Colposcopy (Cervical Biopsy)

A colposcopy is a procedure used to closely examine the cervix, vagina, and/or vulva using a lighted magnifying instrument called a colposcope.

A colposcopy is usually a follow-up to a Pap smear, not an alternative test.

A Pap smear detects cell changes that can lead to cervical cancer, but it doesn’t provide a diagnosis. A colposcopy can check for cancers of the cervix, vagina, and vulva. It can also check for changes that may lead to cancer.

If your doctor sees abnormal cells, they may take a biopsy during the colposcopy procedure. A cervical biopsy collects a sample of tissue from the cervix and can detect pre-cancer or cancer. A biopsy of the vulva or vagina can detect pre-cancer or cancer in those areas.

What Is a Colposcopy?

A colposcopy is most often performed after an abnormal Pap smear to evaluate abnormal cells that cannot be seen with the naked eye.

To perform the procedure, doctors use a device called a speculum to hold open the walls of the vagina. Then they place a special, lighted tool called a colposcope just outside the vulva. It allows them to see the inside of the cervix and vagina and the outside of the vulva.

If your doctor notices a problem area, they may perform a biopsy by taking a small bit of tissue to sample and send to the laboratory. A specialist looks at the tissue sample under a microscope in the lab. A colposcopy biopsy will show if you have cells that are precancerous or cancerous.

You may need more than one colposcopy and biopsy. Sometimes, doctors use the procedure to check on the results of a treatment.

Conditions we diagnose with colposcopy

Colposcopy can help doctors diagnose:

• Precancerous changes of the cervix, vagina, or vulva.
• Cervical, vaginal, or vulvar cancer.
• Cervicitis, genital warts, or polyps (benign growths).

Why Would I Need a Colposcopy?

Your doctor may recommend a colposcopy if the results of a Pap test show abnormal changes in the cells of your cervix. It is a follow-up test that can lead to a diagnosis of cervical cancer. Doctors can also use colposcopy to look for signs of precancer, cancer, and other problems in the vagina or vulva.

You may need a colposcopy if you have:

• An abnormal Pap test.
• A Pap with high‑risk HPV types.
• Abnormal vaginal bleeding or bleeding after sex.
• Vulvar itching, burning, or abnormal skin changes.

What Are the Risks and Complications of Colposcopy?

There are very few serious risks to colposcopy. As with any surgery or medical procedure, there is a small risk of infection. Your doctor will give you antibiotics if you develop an infection.

The vinegar or iodine solution used in colposcopy may sting or tingle a bit. But overall, the discomfort during the procedure is like that of a routine pelvic exam. You may feel some pressure, but it shouldn’t be painful.

Likewise, there are few risks to a biopsy of tissues of the cervix, vagina, or vulva. You may feel a pinch when doctors remove the tissue.

What Should I Expect from Colposcopy?

Colposcopy is usually done in the gynecologist’s office. You’ll go home right after the procedure.

How to prepare for colposcopy

Your doctor will give you specific instructions on how to prepare for your colposcopy.

These might include:

• Bring a list of current medications with you. Let your doctor know if you have allergies or have had reactions to any medications.
• Remove any jewelry, such as a belly button ring or vaginal piercing.
• Tell your doctor if you are pregnant or suspect you may be pregnant. Colposcopy is usually safe when you’re pregnant. However, being pregnant raises your risk of bleeding after a biopsy.
• Try to schedule your colposcopy when you are not having your period. That way, your doctor will have a better view of the cervix and vagina. If you get your period on the day of the appointment, call your doctor’s office to see if you need to reschedule.
• You can drive right after a colposcopy, but you may prefer to bring a friend or loved one to drive you home. You may feel slightly dizzy or faint after the procedure.
• You can eat and drink normally before your appointment. You don’t need to fast.
• You do not need to shave your pubic hair before a colposcopy.
• Your doctor may suggest taking an over-the-counter (OTC) pain medicine before the procedure. That will help with any slight discomfort you may feel.

Starting 48 hours before the test, you should not:

• Douche.
• Have sex or any kind of vaginal penetration.
• Use tampons.
• Use vaginal medicines or creams.  

How long does a colposcopy take?

A colposcopy takes about 10 to 20 minutes. If your doctor finds abnormal tissue and you need a biopsy, the procedure will take about 10 minutes longer.

During your colposcopy

Here’s what happens when you get to the doctor’s office.

• You will take off your clothes and put on a hospital gown.
• You’ll lie on your back on the examining table, with your feet in stirrups as you would for a regular pelvic exam.
• The doctor will insert an instrument called a speculum into your vagina. It’s the same instrument they use during a Pap test. The speculum gently spreads the walls of the vagina open so that the cervix is visible.
• The doctor will place the colposcope just outside your vulva.
• They will shine a light into your vagina and look through the colposcope. This gives your doctor a magnified view of the cervix, vagina, and vulva.
• Your doctor will use a mild vinegar or iodine solution on a cotton ball or cotton swab. They will gently wipe your cervix and vagina with the solution so that any abnormal tissue will show up more readily. You may feel a slight burning or tingling sensation.
• If your doctor sees any areas of tissue that look abnormal, they will collect samples of the tissue. This process is a cervical, vulvar, or vaginal biopsy.

If you need a biopsy, the doctor will do it right away. You won’t have to come back for another appointment.

Here’s what happens:

• A biopsy may cause mild to moderate pain, like menstrual cramps. Your doctor may have advised you to take an OTC pain reliever before the colposcopy. They will also give you medicine to numb the area.
• Once the biopsy site is numb, your doctor will use a special tool to remove a small tissue sample. They may take more than one sample.
• Your doctor may take a tissue sample from inside the opening of the cervix, an area they can’t see during a colposcopy. This procedure is an endocervical curettage (ECC). Doctors use a curette to take the sample. This tool may cause a pinch or cramp as they remove the tissue.
• The doctor may put a topical medicine on the biopsy area to help stop any bleeding.

Recovery after colposcopy and biopsy

If you have a colposcopy without a biopsy, you should feel normal right away. You may have a small amount of spotting for a day or two. You can resume any of your normal activities.

After a biopsy, you may feel a little soreness for a day or two. A little cramping (like menstrual cramps) and light bleeding are normal. Your doctor may recommend OTC pain medication after a biopsy.

You may have some dark discharge up to a week after your biopsy. This discharge is from the medicine used to help stop bleeding at the biopsy site. It is normal, but you may need to wear a sanitary pad until it stops.

Your doctor will tell you how long you may need to limit your activity after a biopsy. You shouldn’t put anything in your vagina until your doctor says it’s OK to do so.

You should not:

• Douche
• Have sex
• Use tampons

Your doctor will tell you how you will receive the results of your colposcopy.

When to call the doctor about colposcopy complications

It’s rare to have serious complications after a colposcopy or biopsy. However, you should call your doctor if you have any of the following symptoms after the procedure:

• Severe abdomen pain.
• Fever or chills, which can be signs of infection.
• Foul-smelling vaginal discharge.
• Heavy bleeding.

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By UPMC Editorial Staff. Last reviewed on 2026-08-11.