Everything you need to know about getting a colposcopy—the 5-minute procedure that could detect cervical cancer

Like most women, I don’t exactly look forward to gyno appointments. It’s nothing against my doctor—she is lovely, really—the whole experience just isn’t my idea of fun. I spend way too much time worrying about things that don’t actually matter, like if she’ll think I’m not being totally honest about my sexual history or what small talk we’re going to have when my legs are in the stirrups. After I leave the visit, however, I don’t spend any more time worrying about it. It’s crossed off my yearly to-do list and I’ve moved on. See ya next year, doc!

It’s part of the reason I was caught off guard when a few days after a routine appointment, my gynecologist called me and said I needed to see her colleague for a colposcopy. “A what?” I asked her, annoyed that I had to carve time out of my workday yet again. She explained to me that my Pap smear came back abnormal and the colposcopy was a way to screen for cervical cancer. Now she had my attention. Cancer?

I spent the nights leading up to the appointment lying in bed freaking out. I wish I knew then what I knew now: that a colposcopy is essentially a more detailed Pap smear and it takes all of five minutes.

I’m not sure why colposcopies aren’t talked about as much as other things that go down in the gyno’s chair, like STD testing and IUD implantation. To help you navigate a colposcopy, women’s health expert and She-ology author Sherry Ross, MD, explains everything you need to know about the process, including why a doctor might recommend one, what happens during the procedure, and what the next steps are after it’s done.

Why a doctor might recommend a colposcopy

“A colposcopy is a way to look at the cervix in more detail than a pap smear can give,” Dr. Ross says. While a Pap smear involves collecting cells from the cervix, a colposcopy allows the doctor to look at cervical cells through a microscope. (Yes, believe it or not, there’s something even more up close and personal than a Pap.)

Just like what happened to me, Dr. Ross says a gynecologist will often recommend a colposcopy if a Pap smear comes back abnormal as a way to figure out why it was abnormal. An abnormal Pap indicates recent changes in the cervical cells, which can be caused by an infection, including HPV (human papillomavirus). Having HPV can be NBD, but sometimes, it can turn into cervical cancer, which is why it’s important doctors get a closer look at those abnormal cells. (Having an abnormal Pap is not uncommon—according to national cancer center Rosewell Park, an estimated 3 million women in the U.S. have an abnormal Pap each year, and only 1 percent of those will lead to a cervical cancer diagnosis.)

What goes down during the procedure

Having a colposcopy on the books doesn’t require much prep: Dr. Ross advises against having sex the night before and if you have a low tolerance for pain, feel free to pop an OTC painkiller. (She compares the pain level of a colposcopy to that of a Pap smear, while a biopsy will feel slightly more uncomfortable. More on that below…)

Once you’re in your medical gown and on the table, the doctor will come in—colposcopies are typically performed by general practitioners or gynecologists—and you’ll lie back and once again place your feet in those lovely stirrups. The doctor then takes a closer look at the cervix using a colposcope, which is essentially a magnifying glass.

If they see any abnormal cells, Dr. Ross says the doctor will often take a biopsy so they can be screened for cancer in a lab. “A doctor can tell right away if there are abnormal cells or not, but you’ll have to wait a few days to get the results of the biopsy,” Dr. Ross says. Even with a biopsy—most commonly done using a tool called an endocervical brush that collects cells from the designated spot in the cervix—Dr. Ross says the whole procedure takes between five and 10 minutes. She says that the biopsy may feel like a slight pinch and cause some light cramping, but other than that, it’s a relatively pain-free visit.

What happens next

A few different things can happen after getting a colposcopy, depending on what your doctor saw through the magnifying lens. If the doctor didn’t notice anything suspicious while getting a closer look, you can write it off as an insurance measure and go back to seeing your OB/GYN once a year. Dr. Ross also says that colposcopies should be covered by all insurance providers, because it’s a procedure done to detect or prevent cancer.

“Sometimes, a biopsy may show dysplasia, which is a medical word for precancerous cells,” Dr. Ross says. “With these results, it’s recommended to get a Pap smear more regularly, twice a year instead of once a year [or longer], to make sure the they don’t turn into cancerous cells.” She emphasizes that while it’s important to keep an eye on precancerous cells, you shouldn’t freak out if your doctor calls you with these results; it’s just an indicator that you should be extra conscious and keep up with your appointments as directed by the doctor.

As for my colposcopy, a biopsy did show some precancerous cells, which an oncologist I was referred to by my gynecologist urged I have removed through another procedure called a loop electrosurgical excision procedure (LEEP). That one was much more invasive than the colposcopy, but it was effective at removing the precancerous cells. In fact, when I went back to my gyno for a Pap smear a year later, it came back completely normal.

Look, does anyone want to get a pap smear? No. Does anyone want to hear a scary word like “colposcopy” after getting one and then have to make a follow-up appointment to get one? Absolutely not. But hopefully this lets you know that getting one done takes less time than it takes to wait in line at Trader Joe’s, and it’s not as scary as it sounds. Promise.

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