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Need a Colposcopy? You Deserve to Know What Will Happen.

Careful cervical evaluation with honest explanation, individualized pain planning, and permission to pause.

Maybe you have never heard the word colposcopy before.

Maybe you searched online and found stories that frightened you.

Or maybe you have already had a painful colposcopy and are worried that the next one will be the same.

We will not dismiss those concerns. We also will not promise that you will feel nothing.

What we will do is explain the procedure before it begins, make a plan for your comfort, tell you before we touch or biopsy anything, and pause if you ask us to.

A colposcopy should answer an important medical question. It should not leave you feeling confused, surprised, or ignored.

Colposcopy — $350 + pathology fees, usually $50–$100

no membership required.

Schedule a Colposcopy

First: What Is a Colposcopy?

A colposcopy is a close examination of the cervix after an abnormal Pap smear, positive high-risk HPV test, or another finding that needs further evaluation.

The purpose is to determine whether cervical precancer is present—and, if so, where it is and how significant it may be.

What goes inside your body?

A speculum is placed in the vagina, similar to what happens during a Pap smear, so the cervix can be seen.

The colposcope does not go inside you. It stays outside the body and works like a powerful magnifying system.

We apply solutions to the cervix that make abnormal areas easier to see. If an area needs closer evaluation, we may recommend taking a small tissue sample called a biopsy.

Not every colposcopy requires a biopsy.

Dr. Hitchcock explaining a gentle colposcopy instrument to a patient.

What Might a Colposcopy Feel Like?

People experience colposcopy differently. Some describe pressure and mild cramping. Others experience sharper or more significant pain, particularly during biopsy or sampling from inside the cervical canal.

You may feel:

– Pressure or stretching from the speculum
– Mild stinging when a solution is applied
– A sharp pinch or cramp during a cervical biopsy
– A deeper cramp if endocervical sampling is needed
– Mild cramping or spotting afterward

Your experience cannot be predicted by someone else saying that a biopsy is “just a pinch.” Your anatomy, previous experiences, anxiety, pelvic pain, vaginismus, trauma history, and the sampling needed can all affect how the procedure feels.

We would rather know what you are worried about before we begin than have you feel that you must silently endure it.

Dr. Hitchcock talking with patient in a relaxing setting.

If You Had a Bad Experience Before, Tell Us

A previous painful or frightening procedure is medically relevant information.

Tell us what happened:

– Was inserting or opening the speculum painful?
– Was the biopsy worse than you expected?
– Were several samples taken without explanation?
– Did you ask for a pause and feel ignored?
– Were you told that the procedure would not hurt?
– Did you leave without understanding what had been done?

Your answers help us plan the next examination differently.

We cannot promise a pain-free colposcopy. We can promise that your previous experience will not be dismissed, that you will know what is about to happen, and that you can ask us to pause at any time.

Pain Management Is Part of the Plan

Pain during office gynecologic procedures has too often been minimized. Current ACOG guidance recommends discussing and offering pain-management options rather than assuming that no intervention is needed.

There is no single option that works perfectly for every colposcopy. The plan depends on your medical history, previous experience, expected anxiety and pain, and whether biopsy or endocervical sampling is likely.

Options may include medication taken before the appointment and topical or injected local anesthetic when appropriate. The evidence for local anesthetic during cervical biopsy is mixed, and the injection itself can be uncomfortable, so we discuss the advantages and limitations rather than presenting one approach as right for everyone.

If pain is one of your main concerns, contact us before the appointment. It is better to make a plan in advance than to begin that conversation after you are already in the procedure room.

[Read ACOG’s guidance on pain management]

What Happens During the Appointment?
WE REVIEW YOUR RESULTS
We start with your Pap, HPV, previous biopsy, treatment history, and the reason colposcopy was recommended. An abnormal Pap or positive HPV test does not mean that you have cervical cancer. Colposcopy helps determine what, if anything, is actually present.
WE EXAMINE THE CERVIX
After placing the speculum, we examine the cervix under magnification. The colposcope remains outside the body. Solutions applied to the cervix help reveal areas that may need biopsy.
WE BIOPSY WHEN THE FINDINGS INDICATE IT
If an area appears abnormal, we may take a small sample and send it to pathology. We tell you before taking it. Not every patient needs a biopsy. When several abnormal areas are visible, more than one targeted biopsy may be necessary because a single sample can miss the area with the most significant changes.
WE SAMPLE THE CERVICAL CANAL WHEN NEEDED
Sometimes we need information from inside the cervical canal, where the colposcope cannot see. This is called endocervical sampling. It is not necessary for every patient, and we explain why we recommend it before proceeding.
WE EXPLAIN WHAT HAPPENS NEXT
Before you leave, we review what we saw, whether biopsies were taken, what you may experience afterward, when pathology is expected, and how you will receive the results.
image of colposcope

What Should You Expect Afterward?

If no biopsy is taken, you may have little or no discomfort afterward.

After a cervical biopsy, mild cramping, spotting, or dark discharge from the solutions used to control bleeding can occur. We will give you instructions based on exactly what was done.

Most patients can drive themselves home and return to normal activities. If your pain-management plan includes medication that could impair driving, we will tell you in advance that you need someone to drive you.

We will also tell you when to contact us about bleeding, pain, fever, or another symptom that is more than expected.

Nurse holding paperwork

Colposcopy Pricing

Colposcopy

$350

Pathology

Usually approximately $50–$100, depending on the number and type of specimens submitted.

You do not need to be a Hitchcock Family Medicine member.

Members receive additional discounts on cervical dysplasia services.

We believe you should understand both what we are doing and what it will cost before the procedure begins.

Frequently Asked Questions
How long does a colposcopy take?
The actual examination is usually fairly brief. We schedule enough time to review why you are there, explain the procedure, perform the examination without rushing, and talk through what happens next.
Does the colposcope go inside me?
No. The speculum goes into the vagina just as it does during a Pap smear. The colposcope remains outside the body and magnifies the view of the cervix.
Will I definitely have a biopsy?
No. Biopsy depends on your underlying risk and what we see during the examination.
How many biopsies might you take?
That depends on what the cervix looks like. When several abnormal areas are visible, ASCCP standards recommend multiple targeted biopsies—generally two to four—to improve detection of high-grade disease. The goal is not to take a predetermined number. It is to adequately sample the clinically relevant areas.
Can I take something for pain beforehand?
Many patients can use an over-the-counter pain medication before colposcopy, but what is appropriate depends on your medical history and medications. If you are particularly worried about pain, contact us before the appointment so we can discuss the plan rather than waiting until you are already in the procedure room.
Can I drive myself home?
Most patients can drive themselves after a routine colposcopy and cervical biopsy. If your individual plan includes medication that could impair driving, we will tell you beforehand.
Can I go back to work afterward?
Most patients can return to normal activities after a routine colposcopy. If biopsy is performed, mild cramping or spotting may occur.
Can I have sex afterward?
If no biopsy is performed, there may be little or no restriction. After cervical biopsy, we may recommend avoiding vaginal intercourse, tampons, or other vaginal insertion for a short period while the biopsy sites heal. Your specific instructions will depend on what was done.
How long will pathology take?
We will tell you the expected pathology turnaround at the time of your procedure and how you will receive your results. Just as importantly, we will tell you what the possible results mean and what each result would likely lead to next.
What happens if the biopsy shows CIN2 or CIN3?
CIN2 and CIN3 are managed differently. Some appropriately selected patients with CIN2 may be candidates for close surveillance. CIN3 should be treated. We will review the pathology in the context of your entire cervical history before recommending the next step.
What if I am extremely anxious about the procedure?
Tell us before we start. Anxiety and previous procedural experiences can meaningfully affect pain perception and the overall experience of an office gynecologic procedure. Current ACOG guidance specifically recommends that pain and anxiety management be individualized according to the patient’s expectations and previous experiences. There is no award for silently enduring a procedure. We would rather know what you are worried about so we can talk through what is realistic and what options may help.
What if my last colposcopy was terrible?
Tell us. We want to know what happened, what was painful, what made the experience difficult, and what you are most worried about happening again. A previous difficult procedure should inform how we approach the next one.
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Need a Colposcopy?

You do not need to be a Hitchcock Family Medicine member, and you do not need to arrive already knowing what your results mean.

If you’ve been told you need a colposcopy—or you have an abnormal Pap or HPV result and aren’t sure what the next step should be—start with the information you already have.

You bring the results. We’ll help you understand what comes next.

Schedule a colposcopy

Written and medically reviewed by Matthew Hitchcock, MD
Board-Certified Family Physician
Last reviewed: August 26, 2026

image of colposcope Colposcopy Dr. Hitchcock talking with patient in a relaxing setting. Second Opinion Dr. Hitchcock explaining a gentle colposcopy instrument to a patient. Imiquimod Nurse holding paperwork CIN2-3 Traveling

Have cervical dysplasia results and not sure what comes next?

You do not need to know exactly what kind of appointment or treatment you need before contacting us.

If you have an abnormal Pap or HPV result, need a colposcopy, have been diagnosed with CIN1, CIN2, or CIN3, have been told you may need a LEEP, or want a second opinion about your options, start with the results you already have.

Our team will review your request and help you understand the appropriate next step.

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