A colposcopy is a medical procedure involving a magnified examination of the cervix, vagina, and vulva, typically performed after an abnormal cervical screening result. This allows a healthcare provider to closely inspect tissues and identify areas requiring further evaluation. Many individuals are concerned about post-procedure bleeding, and this article addresses the common occurrences following a colposcopy.
Understanding Expected Post-Procedure Bleeding
Light bleeding or spotting is a common and expected outcome following a colposcopy, especially if a biopsy was performed. The discharge is typically light, appearing pink, brown, or dark-colored, and the blood loss should be significantly less than a normal menstrual period. This spotting usually begins immediately and resolves completely within a week, gradually lessening in intensity and volume. Mild cramping, similar to menstrual discomfort, may also accompany the spotting for the first 24 to 48 hours and can be managed with over-the-counter pain relievers.
Sources of Post-Colposcopy Spotting
The discharge experienced after the procedure is directly related to how the colposcopy was performed, especially if a cervical biopsy was necessary. When a small tissue sample is taken for laboratory analysis, the removal creates a minor wound on the cervix. This tiny site is the immediate source of the initial light bleeding or spotting.
To stop the bleeding from the biopsy site, the clinician often applies a topical hemostatic agent, such as Monsel’s solution or silver nitrate. Monsel’s solution is a ferric subsulfate paste that chemically seals the small blood vessels to achieve hemostasis. As the body naturally expels this substance over the next few days, it often results in a dark, thick, or coffee-ground-like discharge.
Silver nitrate, another common hemostatic agent, can also be used to cauterize the small wound. This may lead to a dark, sometimes silvery-black, discharge as the solution sloughs off. This dark, discolored discharge is the residue of the applied medication, not old or clotted blood, which can help provide reassurance during the recovery period.
Warning Signs and When to Contact Your Provider
While light spotting is expected, certain symptoms indicate a potential complication requiring immediate medical attention. Abnormal bleeding includes soaking through more than one standard sanitary pad per hour for two consecutive hours, or passing large blood clots atypical for your menstrual cycle.
Signs suggesting infection should also be reported promptly. These include a persistent or increasing fever, chills, or severe pelvic pain that does not improve with medication. Additionally, a vaginal discharge with a foul odor, or one that appears thick, yellow, or green, warrants contacting your care team.
Post-Procedure Care and Recovery Guidelines
Adhering to specific care guidelines after a colposcopy, especially one involving a biopsy, is important for healing and infection prevention. To minimize the risk of introducing bacteria to the healing tissue, it is generally recommended to avoid placing anything into the vagina. This restriction typically means refraining from using tampons and instead using external sanitary pads to manage any discharge or spotting.
Patients are usually advised to avoid douching and sexual intercourse for a period, often between one to two weeks, or as otherwise instructed by the provider. This time frame allows the minor wounds on the cervix to close and fully heal, preventing irritation or disruption of the hemostatic seal. Light physical activity is usually fine, but strenuous exercise, heavy lifting, and swimming may also be restricted for a short time to aid recovery.