brief message describing your query. A nurse will call you back as soon as possible from the hospital phone which will appear as an unknown number.   

Please note, these telephone numbers are monitored during normal office hours. 

It may not be possible to return your call the same day.

If you have a serious or urgent health concern then contact your GP, NHS 111 or, in an emergency, 999

If you need this information in large print, easy read, please email patientexperience@dchft.nhs.uk

Useful websites

NHS cervical screening (CSP) programme: www.cancerscreening.nhs.uk

British Society for Colposcopy and Cervical Pathology: www.bsccp.org.uk

NHS: www.nhs.uk/conditions/human-papilloma-virus-hpv/

Contact numbers

We hope that you have found this information useful. If you have any questions or are worried about anything, please speak to the following Dorset County Hospital staff:

Nurse specialist: 01305 254621

Department: 01305 255729 or 01305 254239

About this leaflet

Authors: Mrs Jennifer Potter, Lead Colposcopy
Written: March 2025
Approved: March 2025
Review date: March 2028
Edition: 1

If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk