What Is a Colposcopy—and Why Have So Many of Us Had One Without Talking About It?
If your provider just told you that you need a colposcopy, you’re not alone—and you're definitely not the first to Google it on the car ride home. Colposcopies are actually very common, but most of us don’t realize that until we’ve been through one ourselves. So let’s break it down.
What’s a Colposcopy?
A colposcopy is a follow-up procedure that’s done when your Pap smear or HPV test comes back abnormal. It allows your provider to take a closer look at your cervix (with a special magnifying device called a colposcope—think binoculars for your cervix) and see if there are any concerning or precancerous changes to your cells.
It’s not a surgery. It’s more like a super-focused pelvic exam, and it can include taking small biopsies if something looks suspicious.
How Common Are They?
Colposcopies are very common. Around 1 in 20 women will have an abnormal Pap each year, and millions of colposcopies are performed annually in the U.S. If it feels like all your friends have quietly had one? That’s because… a lot of them probably have.
It’s just that no one talks about it—because cervical health is still weirdly stigmatized, even though it affects so many of us. You’re not broken. You’re not alone. You’re navigating a system that’s only just now learning how to talk about this stuff openly.
Why Do I Need One?
If your screening test shows high-risk HPV or abnormal cells, your provider wants to be proactive. A colposcopy helps identify whether these changes are minor (and likely to go away on their own) or more serious and in need of treatment. In many cases, it’s a precaution. And in most cases, it does not mean you have cancer.
Getting a colposcopy now can help prevent cervical cancer later. It’s early detection in action.
Let’s Talk About Pain (Because No One Ever Does)
Colposcopies aren’t fun. Many providers will belittle it and say it shouldn’t be bad—but many people do experience discomfort, cramping, or even dizziness during or after. Especially if your provider takes a biopsy.
You’re likely to feel:
Pinching or cramping with biopsies
A sharp sting from the vinegar-like solution used to highlight abnormal cells
Lightheadedness or a vasovagal response (more on that below)
And here’s the big news: ACOG (the American College of Obstetricians and Gynecologists) just released new guidance in May 2025 emphasizing that we should be offering pain management during procedures like colposcopies.
Here are options you can ask for:
Pre-procedure NSAIDs like ibuprofen or naproxen (take 30–60 minutes before)
Topical numbing gel applied to the cervix
Local anesthetic (like lidocaine) for biopsies
Anti-anxiety medications if medical trauma or anxiety is a concern
Support tools like music, breathing techniques, or even holding someone’s hand
Your pain is real. You deserve to be comfortable and informed. Ask your provider what they offer—and if they brush you off, that’s a red flag.
Why Do I Feel Like I’m Going to Pass Out?
That dizzy, sweaty, about-to-blackout feeling? It’s called a vasovagal response, and it happens when your body overreacts to being triggered—by discomfort, anxiety, or even just the stress of being in stirrups.
It’s common during pelvic procedures, especially if no one warned you what to expect. It’s your nervous system hitting the brakes. You’re not dramatic. It’s physiology.
To reduce the chances:
Let your provider know if you’ve had this happen before, and if so, perhaps you want someone to drive you for the procedure
Ask for support (pain management, breathing tips, breaks)
Don’t go in hungry or dehydrated
Request a slower pace if you need it
So Why Did No One Tell Me About This?
Honestly? Because we’re still unlearning shame around sexual health and gynecologic care. Cervical procedures are often framed as “just part of being a woman”—which is code for: grin and bear it, don’t talk about it, and definitely don’t ask for help.
But we’re done with that.
You can talk about it. You can ask for better care. And at Take Back Trust, we’ll keep shouting about it from the rooftops.
You deserve to understand what’s happening to your body—and to be treated with respect every step of the way.
