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Colposcopy
Colposcopy is a magnified examination of the cervix. It is most often recommended after an abnormal Pap smear or a specific HPV test result, for a more precise assessment. The aim is earlier diagnosis — not automatically “bad news”.
With Dr. Maria Raykova in Sofia, the visit is calm, with time for questions and clear explanations.
Book appointmentWho it is for
Suitable for abnormal Pap results, a positive HPV test with certain findings, visible changes, or when the doctor recommends further cervical assessment. The decision is individual — usually after a preventive gynecological exam or a consultation about results.
What is colposcopy?
Colposcopy is a close examination of the cervix — and sometimes the vagina — with a magnifying device (colposcope). The colposcope stays at a distance and magnifies the image; it is not inserted deep into the body.
A solution may be applied so changes are easier to see. If needed, a small biopsy can be taken. The exam is done after clinical judgment and a conversation about the indications.
When is it recommended?
Colposcopy is not routine screening for every woman. It is recommended when there is a reason for a closer look at the cervix.
- abnormal Pap smear results;
- a positive HPV test with certain combinations of findings;
- follow-up after a previous finding;
- visible changes that need a more precise exam.
How does it proceed?
The position is the same as for a gynecological exam. The doctor places a speculum, examines the cervix with the colposcope, and may apply a solution. If a biopsy is taken, this is explained during the visit.
The examination itself is usually brief. The visit also includes a conversation about findings and next steps.
How should you prepare?
Preparation is similar to a regular gynecological exam. If the doctor has given other instructions, follow those.
- Bring previous results — Pap smears, HPV tests, previous colposcopies.
- Avoid vaginal creams, tampons, and spermicides for 24 hours before the procedure, unless told otherwise.
- Write down your questions: will a biopsy be taken, and when will results be ready?
- See also preparation for a gynecological exam.
Is colposcopy painful?
Most women feel mild discomfort similar to an exam — pressure or brief stretching, not severe pain. If a biopsy is taken, there may be brief discomfort or a cramp that usually passes quickly.
If you feel strong pain, say so immediately — the exam can be adapted. More detail: Is colposcopy painful?
Colposcopy and HPV
A positive HPV test means the virus is present, not necessarily a serious finding. Colposcopy is recommended for certain combinations of HPV result, cytology, and clinical history — not automatically after every positive test.
The plan is explained after reviewing your results. Educational: What does a positive HPV test mean?
Colposcopy after an abnormal Pap smear
An abnormal Pap smear is not a cancer diagnosis. Next comes an individual plan: sometimes observation or an HPV test is enough; other times colposcopy is recommended.
The result category, age, and previous tests determine the next step. Details: What follows an abnormal Pap smear?
What happens after the exam?
The doctor explains what was seen and whether further steps are needed. If a biopsy was taken, the result timeline depends on the laboratory — usually a few days to about a week.
Light spotting for 1–2 days is possible, especially after biopsy. Follow instructions about tampons and intercourse. Follow-up may include observation, treatment, or another preventive exam.
Why it matters
Timely care helps you understand your health and make calm decisions together with your doctor.
- A clear picture of your health — before concerns deepen.
- Plain-language explanation of findings and options.
- An individual plan for next steps, tests, or follow-up.
- A calm setting with time for questions.
How the visit goes
- 01
Step 1
Conversation about previous results and the reason for the exam.
- 02
Step 2
Colposcopic examination in a calm setting.
- 03
Step 3
When indicated — additional procedures based on findings, including biopsy.
- 04
Step 4
Clear explanation of the result and a plan for monitoring or treatment.
Frequently asked questions
What is colposcopy?
A close examination of the cervix with a magnifying device (colposcope). The aim is to see areas that need a closer look — not to give a diagnosis over the phone.
When is colposcopy recommended?
Most often after an abnormal Pap smear, a specific HPV result, follow-up of a previous finding, or when the doctor sees changes that need a more precise exam.
Is colposcopy painful?
Most women feel mild discomfort similar to an exam. If a biopsy is taken, there may be brief discomfort. Share any concerns before the procedure.
How should I prepare for colposcopy?
Bring previous results. Avoid vaginal creams and tampons for 24 hours beforehand, unless told otherwise. Write down questions about biopsy and result timing.
Is colposcopy needed after every positive HPV test?
No. A positive HPV result does not automatically mean colposcopy. The decision depends on the type of result, the Pap smear, and clinical history.
Is colposcopy always done after an abnormal Pap smear?
Not always. Sometimes observation or an HPV test is enough. With more significant changes or certain combinations of results, colposcopy is the next step.
What happens after colposcopy?
An explanation of the finding and a plan for observation, treatment, or follow-up. If a biopsy was taken, the doctor will give the expected result timeline.
When will results be ready?
It depends on whether samples were taken. If there is a biopsy, the result usually comes in a few days to about a week. The exact timing is confirmed during the visit.
How do I book an appointment?
Book online via Superdoc or call the clinic at 0894 972 626.
Does the clinic work with NHIF?
Yes, Dr. Raykova works with NHIF (Bulgarian public health insurance). Some tests may require co-payment.
More in the handbook
Educational articles on this topic — they do not replace a personal consultation.
Related services
Useful next steps depending on the clinical context.
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