Colposcopy: what it is, when it is indicated and how it is performed

The colposcopy is an examination of the cervix (also called the cervix), the vagina, and, if necessary, the vulva. It is done with an optical instrument—the colposcope– that does not enter on the body and allows you to observe the area with magnification and good lighting. It is usually indicated after abnormal examinations, altered cytology either HPV positive/persistentbecause it helps to locate and assess injuries which, for the most part, are low grade and they can be controlled. On other occasions, the specialist takes small biopsies to confirm the diagnosis and decide the most appropriate treatment.

This content has been prepared with the collaboration of Dr. Concepción de Lucas Ortega, gynecologist on the ViaCare Centro Médico team, to whom we thank her valuable contribution and professional review.

What exactly is a colposcopy?

Colposcopy is a outpatient testquickly and generally well toleratedwhich is done in consultation. Allows:

• Identify suspicious areas in the cervix after applying reagents (usually acetic acid and, sometimes, Lugol’s solution).
• Select accurately the points where it is convenient take biopsyif histological confirmation is needed.
• Follow up after previous treatment of cervical lesions.

It’s not a surgery, does not require entry and, in most cases, no anesthesia either.

When is a colposcopy usually recommended?

The decision to indicate a colposcopy is clinical and personalized, but more It is frequently recommended before:

• abnormal cytology (e.g., ASC-US, LSIL, HSIL) or indeterminate findings.
• Positive HPV testespecially if the virus persists over time or belongs to types of high risk.
• Disagreements between results (eg, cytology and HPV do not match) that require direct evaluation of the cervix.
• Bleeding after relationshipsvisible lesions in the cervix or vagina, or changes on examination.
• Follow-up after treating cervical lesions (healing/recurrence control).
• injuries in vulva or vagina that require extension of the study (vulvoscopy/vaginoscopy within the same procedure).

The objective is not to “operate”, but see better and, if applicable, confirm with biopsy.

How is it done step by step?

The test usually lasts 10–20 minutes. The usual process is:

• Gynecological position and placement of a speculum to visualize the cervix.
• Observation with the colposcopewhich is located outside the body (does not touch the patient).
• Application of acetic acid and, sometimes, Lugolwhich highlight changes in the epithelium.
• Systematic evaluation of the cervix (and, if applicable, the vagina and vulva) identifying patterns.
• Targeted biopsy only if there are suggestive areas; The sample is small and is sent to Pathological Anatomy.
• Control of the local bleeding if a biopsy is taken (usually minimal) and recommendations for home.

Hurts? Is anesthesia used?

• No biopsythe sensation is similar to a cytology: mild discomfort through the speculum.
• With biopsyit can be noticed puncture or pressure of seconds. It is normal a slight staining for 24–48 hours. It does not usually require anesthesia; In selected cases, local anesthesia can be used.

Preparation before the test

Simple preparation improves the comfort and quality of the examination:

• Avoid sexual intercourse, tampons and douching during 24–48 hours previous.
• If possible, don’t program it in days of heavy menstrual bleeding.
• Let me know if you are pregnant or take anticoagulants/antiplatelets.
• Carry previous reports (cytologies, HPV test, treatments).
• It is useful to go with a compress in case there is subsequent staining.

Results: how they are interpreted

After the colposcopy, your gynecologist will explain the main finding and the plan:

• Normal scan: no relevant injuries; Follow-up according to guides is usually enough.
• Low grade changes: many times they return spontaneously; periodic control is scheduled.
• High grade changes: require confirmation with biopsy and, if confirmed, specific treatment to prevent progression.
• Biopsy: is the proof that confirms the diagnosis and guides management (observation, outpatient treatment, etc.).

Biopsy result timelines vary by center; The patient is informed how and when they will receive it.

Risks and side effects

Colposcopy is a test safe. Adverse effects are rare and usually mild:

• Discomfort/belly ruler type for hours.
• Stained vaginal 24–48 h if there was a biopsy.
• Oddities: heavier bleeding either infection.
• In pregnancy Biopsy is usually avoided unless it is essential; The diagnostic examination is, in general, safe.

Consultation if you have heavy bleeding, fever, severe pain or bad vaginal odor.

Care after colposcopy

After the test you can lead a normal life if you feel well. If a biopsy was performed, it is recommended:

• Avoid sexual intercourse, tampons and douching during 48 hours (or whatever your specialist indicates).
• Use a pad (not a tampon) if there is staining.
• Monitor the alarm signals described above.

Colposcopy in special situations

• Pregnancy: the priority is diagnosis and conservative follow-up; unnecessary procedures are minimized.
• IUD carriers: the test can be done; The IUD does not prevent colposcopy.
• Adolescents and young people: I drive regularly conservativewith close follow-up if there are low-grade findings.

Common myths (and reality)

• “It hurts a lot” → It is not usually painful; with a biopsy there may be brief discomfort and slight staining.
• “Always involves biopsy” → Only if the specialist see suspicious areas.
• “causes infertility” → Colposcopy does not affect to fertility. If injuries need to be treated in the future, the plan is evaluated to protect reproductive function.

Colposcopy is a test clue to study changes in the cervix and safely decide the better handling. Its purpose is diagnosticit is done in consultationand most patients tolerate it no problems. If they have indicated it to you, go well informed It will help you to live it with peace of mind and to continue, afterwards, the control or treatment plan Check with your gynecologist.

In Viamed We have specialists in Gynecology that can solve your doubts and schedule your colposcopy with all the guarantees. Make your appointment.