What is a Colposcopy?
A colposcopy is a simple outpatient examination that allows a specialist to look closely at the cervix and is usually carried out after an abnormal smear test.
A colposcopy is performed in clinic and is similar to having a smear test. The colposcope stays outside the body and provides a magnified view of the cervix so that abnormal cells can be identified more clearly. Special solutions may be applied to the cervix to highlight any areas of concern.
If necessary, a small biopsy (sample of tissue) may be taken during the procedure for further analysis. A colposcopy is not a surgical procedure, does not involve cutting, and most people are able to return to normal activities the same day.
What Does an Abnormal Smear Test Mean?
An abnormal smear test means that minor changes have been found in the cells of the cervix. These changes are usually not cancer and are often described as pre-cancerous changes that can be monitored or treated if needed.
If you have received a letter saying your smear was abnormal, it is natural to feel anxious. However, an abnormal smear almost always means that early cell changes have been detected — not cervical cancer. In fact, smear tests are designed to identify these changes long before they become serious, so this result shows that the screening test has done its job. Your GP might recommend a colposcopy for further tests.
Abnormal smear results are common, affecting around one in twelve smear tests, but it is extremely rare for an abnormal result to represent cancer.
Our colposcopy service
At London Gynaecology, our colposcopy service is built around reassurance, expertise, and ease of access. We know that needing a colposcopy can be a worrying experience, which is why we prioritise both clinical excellence, speed of access and patient comfort.
We offer daily colposcopy clinics across three convenient London locations, six days a week. Our team includes both male and female colposcopists to accommodate individual preferences, and we reserve dedicated appointment slots specifically for colposcopy to ensure timely access, even at short notice.
Abnormal smears often represent a pre-cancerous abnormality on the cervix. These pre-cancerous abnormalities are caused by Human Papilloma Virus (HPV or Wart virus). This is a very common infection and 60-70% of women (and men) get it at some stage in life. Most (95%) women will shake it off through their immunity, but in some women it may linger on and cause abnormal smears. More information on HPV can be found by clicking here.
Colposcopy is a simple outpatient clinic procedure to examine the cervix. As an experience, it is very similar to having a smear test performed. During colposcopy, the cervix is visualised using a speculum and is examined under magnification and bright light to look for signs of any abnormality.
Two dyes are applied to the cervix (acetic acid and iodine) which highlight the abnormality if present. From the colposcopy appearance, the abnormalities can also be graded as low grade (CIN1) and high-grade changes (CIN2-3).
Colposcopy examination is carried out by a specialist gynaecologist who is accredited by the British Society of Colposcopy and Cervical Pathology (BSCCP). A nurse will also be present and you will be given an option to see your cervix on the screen.
During the consultation a detailed medical history will be obtained. You will also have an opportunity to ask the specialist any questions that you may have.
A nurse is always present during the colposcopy examination and will assist you. A speculum examination is performed to visualise the cervix and a colposcope is used to assess it under high magnification. Two solutions are used to highlight abnormal areas, if any. A biopsy may be obtained from these areas after application of local anaesthesia.
A colposcopy is often performed following an abnormal smear. It allows the specialist to assess the cervix and grade any abnormalities if present.
Sometimes, a colposcopy is performed for assessment of certain symptoms such as bleeding after sex OR persistent vaginal discharge OR if your GP is concerned about the appearance of your cervix.
Colposcopy as an experience is very similar to having a smear test. There may be some discomfort involved with the insertion of a speculum, but you should not experience sharp pain. If you find smears uncomfortable, he/she will be able to use a smaller speculum or a numbing gel called Instillagel. If a biopsy is needed, it may also be carried out after the application of local anaesthetic.
The commonest form of treatment is LLETZ (Large Loop Excision of Transformation Zone). It is also known as LEEP (Loop Electrosurgical Excision Procedure, an American term). This is commonly carried out as an outpatient procedure under local anaesthesia. After numbing the cervix with local anaesthetic, a heated wire loop is used to remove the abnormal cells. It is a quick procedure that takes approximately 10 minutes. Similar to having a biopsy, some women report discomfort, but no sharp pain…
Please refer to this special page on treatment for further information.
An examination will usually take 30 minutes. The colposcopy itself will take 5-7 minutes and you will be able to go home or back to work straight away. If you have had a cervical biopsy you may experience some light vaginal bleeding whichcan last up to 48 hours. In addition, some women report some mild lower abdominal discomfort but this will not usually stop you returning to your daily activities.
The examination may show a normal cervix or low grade or high grade changes. Your specialist will explain the findings. Depending on your clinical circumstances, you may or may not need treatment.
Nothing needs to be avoided if only a colposcopy is performed.
If a biopsy is also taken, it is best to avoid intercourse, bathing and swimming for 3-4 days. It is ok to shower.
If you are seen for a colposcopy and treatment, then you should avoid intercourse, swimming, bathing, using tampons or strenuous exercise for a period of 4 weeks.
Our standard colposcopy package includes:
- A consultation with a consultant gynaecologist
- Full history taking
- Colposcopy procedure
- Explanation of results
- Detailed written report emailed or posted to you and your GP
- Direct access for any urgent health concerns
Book your Colposcopy appointment online
An abnormal smear result can be a worrying time. Our colposcopy package gives reassurance with thorough analysis of the cells and treatment, if required, often within the same appointment.
What will the colposcopy show?
The examination may show a normal cervix or low grade or high grade changes in the cells on the surface of the cervix, CIN (Cervical Intra-epithelial Neoplasia). These are pre-cancerous changes within the cervical epithelium (lining cells of the neck of womb).
There are three grades of CIN:
There are various ways of treating CIN, but the common options. are:
LLETZ (Large Loop Excision of Transformation Zone):
An effective diagnostic and curative outpatient procedure, targeting abnormal cells to prevent cervical cancer.
Cone Biopsy (Extended or deeper excision):
Carried out by Laser, Knife or Needle.
Additional Colposcopy Information
If you wish to learn more about our colposcopy pricing, visit our colposcopy package page for self pay patients.
Results
Your specialist will discuss the colposcopy findings with you. The results will usually be ready within 10 days.
GP Referrals
GP referral letters are not needed unless you are claiming your visit on insurance and your insurer requires one. However, GP referral letters are helpful because they provide your information and history so if you do have one please bring it with you to your appointment.
Resources
To learn about Colposcopy or Treatment of CIN, please see our patient information leaflets.
Other related conditions and treatments
Cone biopsy
A cone biopsy is a minor surgical procedure used to remove a cone-shaped section of abnormal tissue from the cervix. It is typically recommended when high-grade...
Vulvoscopy
A vulvoscopy is an examination of the vulval skin using a telescope. It is performed for the investigation of vulval itching or pain or irritation and...
Abnormal Smear (PAP Test)
