Colposcopy: Purpose, Procedure, Biopsy, Results and Recovery
Updated: 2 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: November 2026 · How we review
Quick Answer: What is a colposcopy?
A colposcopy checks the cervix, vagina and vulva for abnormal tissue, mainly cells that could turn into cancer. A provider looks through a colposcope, a lighted magnifying instrument that stays outside the body. It's often done after an abnormal Pap smear or a positive HPV test. It takes 10 to 20 minutes, and a biopsy may be taken. [1]
What the research says
Taking more than one biopsy finds more precancer. In a study of 690 women referred for colposcopy, a single biopsy detected 60.6% of high-grade precancerous lesions. Detection rose to 85.6% with two lesion-directed biopsies and 95.6% with three. (Wentzensen et al., Journal of Clinical Oncology, 2015) [2]
Going straight to colposcopy finds high-grade changes sooner. A review of 5 trials with 11,466 women with minor Pap changes found that immediate colposcopy detected high-grade lesions earlier than repeat Pap tests, but by 24 months detection was similar (17.9% versus 18.3%). Women watched with repeat Pap tests were more likely to miss follow-up. (Kyrgiou et al., Cochrane Database of Systematic Reviews, 2017) [3]
Numbing injections can ease pain during cervical treatment at colposcopy. A review of 19 trials with 1,720 women treated for precancer found that a local anesthetic combined with a blood-vessel-tightening medicine reduced pain compared with no treatment. Pain pills taken beforehand showed no clear benefit over placebo in 2 small trials. (Gajjar et al., Cochrane Database of Systematic Reviews, 2016) [4]
Key takeaways
A colposcopy uses a magnifying, lighted instrument to look for abnormal tissue on the cervix, vagina and vulva. [1]
It is usually recommended after an abnormal Pap smear, an abnormal pelvic exam or a positive HPV test. [1]
The test takes 10 to 20 minutes in an office or clinic, and most people go home the same day. [1]
Any abnormal tissue can be biopsied, and results usually come back in 2 to 10 days. [1]
Abnormal results are usually precancerous and can be monitored or treated before cancer develops. [1] [2]
What is a colposcopy?
A colposcopy is a test to check your cervix, vagina and vulva for abnormal tissue. It mainly looks for cells that could become cancer, a condition called cervical dysplasia. It can also check for genital warts and cervical polyps. [1]
The colposcope is a lighted instrument that works like a microscope to magnify the area. It has binocular-like lenses, so your provider can see your cervix while sitting at your feet. The colposcope stays outside your vagina for the whole test. [1]
Why is a colposcopy done?
Your provider may recommend a colposcopy to take a closer look when a screening test or symptom suggests a problem. Common reasons include: [1]
Reason | What it means |
Abnormal Pap smear | Your Pap test found cell changes that need a closer look |
Abnormal pelvic exam | Your pelvic exam showed a result that needs a closer look |
Positive HPV test | Your test found a human papillomavirus (HPV) infection |
Symptoms | Abnormal vaginal bleeding or vulvar itching |
Sources: [1]
Finding abnormal or precancerous cells early allows them to be watched or treated before they can turn into cancer. [1]
What are the types of colposcopy biopsy?
If your provider sees abnormal tissue, they take a small sample to send to a lab. There are two main ways to do this. [1]
Biopsy type | How it is done |
Punch biopsy | A circular, scalpel-like tool removes a round piece of tissue in one motion |
Endocervical curettage (ECC) | A spoon-shaped tool scrapes the lining of the cervix |
Sources: [1]
How do you prepare for a colposcopy?
A few simple steps help your provider get a clear view of your cervix and accurate results. [1]
Tell your provider if you are pregnant. A colposcopy can be done during pregnancy, but the risk of bleeding may be higher.
Plan around your period. Schedule the test for a time when you are not menstruating, because bleeding makes the cervix harder to see.
Keep the vagina clear for 48 hours. Avoid sex, tampons and vaginal creams or suppositories, which can affect results.
Ask about pain relief. Your provider may suggest an over-the-counter pain reliever such as acetaminophen or ibuprofen on the day of the test.
Expect a pregnancy test. If you menstruate, you will likely give a urine sample first, so arrive with a full bladder.
Sources: [1]
What happens during a colposcopy?
A colposcopy is done in a medical office or clinic. It usually takes 10 to 20 minutes. [1]
You lie on an exam table with your feet in stirrups.
Your provider gently inserts a lubricated speculum to widen your vagina.
You may get a local anesthetic injection or lidocaine spray to numb the area.
Your provider examines your cervix, vaginal walls and vulva through the colposcope.
A vinegar solution (acetic acid) is applied with a cotton swab to highlight suspicious areas. It may burn slightly.
Any abnormal tissue is biopsied and sent to a lab.
If needed, medicine is applied to stop bleeding at the biopsy site.
Sources: [1]
Does a colposcopy hurt?
Pain varies from person to person and is hard to predict. You may feel pressure from the speculum and mild burning from the vinegar solution. A biopsy can cause pinching or cramping and is usually the most uncomfortable part. Options to ease pain include an over-the-counter pain reliever beforehand, a local anesthetic injection, lidocaine spray and, rarely, general anesthesia. [1] [4]
Colposcopy at a glance
Item | Typical detail |
Where it is done | Medical office or clinic |
How long it takes | 10 to 20 minutes |
Pain relief | Pain reliever, numbing injection or lidocaine spray; rarely general anesthesia |
Going home | Most people go home the same day |
Biopsy results | Usually within 2 to 10 days |
Sources: [1]
What happens after a colposcopy?
If you did not have a biopsy, you can usually return to normal activities right away. You may have mild spotting for a few days. [1]
If you had a biopsy, healing can take a few days. It is normal to have: [1]
Light vaginal bleeding and vaginal pain for a few days
Dark, black or brown discharge from the vinegar solution
Pads can help manage bleeding and discharge. Avoid putting anything in your vagina, including tampons and penetrative sex, and ask your provider how long to wait. [1]
What do colposcopy results mean?
Biopsy results usually come back within 2 to 10 days. Ask your provider when and how you will get them. [1]
Result | What it means | Usual next step |
Normal | No abnormal cells were found | No treatment; keep up with routine cervical cancer screening |
Abnormal: mild dysplasia | Mild precancerous cell changes | Repeat Pap tests over time; it may go away on its own |
Abnormal: more advanced precancer | More serious precancerous changes | Treatment such as a cone biopsy, LEEP or laser surgery |
Cervical cancer (rare) | Cancer cells were found | Your care team creates a treatment plan and explains the stage |
Sources: [1]
A normal result means no abnormal cells were found. When results are abnormal, the cells are usually precancerous, and only rarely does a colposcopy lead to a cervical cancer diagnosis. [1]
What are the risks of a colposcopy?
A colposcopy is generally safe and low risk. Occasionally, it can cause problems that can be treated: [1]
Risk | What to know |
Significant bleeding | Occasional; risk may be higher during pregnancy; treatable |
Infection | Occasional; watch for foul-smelling discharge, fever or chills; treatable |
Sources: [1]
When should you call your provider after a colposcopy?
Contact your provider if you have any of these signs: [1]
Severe pelvic or lower belly pain
Heavy bleeding, more than a usual period
Signs of infection, such as thicker-than-usual or foul-smelling discharge, fever or chills
Questions to ask your provider
Why do I need a colposcopy?
What pain relief options can I use?
Will you take a biopsy, and what type?
How long should I avoid tampons and sex afterward?
When and how will I get my results?
Conclusion
A colposcopy gives your provider a magnified view of your cervix, vagina and vulva to find abnormal tissue, most often after an abnormal Pap smear or a positive HPV test. It takes 10 to 20 minutes, is done in an office and usually lets you go home the same day. [1]
Most abnormal results are precancerous changes that can be monitored or treated early. Preparing well, knowing what to expect afterward and watching for warning signs help keep the test safe and useful. [1] [2]
Keep learning: Read our guides to cervical dysplasia, HPV and LEEP. For more on this test, see the MedlinePlus guide to colposcopy.
FAQ
What is a colposcopy?
A colposcopy is a test that uses a lighted, magnifying instrument called a colposcope to check your cervix, vagina and vulva for abnormal tissue.
Why would I need a colposcopy?
It is usually done after an abnormal Pap smear, an abnormal pelvic exam or a positive HPV test, or for symptoms such as abnormal vaginal bleeding or vulvar itching.
How do I prepare for a colposcopy?
Schedule it when you are not on your period and avoid sex, tampons and vaginal creams or suppositories for 48 hours before. Tell your provider if you are pregnant.
Does a colposcopy hurt?
You may feel pressure from the speculum, mild burning from the vinegar solution and pinching or cramping if a biopsy is taken. Numbing medicine or a pain reliever can help.
How long does a colposcopy take?
A colposcopy usually takes 10 to 20 minutes in a medical office or clinic, and most people go home the same day.
Can I have a colposcopy while pregnant?
Yes. A colposcopy can be done during pregnancy, but the risk of bleeding may be higher, so tell your provider before the test.
What is a normal colposcopy result?
A normal result means no abnormal cells were found. You need no treatment, but you should keep up with routine cervical cancer screening.
What does an abnormal colposcopy result mean?
Abnormal cells were found, and they are usually precancerous. You may need close monitoring or treatment such as LEEP, a cone biopsy or laser surgery.
How long do colposcopy biopsy results take?
Biopsy results usually come back within 2 to 10 days. Ask your provider how and when you will get them.
What are the risks of a colposcopy?
A colposcopy is generally safe and low risk. It can occasionally cause significant bleeding or infection, and both can be treated.
When should I call my provider after a colposcopy?
Call for severe pelvic or lower belly pain, bleeding heavier than a period, or signs of infection such as foul-smelling discharge, fever or chills.
Related Reading
Cryotherapy of the Cervix: Procedure, Risks and Recovery explains cryotherapy of the cervix.
Learn more in our guide to What Is Cervical Dysplasia (Cervical Intraepithelial Neoplasia)?.
Learn more in our guide to Understanding HPV: Causes, Symptoms, and Prevention.
Learn more in our guide to LEEP: Procedure, Purpose, Side Effects and Recovery.
Learn more in our guide to Cone Biopsy: A Comprehensive Guide to Cervical Conization.
Learn more in our guide to Cervical Cancer: Symptoms, Screening, Diagnosis, Treatment and Support.
Learn more in our guide to Genital Warts: What Causes Them, How They're Treated, and Why the HPV Vaccine Matters.
References
Cleveland Clinic. Colposcopy: Biopsy, Purpose, Procedure, Risk & Results. Cleveland Clinic. Last updated July 29, 2025. https://my.clevelandclinic.org/health/diagnostics/4044-colposcopy
Wentzensen N, Walker JL, Gold MA, et al. Multiple biopsies and detection of cervical cancer precursors at colposcopy. J Clin Oncol. 2015;33(1):83-89. PMID 25422481. https://doi.org/10.1200/JCO.2014.55.9948
Kyrgiou M, Kalliala IE, Mitra A, et al. Immediate referral to colposcopy versus cytological surveillance for minor cervical cytological abnormalities in the absence of HPV test. Cochrane Database Syst Rev. 2017;1(1):CD009836. PMID 28125861. https://doi.org/10.1002/14651858.CD009836.pub2
Gajjar K, Martin-Hirsch PP, Bryant A, et al. Pain relief for women with cervical intraepithelial neoplasia undergoing colposcopy treatment. Cochrane Database Syst Rev. 2016;7(7):CD006120. PMID 27428114. https://doi.org/10.1002/14651858.CD006120.pub4
Medical disclaimer
This article is for general education only and does not replace advice from a qualified healthcare professional. Talk to your doctor about your own diagnosis and treatment, and seek emergency care right away for severe or sudden symptoms.
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