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Sometimes it is necessary to get more information about what is happening to your cervix. To do this, you can be referred for a colposcopy and/or a biopsy. These procedures are explained below.

1. Colposcopy

An examination called a colposcopy will be needed if:

• you have a low grade change that continues over several Pap smears;
• you are over 30 years old with a low grade abnormality and have not had a negative result (or a Pap smear at all) in the last 2-3 years;
• a definite or possible high grade abnormality is found on your Pap smear; or
• any glandular abnormality is found on your Pap smear.

For this examination, the specialist uses a colposcope, which is like a large microscope. The colposcope allows the specialist to have a magnified view of the cervix to check the extent and nature of any abnormality.

You may be referred directly to a colposcopy clinic or to a gynaecologist experienced in colposcopy. Before the examination, talk with the specialist to make sure that you know what is going to happen.

2. How is a colposcopy done?

You will be asked to partially undress and then lie on an examination couch. Special support rests are used to keep your legs in a comfortable position.

Once you are comfortable the specialist will insert a speculum into your vagina, like was done for your Pap smear. A solution will be painted on to your cervix to highlight any abnormal areas. The specialist then looks at the highlighted areas through the colposcope to carefully examine your cervix. In this way, the specialist can see the location and pattern of any abnormal cells. The colposcope itself does not touch or enter your body.

This whole examination usually takes 10-15 minutes and most women do not experience any pain. Some discomfort may result from having the speculum inside the vagina for this length of time.

Try to relax during the examination. You might like to find out about some relaxation techniques before your appointment, such as breathing deeply and calmly and imagining you are in a favourite place.

Ask the specialist or nurse to explain what they are doing. Some colposcopes are fitted with a TV screen so you can see what is happening. Talk to your specialist about what was found during the examination.

3. Biopsy

During the colposcopy examination, a small sample of tissue (a biopsy) may be taken from any abnormal looking areas of the cervix. The sample will be sent to a laboratory for testing and it will take up to two weeks for the result to come back to the specialist. Arrangements should be made for you to discuss the results when they are available and whether any treatment is required.

If a biopsy is taken, some discomfort may be experienced for a short time. You may experience some “spotting” of blood for a few hours afterwards. It can be a good idea to take a sanitary pad (not a tampon) with you to the consultation.

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