Colposcopy: what to expect and what results mean
A colposcopy is a closer look at the cervix, vagina and vulva through a lighted magnifying device called a colposcope, so your provider can find problems that cannot be seen by the eye alone. (ACOG) (MedlinePlus, 2024)
Why a colposcopy is done
It is most often done after an abnormal Pap test or HPV test. It may also be recommended for bleeding after sex, or when your provider sees abnormal areas on the cervix during a pelvic exam. (MedlinePlus, 2026) ACOG adds that it may be done for certain types of HPV infection, and to look at other problems such as genital warts, an inflamed cervix, polyps, pain or bleeding. (ACOG) It can also be used to check for abnormal changes that come back after treatment. (MedlinePlus, 2026)
In the US, the ASCCP guidelines decide whether you need a colposcopy from your risk of serious cell changes, which depends on your current result, your past results and your history. (NCI, 2024) The 2019 guidelines were updated through 2023 (ASCCP, 2024) and are now kept up to date by an Enduring Consensus Guidelines committee. (Enduring Guidelines, 2024) What each Pap result means is on Pap and HPV test results.
In England, the NHS usually invites you for one of 4 reasons: abnormal cells plus a high-risk HPV infection; a high-risk HPV infection that has not gone away; several screening tests without a result; or a cervix that did not look as healthy as it should at screening. You can choose whether to have it. (NHS England, 2026)
Before the appointment
- Do not douche, use tampons or vaginal medicines, or have sex beforehand. ACOG says for at least 24 hours; the MedlinePlus test page says 48 hours. Ask your provider which applies to you. (ACOG) (MedlinePlus, 2024)
- Tell your provider if you are pregnant or could be pregnant. (MedlinePlus, 2026)
- You may be more comfortable if you empty your bladder and bowel first. (MedlinePlus, 2026)
- You can ask to bring a support person. (MedlinePlus, 2026) (NHS England, 2026)
What happens during a colposcopy
It is usually done in the provider's office and takes 10 to 20 minutes. (MedlinePlus, 2024)
- You lie on your back on the exam table with your feet in stirrups, as for a pelvic exam. (MedlinePlus, 2026) (ACOG)
- A speculum, the same instrument used for a Pap test, holds the vaginal walls apart so the cervix can be seen. (MedlinePlus, 2024)
- The cervix and vagina are gently cleaned with a vinegar or iodine solution. This removes mucus and highlights abnormal areas. You may feel a slight sting or burning. (MedlinePlus, 2026) (ACOG)
- The provider looks through the colposcope, placed at the opening of the vagina. It does not touch you. Photographs may be taken. (MedlinePlus, 2026)
- If any area looks abnormal, a small tissue sample (biopsy) is taken with small tools; several samples may be taken. You may feel a pinch or cramp each time. (MedlinePlus, 2026)
- Sometimes a sample is also taken from inside the opening of the cervix, an area that cannot be seen during a colposcopy. This is called endocervical curettage (ECC). (MedlinePlus, 2024) (MedlinePlus, 2026)
A pathologist examines the tissue and sends a report to your provider. (MedlinePlus, 2026)
Afterwards
Without a biopsy, you should feel fine right away and may have a little spotting for a couple of days. With a biopsy, you may have pain and discomfort for 1 or 2 days, some bleeding, and a dark discharge for a few days. (ACOG) MedlinePlus says it is normal to have a little bleeding and discharge for up to a week after a biopsy. (MedlinePlus, 2024) For a short time, do not have sex, use tampons or douche; MedlinePlus says up to a week, so ask your provider how long to wait. (ACOG) (MedlinePlus, 2026)
MedlinePlus says to contact your provider right away if: (MedlinePlus, 2026)
- Bleeding is very heavy or lasts for longer than 2 weeks.
- You have pain in your belly or in the pelvic area.
- You notice any signs of infection (fever, foul odor, or discharge).
ACOG says to call right away for heavy vaginal bleeding (using more than one sanitary pad per hour), severe lower abdominal pain, fever or chills. (ACOG)
What biopsy results mean, in general terms
Abnormal biopsy changes are called dysplasia, or cervical intraepithelial neoplasia (CIN), graded 1 to 3 by how abnormal the cells look and how much tissue is affected. (MedlinePlus, 2026) (NCI, 2024) In the NHS programme, around 4 in 10 people who have a colposcopy get a normal result and around 6 in 10 have abnormal cells found. (NHS England, 2026)
| Result | What the sources say |
|---|---|
| Normal | No cancer and no abnormal changes were seen. Your provider may still want to watch for cell changes with more frequent Pap tests or colposcopies. (MedlinePlus, 2026) (MedlinePlus, 2024) |
| CIN 1 (mild dysplasia) | Mild, low-grade changes. They usually go away on their own and do not need treatment. (NCI, 2024) (MedlinePlus, 2026) |
| CIN 2 (moderate dysplasia) | Moderate changes, typically treated by removing the abnormal cells. CIN 2 can sometimes go away on its own, so some people choose, with their provider, to be checked closely instead. (NCI, 2024) |
| CIN 3 (severe dysplasia) | Severely abnormal cells. CIN 3 is not cancer, but it may become cancer if not treated, and doctors cannot yet tell which cases will. (NCI, 2024) (MedlinePlus, 2026) |
| AIS (adenocarcinoma in situ) | An advanced lesion in the glandular tissue of the cervix. AIS may be called precancer and may become cancer if not treated. (NCI, 2024) |
| Cancer | Cancer cells were found. In the NHS programme, around 2 in 100 people who have a colposcopy get this result. (MedlinePlus, 2024) (NHS England, 2026) |
A normal colposcopy result is possible even when your screening result was abnormal. (NHS England, 2026) If the biopsy does not find the cause of the abnormal results, you may need a procedure called a cold knife cone biopsy. (MedlinePlus, 2026)
What follow-up usually looks like
- No high-grade changes after a minimally abnormal result: in the ASCCP example, a person with an HPV-positive ASC-US result whose colposcopy shows less than CIN 2 returns in 1 year. (ASCCP, 2024)
- CIN 2 checked closely instead of treated: for people 25 or older, ASCCP describes colposcopy and HPV-based testing every 6 months for up to 2 years. (ASCCP, 2024) NCI says CIN 2 must be treated if it progresses to CIN 3 or does not go away in 1 to 2 years. (NCI, 2024)
- After treatment for CIN 2 or worse: ASCCP recommends 3 negative HPV tests or cotests at 6, 18 and 30 months before a return to testing every 3 years. (ASCCP, 2024)
- A colposcopy that was recommended but not done: if the earlier result was high grade, ASCCP still recommends the colposcopy. (ASCCP, 2024)
Your doctor decides what your result means for you. This page does not give treatment advice. If you have an abnormal result, see after an abnormal screening result for questions to ask.
Where they differ:
- Where it is done: in the US, usually in your provider's office; in England, usually in an outpatient hospital clinic. (MedlinePlus, 2024) (NHS England, 2026)
- Your period: US sources say it is best done when you are not having your period; the NHS says you can still come, or rearrange if you prefer. (ACOG) (NHS England, 2026)
- Waiting for biopsy results: most often 1 to 2 weeks per MedlinePlus; about 4 to 8 weeks by post in England. (MedlinePlus, 2026) (NHS England, 2026)
- After CIN 1: NCI says CIN 1 usually goes away without treatment and US follow-up is risk-based; the NHS usually invites you for another screening test in 12 months. (NCI, 2024) (NHS England, 2026)
- CIN 2 monitoring: the NHS offers it when only a small area is affected, checking every 6 months for up to 2 years; ASCCP describes a similar 6-month schedule for up to 2 years. (NHS England, 2026) (ASCCP, 2024)
- After treatment: the NHS invites you for a screening test 6 months later; ASCCP recommends tests at 6, 18 and 30 months. (NHS England, 2026) (ASCCP, 2024)
Questions people ask
Does a colposcopy mean I have cancer?
No. A colposcopy is a closer look to find out whether abnormal cells are there and how serious they are. Most people who have a colposcopy do not have cervical cancer. (NHS England, 2026)
Does a colposcopy hurt?
You may feel some discomfort when the speculum goes in, and the solution may sting, tingle or burn. If a biopsy is taken you may feel a pinch or cramp, and you may be sore for a day or two. (MedlinePlus, 2024) (MedlinePlus, 2026)
How long does a colposcopy take?
Usually 10 to 20 minutes in the office, and about 10 minutes longer if a biopsy is taken. (MedlinePlus, 2024)
Can I have a colposcopy on my period?
US sources say it is best done when you are not having your period, and not during a heavy period. The NHS says you can still have it on your period, or call the clinic to rearrange. (ACOG) (MedlinePlus, 2026) (NHS England, 2026)
How long do colposcopy biopsy results take?
MedlinePlus says biopsy results most often take 1 to 2 weeks. In England, results come by post about 4 to 8 weeks later. (MedlinePlus, 2026) (NHS England, 2026)
Can I have a colposcopy while pregnant?
Colposcopy is generally safe during pregnancy, but pregnancy raises the risk of bleeding after a biopsy. Tell your provider if you are or could be pregnant. (MedlinePlus, 2024)
Will a colposcopy affect getting pregnant later?
MedlinePlus says a colposcopy and biopsy will not make it harder to become pregnant or cause problems during pregnancy. (MedlinePlus, 2026)