If you have an abnormal Pap smear, your doctor might recommend a colposcopy and biopsy. It sounds very complicated, but it really isn't.
For the procedure, you'll be in the same position as you are for a Pap smear--flat on your back, feet in the stirrups. A colposcope is nothing more than a fancy name for a big magnifying glass that the doctor uses to look at your cervix. I always think it feels warm because it has a very bright light on it, and that puts out some heat.
To identify abnormal cells, your doctor will swab your cervix with a big Q-tip dipped in acetic acid, which is vinegar. The acetic acid makes the abnormal cells turn white. Then your doctor will take a metal tool and pinch off a little piece of your cervix where she sees those white cells.
Yes, it hurts. It feels like a really bad cramp or a sharp pinch like getting a shot of novocaine. But it ends quickly. The first time I had it done, she took 6 biopsies. I never wanted to go back!
The whole purpose is to see what's going on beneath the surface of your cervix. Sometimes the surface looks rather normal, but right underneath, the cells are changing.
I have heard of women who refused the biopsy because they thought it wasn't necesary--that they would wait for a followup Pap smear instead to see if it improves. I think that's really foolish, I do. The colposcopy and biopsy are not that big of a deal. They leave no scars because they are that small and heal quickly.
I know I said it hurts, but it's really quick, and it doesn't affect your future fertility at all. In fact, sometimes they do it during pregnancy. It is such a tiny pinch of tissue that they remove. I think the anticipation is worse than the actual biopsy because you are nervous about it, just like when the dentist has to give you a shot to numb your mouth. The pain is very short-lived.
So if your doctor recommends an exam with a colposcope and biopsy, just do it. Ask if you can take some ibuprofen before you go to help with the cramping feeling.
The biopsy can tell your doctor about what's going on better than just a Pap smear can. It may be very reassuring to know that things are okay, or if you do need more treatment, it was hopefully caught early.