Answers before anxiety. Clarity before conclusions.
If your Pap smear came back abnormal, the next step may be a colposcopy —
a brief, in-office procedure that lets your doctor examine your cervix more closely.
It is not surgery. It is not a diagnosis in itself. It is a careful look that provides
the information needed to determine your best path forward. This guide explains what
a colposcopy involves, how to prepare, and what your results mean.
A colposcopy is a diagnostic procedure that uses a colposcope
— a magnifying instrument — to closely examine the cervix after an
abnormal Pap smear or positive HPV test. It is
not surgery. It is performed in-office and takes
10 to 20 minutesACOG PB #168. The
ASCCP 2019 risk-based management consensus guidelines determine
when colposcopy is recommended based on the combination of your Pap result, HPV status,
and screening history ASCCP 2019. If abnormal areas are
identified, a small cervical biopsy may be taken during the same visit.
Results are typically available in 1 to 2 weeks and guide the next
step — whether that is continued monitoring or treatment. At Broad Medical
Group, Dr. Jennifer Broad performs colposcopy in Newport Beach
with an emphasis on patient comfort, clear communication, and evidence-based follow-up.
Medically reviewed by Dr. Jennifer Broad, MD, FACOGBoard-Certified Obstetrician-Gynecologist · Newport Beach, CA
Last reviewed: April 2026Next review: October 2026
What Is a Colposcopy?
A colposcopy is a diagnostic procedure that allows your gynecologist to examine the
cervix under magnification. The instrument used — called a colposcope
— is essentially a high-powered, lighted magnifying device that sits outside your body
on a stand. It does not enter the vagina. Think of it as a very precise set of binoculars
that gives your doctor a magnified, illuminated view of the cervical tissue.
Colposcopy is performed in-office, takes approximately 10 to 20
minutes, and does not require anesthesia, an operating room, or any recovery time.
You can drive yourself to and from the appointment and return to your normal activities
immediately afterward.
It is important to understand what colposcopy is not. It is not surgery. It is
not treatment. It is a diagnostic evaluation — a way to gather more
information after a screening test (your Pap smear) has raised a question. The colposcopy
helps determine whether the abnormality seen on your Pap smear corresponds to actual
changes in the cervical tissue, and if so, what type of changes are present.
At Broad Medical Group, Dr. Jennifer Broad performs colposcopy as
part of the comprehensive management of abnormal cervical screening results. Every step
is explained before it happens, and you are never left wondering what comes next.
Why You Might Need One
Colposcopy is most commonly recommended after an abnormal Pap smear result,
a positive high-risk HPV test, or both. The specific combination of your
Pap result and HPV status determines whether colposcopy is the appropriate next step, based
on the ASCCP 2019 risk-based management consensus guidelines.
Not every abnormal Pap smear requires colposcopy. The ASCCP guidelines use a risk-estimation
framework that considers your current results alongside your screening history to calculate
your individual risk of having a significant cervical abnormality. Colposcopy is recommended
when that estimated risk exceeds a specific threshold.
Common Reasons for Colposcopy
The following Pap smear results may lead to a colposcopy recommendation, depending on
your HPV status and screening history:
ASC-US with positive high-risk HPV — Atypical squamous cells of undetermined significance, combined with a positive HPV test, raises the risk enough to warrant closer evaluation.
LSIL (Low-grade Squamous Intraepithelial Lesion) — Indicates mild cervical cell changes, often associated with HPV. Colposcopy is typically recommended for patients 25 and older.
HSIL (High-grade Squamous Intraepithelial Lesion) — Indicates more significant cell changes that require prompt evaluation. Colposcopy is always recommended for HSIL.
ASC-H (Atypical Squamous Cells, cannot exclude HSIL) — This result carries a meaningful probability of an underlying high-grade lesion. Colposcopy is recommended.
AGC (Atypical Glandular Cells) — Involves the glandular cells of the cervix or endometrium. Requires colposcopy and often additional evaluation including endometrial sampling.
Abnormal cervical appearance — If the cervix looks abnormal during a routine pelvic exam, colposcopy may be recommended regardless of Pap smear results.
Follow-up after previous treatment — Patients who have undergone treatment for cervical dysplasia (such as LEEP) require surveillance, and colposcopy may be part of that follow-up.
Clinical Guideline
The ASCCP 2019 Risk-Based Management Consensus Guidelines replaced the older
results-based algorithms with a risk-estimation approach. Your recommended management is
determined by your estimated risk of CIN 3+ (high-grade cervical dysplasia or worse),
calculated from the combination of your current screening results and your prior screening
history. This means two patients with the same Pap result may receive different recommendations
based on their individual risk profiles.
Perkins et al., J Lower Genital Tract Disease, 2020
Dr. Broad follows the ASCCP guidelines for all cervical screening management decisions.
When she recommends colposcopy, she explains exactly why it is indicated in your specific
situation, what the procedure involves, and what the possible outcomes are — so you
understand the reasoning before you schedule.
What to Expect During the Procedure
Understanding each step of the colposcopy before you arrive can significantly reduce
anxiety. Here is what the procedure looks like from start to finish:
Positioning and Speculum
You will lie on the exam table in the same position as a Pap smear. A speculum is gently
inserted into the vagina to hold the walls open and provide a clear view of the cervix.
This part is identical to what you experience during a routine
Pap smear at your well-woman exam.
Acetic Acid Application
A dilute vinegar solution (acetic acid, typically 3–5%) is applied to the surface
of the cervix using a cotton swab. This is the key step that makes abnormal cells visible.
The acetic acid causes abnormal cells to temporarily turn white — a reaction called
acetowhite change. You may feel a mild, brief stinging sensation, but
most patients report minimal discomfort.
Colposcopic Examination
The colposcope is positioned outside your body, several inches from the speculum. Dr. Broad
looks through the colposcope to examine your cervix under magnification (typically 6x to 40x),
identifying any areas of acetowhite change, abnormal blood vessel patterns, or other features
that suggest dysplasia. A green filter light may also be used to enhance visualization of
the cervical blood vessel pattern.
Cervical Biopsy (If Indicated)
If abnormal areas are identified during the colposcopic examination, Dr. Broad will take
a small tissue sample — a cervical biopsy — from the area of
concern. The biopsy instrument removes a tiny piece of tissue, approximately 2–3
millimeters. Most patients describe this as a brief pinch or cramp that
lasts only a few seconds. One or more biopsies may be taken depending on the number and
location of abnormal areas.
Endocervical Curettage (ECC)
In some cases, an endocervical curettage may also be performed. This involves using a
small brush or curette to sample cells from the endocervical canal — the portion
of the cervix that cannot be directly visualized with the colposcope. You may feel a
brief cramping sensation during this step. ECC is often performed when the transformation
zone (the area where abnormal changes most commonly occur) extends into the canal and
cannot be fully seen.
Completion
A solution (such as Monsel’s paste) may be applied to the biopsy sites to minimize
bleeding. The speculum is removed, and the procedure is complete. The entire process
takes approximately 10 to 20 minutes. You can get dressed and leave the
office immediately afterward.
How to Prepare
Preparation Tip
Take 400–600 mg of ibuprofen (Advil, Motrin) 30 to 60 minutes before your
appointment. This can help reduce any cramping sensation if a biopsy is taken.
This is optional, but many patients find it helpful. If you cannot take ibuprofen,
acetaminophen (Tylenol) is an alternative, though it is less effective for cramping.
Preparing for a colposcopy is straightforward. In the 24 to 48 hours before
your appointment:
Avoid vaginal intercourse for 24–48 hours prior.
Do not use tampons for 24–48 hours prior.
Avoid vaginal medications, creams, or douches for 24–48 hours prior. These can coat the cervix and obscure the view or interfere with the acetic acid reaction.
Schedule when you are not menstruating. Light spotting is usually acceptable, but active menstrual bleeding makes it difficult to adequately examine the cervix. If your period arrives unexpectedly before your appointment, call the office and we will help you reschedule.
Beyond these precautions, you can prepare normally:
Eat and drink normally before the appointment. No fasting is required.
You can drive yourself to and from the appointment. No sedation is involved.
Wear comfortable clothing. You will change into a gown for the procedure.
Bring your questions. Write down anything you want to ask Dr. Broad about the procedure, your abnormal Pap result, or what happens next.
After the Procedure
Recovery from colposcopy is minimal. If no biopsy was taken, you should
have no restrictions or symptoms at all. If a biopsy was performed,
here is what to expect:
Normal After-Effects (1–3 Days)
Mild cramping similar to menstrual cramps. Usually resolves within a few hours to one day. Over-the-counter ibuprofen or acetaminophen is effective.
Light spotting or vaginal bleeding for 1 to 3 days. This is expected and normal.
Dark brown or black discharge for several days. This is from the Monsel’s solution applied to the biopsy site to control bleeding. It can look alarming but is completely normal and will resolve on its own.
Restrictions After Biopsy
For 48 hours after a cervical biopsy, please avoid:
Vaginal intercourse
Tampons (use pads for any spotting)
Douching
These restrictions allow the biopsy site to heal and reduce the risk of infection. After
48 hours, you can resume all normal activities.
When to Call the Office
While complications from colposcopy are rare, contact Broad Medical Group
if you experience heavy vaginal bleeding (soaking more than one pad per hour), fever above
100.4°F, severe pelvic pain, or foul-smelling vaginal discharge. These symptoms are uncommon
but warrant evaluation.
Getting Your Results
Biopsy results are typically available in 1 to 2 weeks. Dr. Broad personally
reviews every pathology report and contacts you to discuss the findings, explain what they
mean, and outline the recommended next steps. You will not be left to interpret results on
your own through a patient portal.
Understanding Your Results
Your colposcopy biopsy results will fall into one of several categories. Each carries a
different clinical significance and a different recommended path forward, guided by the
ASCCP management guidelines.
Normal (No Dysplasia)
If the biopsy shows no abnormal cells, this is reassuring. The abnormality on your Pap
smear may have been caused by inflammation, infection, or a sampling variation rather than
true dysplasia. Follow-up typically involves returning to routine screening at an interval
determined by your overall risk profile. Dr. Broad will explain your specific follow-up
schedule.
CIN 1 — Low-Grade Cervical Dysplasia
CIN 1 (cervical intraepithelial neoplasia grade 1) represents mild cell changes,
most often caused by an active HPV infection. CIN 1 is not cancer and is not
precancer. In the majority of cases — particularly in younger patients — CIN 1
resolves on its own within 1 to 2 years as the immune system clears the
HPV infection.
Clinical Note
CIN 1 often resolves without treatment. Studies show that approximately 60% of
CIN 1 lesions regress spontaneously within 1 year, and up to 90% resolve within 2 years. For
this reason, the ASCCP recommends observation with repeat testing rather than immediate treatment
for most patients with CIN 1. Treatment is reserved for CIN 1 that persists for more than 2 years.
ASCCP 2019
For CIN 1, the typical management plan is observation with repeat co-testing
(Pap + HPV) in 12 months. If the repeat testing is normal, you return to routine
screening. If the abnormality persists, further evaluation or treatment may be discussed.
CIN 2 — Moderate-Grade Cervical Dysplasia
CIN 2 represents moderate cell changes that are considered a threshold
for clinical intervention. CIN 2 is classified as a high-grade lesion and is less likely
to resolve spontaneously than CIN 1, although regression does occur in some cases,
particularly in patients under 25.
For most patients aged 25 and older, treatment is recommended for CIN 2.
The most common treatment is a LEEP (loop electrosurgical excision procedure),
which uses a thin, electrically heated wire loop to remove the abnormal tissue from the
cervix. LEEP is an outpatient procedure that can be performed in the office under local
anesthesia.
CIN 3 — High-Grade Cervical Dysplasia
CIN 3 represents severe cell changes that are considered a true precancer.
Left untreated, CIN 3 carries a significant risk of progressing to invasive cervical cancer
over time. Treatment is always recommended for CIN 3 and typically involves
a LEEP or, in some cases, a cold knife cone biopsy (conization).
It is critical to understand that CIN 3, while serious, is not cancer. It
is a precancerous change, and when identified and treated promptly, outcomes are excellent.
This is exactly why the screening and colposcopy process exists — to identify and
treat these changes before they ever become cancer.
Your Results, Explained Personally
Regardless of the result, Dr. Broad reviews every set of colposcopy
findings with you personally. She explains what the pathology report means in plain language,
discusses why a specific management plan is recommended, answers your questions, and ensures
you understand and feel comfortable with the next steps. You are never handed a result
without context.
Key Takeaways
Colposcopy is a brief, in-office diagnostic procedure — not surgery, not treatment. It takes 10 to 20 minutes and requires no anesthesia or recovery time.
Not every abnormal Pap requires colposcopy. The ASCCP 2019 guidelines use a risk-based approach that considers your Pap result, HPV status, and screening history to determine the appropriate next step.
Most patients report minimal discomfort — similar to a Pap smear. A biopsy, if taken, causes a brief pinch lasting a few seconds.
CIN 1 (low-grade) often resolves on its own and is typically monitored rather than treated. CIN 2/3 (high-grade) is treatable with a LEEP or excisional procedure.
Results are available in 1 to 2 weeks. Dr. Broad reviews your biopsy findings with you personally and explains the recommended management plan.
Early detection and follow-through are the goal. Colposcopy exists to identify cervical changes before they become cancer — and when they are identified, treatment is highly effective.
References & Clinical Sources
Perkins RB, Guido RS, Castle PE, et al. 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. Journal of Lower Genital Tract Disease, 24(2), 102–131. 2020.
American College of Obstetricians and Gynecologists. Practice Bulletin No. 168: Cervical Cancer Screening and Prevention. Obstetrics & Gynecology, 128(4), e111–e130. 2016. Reaffirmed 2023.
World Health Organization. WHO Guideline for Screening and Treatment of Cervical Pre-Cancer Lesions for Cervical Cancer Prevention. 2nd ed. Geneva: WHO; 2021.
U.S. Preventive Services Task Force. Screening for Cervical Cancer. JAMA, 320(7), 674–686. 2018.
If you have been told you need a colposcopy, or if you have abnormal Pap smear results
and want a clear explanation of what they mean, Dr. Broad is accepting new patients
in Newport Beach and Orange County.
Medical Disclaimer: This content is for educational purposes only and does not
constitute medical advice, diagnosis, or treatment. Consult Dr. Jennifer Broad or your healthcare
provider for guidance specific to your situation. Current as of April 2026.
If you are experiencing a medical emergency, call 911 immediately.
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