Abnormal Results? Why You Need a Colposcopy & Medically Approved Next Steps

Hearing that you have "abnormal results" after a Pap smear or HPV test can feel unsettling. It's normal to worry. But abnormal does not automatically mean cancer. In many cases, changes in the cervix are mild and treatable — or even temporary.

One of the most common next steps after abnormal cervical screening results is a colposcopy. Below, you'll learn what a colposcopy is, why it's recommended, what to expect, and what medically approved next steps may look like.

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What Does "Abnormal" Mean?

Abnormal cervical screening results usually mean that some cells on your cervix look different from normal under a microscope. These changes are often caused by human papillomavirus (HPV), a very common virus that most sexually active people will have at some point.

Abnormal results can range from:

• Mild cell changes (low-grade)
• Moderate to severe cell changes (high-grade)
• Rarely, findings that raise concern for precancer or cancer

Most mild abnormalities go away on their own, especially in younger women. However, some changes can progress over time if not monitored or treated. That's why follow-up is important.

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What Is a Colposcopy?

A colposcopy is a medical procedure that allows your doctor to closely examine your cervix, vagina, and vulva using a special magnifying instrument called a colposcope.

The colposcope stays outside your body. It works like a microscope, helping your doctor see abnormal areas more clearly.

During a colposcopy:

1. You lie on an exam table like you would for a Pap test.
2. A speculum is placed in the vagina.
3. The cervix is cleaned with a mild solution that highlights abnormal cells.
4. The doctor examines the cervix with magnification.
5. If needed, a small tissue sample (biopsy) is taken.

The procedure usually takes 10–20 minutes.

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Why Do You Need a Colposcopy?

A colposcopy is recommended when cervical screening suggests that more information is needed.

Common reasons include:

• Abnormal Pap smear results
• Positive high-risk HPV test
• Persistent HPV infection
• Follow-up of previously treated cervical changes
• Visible abnormalities on the cervix

The purpose of a colposcopy is to:

• Confirm whether abnormal cells are present
• Determine how severe the cell changes are
• Rule out cervical cancer
• Guide appropriate treatment

It is a diagnostic tool — meaning it helps clarify what is happening so you and your doctor can make informed decisions.

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Does a Colposcopy Mean I Have Cancer?

No.

Most people who have a colposcopy do not have cervical cancer. In fact:

• Many biopsies show mild or moderate changes.
• Some show no significant abnormalities at all.
• Cervical cancer is uncommon, especially when screening is done regularly.

The goal of screening and colposcopy is early detection — to catch and treat abnormal cells before they become cancer.

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What Does the Biopsy Tell You?

If a biopsy is taken during your colposcopy, the lab will examine the tissue and classify the changes.

Results may include:

• Normal tissue
• Low-grade squamous intraepithelial lesion (LSIL) – mild changes
• High-grade squamous intraepithelial lesion (HSIL) – more serious changes
• Cervical intraepithelial neoplasia (CIN 1, 2, or 3) – increasing severity
• Rarely, invasive cervical cancer

These findings help determine your next step.

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Medically Approved Next Steps After a Colposcopy

Your treatment plan depends on the biopsy results, your age, medical history, and personal preferences.

1. Observation and Monitoring

For mild abnormalities (such as CIN 1):

• No immediate treatment may be needed.
• Repeat Pap and/or HPV testing in 6–12 months.
• Many mild changes resolve on their own.

This "watchful waiting" approach is safe when guided by a doctor.

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2. Treatment for Moderate to Severe Changes

If moderate or severe abnormalities are found (CIN 2 or CIN 3), treatment is often recommended to remove abnormal cells.

Common procedures include:

• LEEP (Loop Electrosurgical Excision Procedure) – removes abnormal tissue with a thin electrical wire loop
• Cold knife cone biopsy – surgically removes a cone-shaped section of tissue
• Laser therapy – destroys abnormal cells
• Cryotherapy – freezes abnormal cells

These treatments are highly effective at preventing cervical cancer when done early.

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3. Referral to a Specialist

If results suggest invasive cervical cancer (which is uncommon), you may be referred to a gynecologic oncologist for further evaluation and treatment.

Early detection greatly improves treatment success.

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What to Expect After a Colposcopy

Most people recover quickly.

You may experience:

• Mild cramping
• Light spotting or dark discharge
• Temporary vaginal discomfort

If a biopsy was taken, avoid:

• Tampons
• Sexual intercourse
• Douching

for about a week, or as directed by your doctor.

Call your doctor if you experience:

• Heavy bleeding (soaking a pad per hour)
• Fever
• Severe pelvic pain
• Foul-smelling discharge

These are uncommon but should be evaluated promptly.

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Risk Factors for Cervical Cell Changes

Understanding risk factors can help you stay proactive.

Risk factors include:

• Persistent high-risk HPV infection
• Smoking
• Weakened immune system
• Early sexual activity
• Multiple sexual partners
• Lack of regular cervical screening

However, many people with cervical changes have no obvious risk factors beyond HPV exposure.

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Should You Be Worried?

It's natural to feel anxious, but it's important to keep perspective.

Key facts:

• Cervical cancer usually develops slowly.
• Regular screening dramatically lowers risk.
• Most abnormal results are manageable.
• Early treatment is highly effective.

Following through with your colposcopy and recommended follow-up is one of the best things you can do for your long-term health.

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When to Seek Immediate Medical Attention

Speak to a doctor right away if you experience:

• Unexplained vaginal bleeding (especially after sex or between periods)
• Pelvic pain that does not go away
• Bleeding after menopause
• Persistent unusual vaginal discharge

While these symptoms do not automatically mean cancer, they should always be evaluated. If you're experiencing any concerning symptoms and want to better understand what they might mean, you can use a free AI-powered Cervical Cancer symptom checker to help guide your next steps before speaking with your doctor.

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Questions to Ask Your Doctor

Being informed can reduce anxiety. Consider asking:

• What did my abnormal result specifically show?
• What are the chances this will progress?
• Do I need treatment now or monitoring?
• How will this affect future pregnancies?
• When is my next follow-up?

Clear communication helps you feel more in control.

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The Bottom Line

A colposcopy is a safe, effective way to evaluate abnormal cervical screening results. It does not mean you have cancer — it means your doctor is taking the right steps to protect your health.

Most cervical cell changes:

• Are caused by HPV
• Develop slowly
• Are treatable
• Do not turn into cancer when properly monitored

The most important next step is simple: follow your doctor's recommendations.

If you have symptoms that concern you or results you don't understand, speak to a doctor promptly. Anything that could be serious or life-threatening deserves professional medical attention.

Early action leads to the best outcomes.