I got a colposcopy after an HPV diagnosis—here's what that means
Six days before my 33rd birthday—the birthday when I had decided to launch a blog dedicated to the magnifique topic of my sex life—I received the following email from my gynecologist:
“I reviewed your [pap smear] test results—they have the same finding as last time; the [HPV] virus has not cleared. In addition, there are slight changes in the cells. I would recommend you to an OB/GYN to do a colposcopy. It isn’t urgent, but would have an appointment set up within the next 1-2 months.”
My doctor may have told me to set up an appointment for a colposcopy within 1-2 months—but I made an appointment within two hours. But for what? I had no idea what a colposcopy was.
“I had been going to the gynecologist for years. Why, at age 32, had I never heard of this so called ‘common’ procedure?”
A few months earlier, after an abnormal pap smear, my gyno informed me that I had HPV. She recommended that I get a follow-up pap six months later, which led me to the email above. Still living with HPV cells and uncertain about treatment options, my interest in writing about sex came to a screeching halt. I contemplated updating the name of my blog from “My Sex Project” to “Embracing Celibacy.”
Without knowing what to expect from a colposcopy (or even how to pronounce it), I searched for doctors who could perform a mysterious colposcopy. I enunciated my C’s and P’s on the phone until I found a winner—then it was time to figure out what the hell I’d just made an appointment for.
I knew a Google search would lead me down a rabbit hole of anxiety and most likely a news article about a Trump tweet (what doesn’t lead to a Trump tweet these days?), so I turned to Facebook. I asked for friends who had ever gotten a colposcopy to message me. At first, I got a lot of messages that seemed to confuse the mysterious colposcopy with the not-so-mysterious colonoscopy. But, finally, some friends who hadn’t misread my post responded with everything from, “I’ve had multiple colposcopies!” to “They are pretty awful.”
According to Dr. Kamilia Smith, who recently founded Charleston House in Dallas, Texas to advocate for and educate women on their health care journeys, “The colposcopy is a common procedure done in the office with a microscope…[It] is typically used for cells you can’t see with the naked eye.”
I had been going to the gynecologist for years. Why, at age 32, had I never heard of this so called “common” procedure?
“I always have to explain it.” says Smith. “Since [the HPV virus] is what is most frequently causing the abnormal pap smear, age matters.” says Smith. “Women in their 20s tend to clear HPV very quickly…Women in their 30s, however, need to be watched closer because they are less likely to clear the virus and normalize their pap smear.”
On the day of my appointment, I learned more. Colposcopies are more than just a closer look at your cells—they come with complimentary biopsies. (BOGO?)
“Knowledge is power,” says Dr. Kamilia Smith. “Women need to know what they are up against.”
In order to get a better look at the abnormal cells, microscopic biopsies are obtained during a colposcopy when doctors use biopsy forceps which, full disclosure, are anything but microscopic. Biopsy forceps look like the scissors I used during my scrapbooking phase, and during my appointment, I wondered out loud if my doctor was going to take a biopsy or cut my cervix into a decorative lace pattern. She assured me that, despite the intimidating tool, the colposcopy would entail no more than some quick pinching.
Thirty seconds of uncomfortable cramps later, it was over. Relieved, I wondered how much I’d end up paying for 30 seconds of cramping. I started fantasizing about a medical plan that was based on length of appointment and not procedure (who in 2020 would support this? Warren? Bernie?) when the doctor announced that in order to cover all of our bases, she was going to also perform unknown procedure #2: an endometrial biopsy.
An endometrial biopsy “check[s] the lining of the uterus for uterine infections, endometriosis, fertility or endometrial cancer” by inserting a biopsy pipelle into the cervix, explains Healthline. They are usually more painful because they “are going to a higher place in the uterus cavity where there are more nerves.” says Dr. Kamilia Smith.
“This won’t feel good,” my doctor conferred.
I appreciated her honesty, but in that moment, I wanted a hug—no, I wanted a live Spice Girls performance in front of my spread legs, the gals reassuring me of my own girl power. I was scared, but my doctor assured me that if I was able to have an abortion without sedation, then I could survive this. Zigazigah?
My doctor began the procedure, but after some time, confessed, “She won’t open up.” Like myself, my cervix was over it.
So what do you do when your body says “Nah?” You reschedule an appointment for a week later. Except, this time, my doctor also prescribed me item #3 of vagina treatments I had never heard of until that day: misoprostol. Misoprostol, when taken with mifepristone, aids in the termination of pregnancies. But when inserted into your vagina alone, misoprostol dilates and softens your cervix. How romantic.
“’This won’t feel good,’ my doctor conferred. I appreciated her honesty, but in that moment, I wanted a hug—no, I wanted a live Spice Girls performance in front of my spread legs, the gals reassuring me of my own girl power.”
The night before my rescheduled endometrial biopsy, I had to start the softening process by inserting two of the misoprostol pills as far up my vagina as I could. That freaked me out. When a tampon is inside me, I know where it is. I see it. I pull it out. But these bad boys weren’t leaving. No, they were going to dissolve into me. I went to bed wondering if I would wake up with a leaking vagina, or a vagina at all.
Thankfully my vagina was still intact when I woke up ,and I inserted the last of the two misoprostol pills, hoping my cervix would stay soft enough to get through the procedure. An hour later, I was back in stirrups and my doctor once again tried inserting the pipelle. She and the assistant both ‘Yay!’-ed. She was in.
The endometrial biopsy was also fairly quick, maybe lasting for a minute—but to call it uncomfortable would be an understatement. That minute felt like unpleasant, aggressive fingering by an overzealous, clueless lover. I moaned and cringed right up until the moment the doctor was out. She handed me two pain pills. Girl power.
“Now that some time has passed since my week of vagina discoveries, I’m happy to say that we’re back on good terms. Because it was never my body or my vagina that I was actually mad at—it was my lack of knowledge. “
Now that some time has passed since my week of vagina discoveries, I’m happy to say that we’re back on good terms. Because it was never my body or my vagina that I was actually mad at—it was my lack of knowledge. I didn’t know the words being said to me about my own body and that didn’t feel good. I could have all the girl power in the world, but without knowledge, what good is it?
“Knowledge is power,” says Dr. Kamilia Smith. “Women need to know what they are up against.” There may never be a pamphlet big enough (or a Spice Girls reunion tour long enough), but women should be empowered earlier, and better. Especially when it comes to common diagnoses and procedures that a majority of us will experience. I learned more about my vagina in seven days than I had in the past decade. This experience proved to me that I need to know more about my own body. We all should. Those three months of middle school sex ed spent finding private parts in a word search taught me nothing but how to read “fallopian tubes” backwards. Impressive, but I think we can do better.