Episode 15: What's a Colposcopy and Why Do I Need to Have That Done?

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Hi, I'm Dr. Tabatha, the Functional Gynecologist. I'm a board-certified OB-GYN and functional medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey, and I'm super excited to share my wisdom and unique perspective as it pertains to women's health. So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, insomnia, you name it, Then you've come to the right place. I want to be your functional gynecologist, so welcome. Okay, the question of the week: what is a colposcopy and why do I need to have that done? So, a colposcopy is a way of looking at your cervix with a magnifying device called the colposcope. We do this because you've most likely had an abnormal Pap smear, a persistent low-grade change that isn't resolving, an ASC-US Pap smear, which means it's abnormal but we're not sure what's going on, and you have the HPV virus was positive, or you have high-grade changes seen on your Pap smear. Those are all reasons to have a colposcopy done. We also do it as follow-up to see if you have healed or resolved your issues after a procedure called a LEEP. We also do it for chronic cervicitis, genital warts on the cervix, persistent bleeding with intercourse, or pain. So, the colposcopy lets us look at the surface of the cervix in a magnified view. It's kind of like a Pap smear exam in that you're in the stirrups and laying there, but it takes a little bit longer. We actually put vinegar on your cervix to help make any of the abnormal cells show up easier. So, we can see any of the changes we're looking for. Some whitening areas or some atypical blood vessels to show up, or a pattern called mosaicism, where the abnormal cells start to change what your cervical cells look like. If there's anything suspicious or concerning, we're gonna take a little biopsy. We use an instrument that takes a little piece off of the suspected area, and we send that to the pathologist, and they look under their microscope, which is much more magnified, to see at the cellular level, are your cells abnormal? abnormal and precancerous. We can also do an endocervical curettage where we're getting cells from inside of the cervix that we can't see. So the cervix is kind of like a little tube, or it looks like a donut on the outside with a tube, and so we can't see inside the tube. So sometimes we need to blindly take a biopsy of that to make sure we're not missing any abnormal cells growing in there. Most of the time, abnormal cells start at the junction on the external side of the cervix where we can see it. If you have an ECC, or endocervical curettage, done, that feels pretty crampy. It's not that comfortable, I'll admit, but it only lasts a minute or 2, and then you're usually fine. If you have that or a cervical biopsy, you might feel a little crampy for a day or 2, But you can go about your normal day after you leave your appointment. If we take biopsies, we'll most likely put a chemical cautery mixture on there to stop the bleeding. That's called Monsel's. That can cause a brown discharge for a few days, and it can even look like coffee grounds when it comes out after it's mixed with the blood. So you get a little funky discharge for a few days, nothing crazy. And 24 hours of nothing in the vagina. So it's really not that invasive, no downtime or anything like that. So that's it. If you have an abnormal Pap smear and you've been told that you need a colposcopy, don't freak out. It's not that terrible of a procedure. It's more looking, maybe a little bit of a biopsy, but it's not that invasive. And hopefully your gynecologist will talk you through everything that's happening, and it will only take about 5 minutes. It does take up to a week to get those biopsy results back from the pathologist. Often, if they're low-grade changes, you'll just need repeat Pap smears until your body clears that HPV virus and your cells revert back to normal. High-grade changes might require something called a LEEP procedure, which we'll talk about in the future. So that's it. Shoot me your questions so I can Shout you out on question of the week, and keep listening because in a future episode we're actually going to dive deep into HPV or the human papillomavirus, how it causes abnormal cervical cells and leads to cervical cancer, and all those juicy details in between. So for now, please consider subscribing to the podcast if you haven't already. Give me a five star. Our review and share it with your friends. We want to get the word out, help other women so they're not struggling and scared with their female issues. Education is power, knowledge is key. So keep listening. Now go have an awesome week and I'll talk to you soon. Take care.