I was just wondering what a colposcopy is. Something irregular turned up on my pap smear. My gynecologist gave me sulfa-based creams, but the irregularity on the cells from my cervix was still there on my next exam. Now, I have to have a colposcopy, and I was wondering what that entails - my doctor said that it was just to see if further action needed to be taken. Could you tell me, if at all possible, what purpose colposcopies serve and what is wrong with the cells. In other words, do you have any idea, from a vague description, what could be wrong? Thanks

The part of the cervix exposed to the vagina is a very active site for cell growth. Pap smears tell us if this cell growth is healthy and normal, or if it has changed in any way. Of course, abnormalities of cell growth can be of varying degrees of severity. Thus, when your Pap smear results indicate some irregularity, it can mean a few things.

The most common explanation for irregular Pap smear results is "atypical" cells. This is not cancer - it simply means that some of the cells began growing in an aberrant fashion. Or, you could possibly have a somewhat more serious condition called dysplasia, or cervical intraepithelial neoplasia (CIN). For more information on what dysplasia and atypical cells involve, you can read What is dysplasia? under General Health in Alice's archives.

In either case - atypical cells or dysplasia - treatment involving antibiotic sulfa-based creams is completely unnecessary and ineffective. Usually, you can wait a few months to see if the abnormality resolves on its own. However, if your next Pap smear also comes back "irregular," then you'll want to have a more accurate and thorough diagnostic test done. That's basically what a colposcopy is.

Colposcopy allows your doctor to get a good look at what's going on among your cervical cells. It involves using a colposcope, an instrument that magnifies the area 10 to 20 times, and a staining solution, which makes it easier to distinguish between the healthy, normal cells and the atypical cells. If any questionable areas of atypical growth are obvious, they can be biopsied in order to determine the extent of the problem, and to decide on a course of treatment, if any is needed. A colposcopy really isn't much more uncomfortable than a gynecological exam. It takes less than an hour, can be done in your doctor's office, and doesn't require any anesthesia.

Alice knows it can be scary to receive abnormal test results (of any kind). It probably sounds worse than it really is---hopefully, knowing more about it will ease some of your concerns. If you're being seen by a health care provider at Columbia, you can ask your provider for an information sheet on colposcopies. If you're being seen by someone outside of Columbia, you may want to ask him/her for more information about your Pap smear results and the colposcopy.

Alice

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