Pap Smear Result “Abnormal.” Now What?

Last year, you had your annual Pap smear, and you breathed a sigh of relief when the results come back normal. But for some reason, this year, the results came back…abnormal.  What now? What is the next step? Well, following an abnormal Pap smear test, your provider will typically order a colposcopy.

A colposcopy is a procedure which allows a close-up look at your cervix, vaginal tissues, or vulvar areas.  A colposcope is the instrument used in a colposcopy, hence the name of the procedure.  It looks like something you’d see at the dentist or the eye doctor – one of those instruments atop a metal box which can be wheeled anywhere around the office. Its “antennae” protrude out like a robots’ arms, and at the very ends, you see the main piece: A pair of binocular-type microscopes, which emit light in order to view your cervix closer, kind of like a microscope.

The Colposcopy Procedure

A colposcopy is similar to getting a Pap smear, in that a speculum is used to view your cervix easily.  One or two different types of solutions will be applied to your cervix.  The abnormal cells will change colors, signifying to the practitioner whether you need a biopsy.  If so, the biopsy will be sent to a pathologist who returns a report within 7 days.  You may have a follow-up appointment to discuss the results. 

After the Colposcopy

For a few days after the colposcopy, you might experience any of the following:

-Mild bleeding

-Black, coffee-grind looking vaginal discharge. This is from a medication used during the colposcopy.

Should I Do Anything Different After the Colposcopy? 

If a biopsy was taken, refrain from sexual intercourse for one week following the colposcopy. Otherwise, your life should continue as normal. If you are on birth control, continue as prescribed. You may shower, bathe, and use tampons right away.

What results will the doctor give me?

Pap smears are only screening tools, and colposcopies are diagnostic.  This means that a Pap smear may tell us that there is an abnormality, yet the biopsy might come back normal, or a different classification of “abnormal: than the Pap smear report stated. 

Biopsy results are classified as follows:

  • CIN I: Mild dysplasia (abnormal cells)
  • CIN II: Moderate dysplasia
  • CIN III: Severe dysplasia, carcinoma in-situ
  • Cervical cancer

In most cases, anything abnormal simply means that we monitor you closer, typically with more frequent Pap smears. Sometimes, we perform a procedure to remove the abnormal cells, called a LEEP. 

A colposcopy is the best way to assess an abnormal Pap smear and decide next steps. While you might be hesitant about the procedure, and concerned about the results, it is really the easiest, most efficient way to assess your situation. Remember, we’re here to help you be healthiest you possible.