We spoke with Dr. Maria Isabella Sereni, gynaecologist.

Human papillomaviruses (HPV) are double-stranded DNA viruses that primarily target the skin and mucous membranes of the anogenital and oropharyngeal areas. These viruses are extremely common across the global population. Of over 150 identified types, 14 are considered high-risk, as they are linked to the development of cancers in various areas: cervix, vulva, vagina, anus, penis, and head and neck.

HPV is primarily sexually transmitted, and it’s estimated that up to 80% of sexually active women will come into contact with the virus at least once in their lifetime. About 50% of those cases involve a high-risk genotype.

Globally, cervical cancer is the second most common cancer among women. Fortunately, 99% of cervical cancers can be prevented through screening and vaccination.

At our clinic, we offer a complete cervical lesion screening program that includes Pap smears, HPV testing, and colposcopy.

What Is Colposcopy?

Colposcopy is a diagnostic procedure that involves examining the cervix using a special optical instrument called a colposcope, which magnifies the view between 6 to 40 times.

Before the Exam

To prepare for a colposcopy, it’s important to:

  • Avoid sexual intercourse, vaginal creams, suppositories, douches, or tampons for 48 hours before the exam
  • Bring the results of your most recent Pap smears and any previous colposcopies
  • Inform the gynecologist of any medications, especially blood thinners (antiplatelet or anticoagulants), or any allergies (iodine, contrast agents, or local anesthetics)
  • The exam cannot be performed during menstruation, if there is heavy bleeding, or if there is severe vaginal inflammation
  • Inform the doctor if you are pregnant – colposcopy is safe during pregnancy but requires tailored precautions

Q&A with Dr. Maria Isabella Sereni

Deputy Clinical Lead in Colposcopy at the John Radcliffe Hospital, Oxford, and expert in gynaecological cancer prevention and ultrasound diagnostics.

1. What is colposcopy?

Colposcopy is a second-level exam used to identify pre-cancerous lesions of the cervix (Cervical Intraepithelial Neoplasia, CIN).

2. How is diagnostic colposcopy performed?

The procedure involves inserting a speculum to visualize the cervix. The gynecologist then applies solutions – acetic acid and iodine – to highlight abnormal cells under the colposcope. If abnormalities are found, a biopsy is performed for histological analysis.

3. When is colposcopy recommended?

Colposcopy is usually recommended following an abnormal Pap test (cervical smear).

4. What infections can be detected with colposcopy?

Colposcopy can identify signs of high-risk HPV infection.

5. Is the exam painful? What are the risks?

Colposcopy is not particularly long or painful. The main discomfort comes from the use of the speculum, similar to a Pap test. If a biopsy is needed, one might feel cramping similar to menstrual pain, usually brief.
There are no significant risks, and it can be safely performed during pregnancy. Some patients may experience a vagal reaction (faintness or lightheadedness) due to cervical stimulation, but this is usually short-lived.