Patients should follow all preparatory steps recommended by their physician. Patients should inform their physician if they are or may be pregnant. The test should be scheduled during a time other than a woman’s menstrual period. Women should avoid intercourse for 24 hours prior to the test. Also, patients should avoid douching or using any vaginal medicines or spermicidal foams, creams or jellies for 24 hours prior to the colposcopy. These agents may wash away or obscure abnormal cells.

Patients may feel more comfortable if they empty their bladder and bowel beforehand. Taking an over-the-counter pain reliever an hour prior to the exam may help alleviate discomfort during the ensuing exam. However, patients should not take any medication without first consulting their physician.

During the colposcopy, the patient lies down on an exam table with her knees bent and to the sides, and heels resting in supports called stirrups. A sheet covers the woman’s legs and stomach. The physician examines the external genitals before gently inserting an instrument called a speculum into the woman’s vagina to widen it. This allows the physician to more clearly examine the cervix.

The physician or an assistant positions the colposcope so that a clear view of the vagina is obtained. The colposcope, which resembles a lighted microscope or binoculars, does not enter the vagina. A saline solution is used to clean the cervix before a vinegar solution (acetic acid) is applied to the cervix with a cotton ball or swab. This solution makes abnormal tissue appear white and be visible through the colposcope.

If none of the tissue turns white, a second solution known as Lugol’s solution, containing iodine, will be applied to the cervix. This solution stains normal cervical tissues, but leaves abnormal tissues unstained.

The colposcope can be adjusted to increase the magnification of abnormal tissues. This will reveal features such as the course of blood vessels in the tissue, changes in the texture or arrangement of the cells. Some of the colposcopes may allow a photograph to be taken that will document the suspicious areas for future reference. The physician may also perform a biopsy of some of the suspect tissue. This can be sent to a pathologist for examination.

For the most part, a colposcopy is painless. Patients may experience discomfort when the speculum is inserted, and the application of acetic acid may cause a stinging sensation.  A pinching feeling or cramps may be experienced as the tissue is removed. If a biopsy is performed, a numbing gel may be applied.