No Numb, No Thanks: The Truth About Colposcopies and What You Can Ask For

Writer: Amanda Pisciotta

Editor: Youstina Swaha

Why Are So Many Women in Pain During a ‘Painless’ Procedure?

These are just a few quotes from the first five TikTok videos when searching for the word colposcopy:

• "Awful… thought I was going to pass out… can’t stop this crying."

• "Most pain I ever felt in my life… extremely gaslit about it."

• "If this was a man, they would have put me under."

• "They told me it was going to be a pinch, but when I tell you guys it was the most traumatic experience of my life."

According to the Cleveland Clinic, a colposcopy is supposed to be “relatively painless”[1]. But if you listen to the experiences of these women—along with the hundreds of similar videos on TikTok—it’s clear that for many, this procedure is anything but painless. With 3 million colposcopies performed in the U.S. each year, countless women may be experiencing unnecessary pain and distress[2].

So why is there such a disconnect between medical expectations and real patient experiences? Why are so many women suffering through what is supposed to be a routine, cancer-preventative procedure?

This article will provide a comprehensive guide on how women can advocate for themselves during a colposcopy. From pain management options to key questions to ask your provider, every woman deserves a comfortable, informed, and trauma-free gynecological exam. If a colposcopy is meant to save lives, it should not come at the cost of unnecessary suffering.

What is a colposcopy?

A colposcopy is a procedure used to closely examine the cervix, the opening to the uterus, for abnormal cells[3]. Doctors or nurses usually recommend a colposcopy after an abnormal Pap smear, a positive HPV test, or if cervical abnormalities are suspected[1]. It helps to detect precancerous changes, infections, or other conditions that may require further treatment.

During the procedure, you'll lie on an exam table like you would for a pelvic exam[3]. A speculum is inserted into your vagina and gently opened to separate the vaginal walls, allowing a clear view of the cervix[3]. Next, the doctor or nurse will apply a vinegar-like solution to the cervix, which highlights abnormal cells[3]. Then, they’ll examine the area through a colposcope—a magnifying instrument with a bright light[3]. 

If any abnormal areas are found, a biopsy may be taken[3], which involves removing a sample of tissue to send to a lab for further testing[3]. The biopsy process is typically the part of the procedure where patients may feel pain or discomfort. There are two types of biopsies: one takes tissue samples from the surface of the cervix, while the other collects a sample from inside the cervical opening. In some cases, multiple biopsies may be needed[3]. Though it may cause some discomfort, this step is essential for accurately diagnosing issues and plays a critical role in preventing cervical cancer.

Why Are Colposcopies So Painful?

A Medical Professional’s Perspective: The Medical System Is Failing Women

Taylore Passero, RPA-C [TikTok username: Gyno_Girls] explains the widespread issue in women’s healthcare:

“This woman is talking about going in for a colposcopy or a cervical biopsy and not being given any kind of pain management. I just want to say that this is a huge problem we face in healthcare today, especially in women’s health care. I graduated in 2017, so not that long ago, and I was taught not to give pain management options for colposcopies and IUD insertions because the cervix ‘doesn’t have nerve endings’ and women are ‘not going to feel pain’ during this procedure. And that couldn’t be any farther from the truth.

These procedures can be incredibly painful and traumatizing for some. Not only should we be offering pain management, but we should also be offering anxiety management. I’ve learned this firsthand—both as a healthcare provider performing these procedures and as a patient who has undergone a colposcopy without any pain relief. It is deeply uncomfortable for many women. We need to have open conversations with our patients about pain management options, and if you’re a patient, you should advocate for yourself and ask: ‘What are my options to help with pain during this procedure?’”[4]

Medical Guidelines vs. Real-World Experiences

The official medical stance downplays the pain of colposcopies. According to the medical profession:

“A colposcopy is usually no more uncomfortable than having a Pap test. You won’t need any anesthesia or pain medicine.” [1]

In reality, most women are given nothing more than over-the-counter painkillers (such as 600-800 mg of ibuprofen or acetaminophen) before or after the procedure to manage pain and cramping. But what does a colposcopy actually involve?

A colposcopy biopsy involves the removal of small tissue samples from the cervix using a specialized forceps-like instrument. This tool functions similarly to a hole punch, extracting pieces of cervical tissue for further examination. Many women describe the experience as a sharp, intense pain that lingers well after the procedure.

What makes this lack of pain management particularly troubling is that, for most other types of biopsies—including those performed on the skin—local anesthesia is a standard part of care. Whether it’s a punch biopsy, shave biopsy, or excisional biopsy, patients routinely receive numbing medication to ensure a painless experience [5]. So if doctors wouldn't perform a skin biopsy without anesthesia, why is it acceptable to remove tissue from the cervix—a sensitive organ—with nothing but Motrin and "positive thoughts"? Why are women told they’re overreacting when they express pain?

The Truth: The Cervix Has Nerve Endings, and We Are Ignoring Them

For years, the medical field wrongly claimed that the cervix lacks nerve endings, justifying the lack of pain management. We now know this is false—yet the procedures have not changed [6].

Women’s pain is being dismissed, yet again.

The medical community must update these procedures to reflect what we now know about the cervix. But until that happens, women need to be equipped with the knowledge and strategies to advocate for themselves.

In the next section, we will cover what you can ask for during a colposcopy to make the experience more manageable. No one should have to endure unnecessary pain during a life-saving procedure.

How to Advocate for a More Comfortable Colposcopy:

A colposcopy can be an uncomfortable and anxiety-inducing experience, but patients have the right to advocate for their comfort during the procedure. Here are some options you can request to help make the experience more manageable:

Communicate Your Pain Levels & Set Boundaries

• Ask your provider to stop if the pain becomes too severe: You have the right to pause or adjust the procedure if needed.

• Request a slower approach: Ask your provider to move carefully and check in with you throughout the exam.

Adjust the Speculum Insertion

• Insert the speculum yourself: Some patients find this helps reduce discomfort.

• Request lubrication: More lubricant can ease insertion and reduce irritation[7].

• Ask for a smaller speculum: A pediatric-size speculum may be an option for those who experience pain with a standard one[10].

• Request that equipment be warmed: Cold instruments can increase discomfort, so asking for them to be warmed can help[11].

Plan for More Time & Preferred Care

• Schedule a longer appointment: Request a double appointment so you and your provider don’t have to rush.

• Ask for a provider of your preferred gender: If it makes you more comfortable, you can request a specific provider.

Pain Management & Anxiety Relief Options

• Request medication for pain, anxiety, or sedation, such as:

  • Lidocaine (injection or spray) to numb the cervix[8]

  • Nitrous oxide (laughing gas) for relaxation[9]

  • Anesthesia (may not always be available but can be discussed)[8]

  • Anti-anxiety medications like Xanax, Ativan, or propranolol to help with nerves[12]

Use Self-Soothing & Support Strategies

• Practice self-soothing techniques such as deep breathing, listening to music, or using a stress ball.

• Bring a support person or chaperone for comfort and reassurance.

Remember: You Deserve a Comfortable & Respectful Experience

Advocating for yourself during a colposcopy is essential. Providers should listen to and accommodate your needs to ensure the procedure is as comfortable as possible. Don’t hesitate to ask for adjustments—your well-being matters.

Why is this important?

Cervical cancer is the fourth most common cancer among women globally, with around 660,000 new cases and 350,000 deaths reported in 2022[13]. However, cervical cancer is 100% preventable[14]. Despite this, around 350,000 women still lose their lives to the disease every year, according to the ACS Global Cancer Reports[14]. Johns Hopkins highlights that with the HPV vaccine, routine Pap smears, and colposcopies when necessary, cervical cancer can be completely prevented[15]. This makes it even more crucial to ensure that life-saving procedures like Pap smears and colposcopies are made less painful for women, as they play a vital role in detecting and preventing cervical cancer.

The tips and strategies provided in this article are not just helpful for one specific group of women; they benefit all women undergoing these procedures, especially those who experience discomfort. This includes women with past trauma—whether sexual or medical, those with vaginismus, and even virgins who may find the procedure physically and emotionally challenging. First-time visitors to gynecologists, who may be unfamiliar with the process, also need guidance on what to expect and how to make the experience more comfortable. These tips give women the tools they need to advocate for themselves, ensuring their visits are as painless as possible.

While TikTok serves as a platform for sharing women's experiences, it often instills fear in others considering these essential procedures. Moreover, the voices criticizing those who avoid cervical biopsies due to fear are not helpful—they simply judge, without offering constructive advice. This article, however, serves as a means to provide actionable tips, grounded in real experiences, that women can use to make their colposcopy procedures more bearable. While colposcopies are indeed painful, they are essential for cancer prevention. By empowering women with these tools, we not only reduce the pain of these necessary exams but also help save lives. The goal should be to improve women's healthcare by making these procedures less traumatic, so that women can benefit from early detection, prevent cancer, and ultimately save their own lives.

Sources:

1. Cleveland Clinic. Colposcopy. Retrieved April 10, 2025, from https://my.clevelandclinic.org/health/diagnostics/4044-colposcopy

2. National Cancer Institute. Multiple biopsies are superior to a single biopsy in detecting cervical cancer precursors. Retrieved April 10, 2025, from https://www.cancer.gov/news-events/press-releases/2014/multiplecolposcopyjco

3. Planned Parenthood. What is a colposcopy? Retrieved April 10, 2025, from https://www.plannedparenthood.org/learn/cancer/cervical-cancer/what-colposcopy

4. Gyno_Girls. (2023, April 4). Pain management options for GYN procedures [Video]. TikTok. Retrieved April 10, 2025, from https://www.tiktok.com/t/ZT2wXJCpE/

5. Yale Medicine. Skin biopsies: What you should expect. Retrieved April 10, 2025, from https://www.yalemedicine.org/news/skin-biopsy

6. Danish, A. Debunking the cervix: Fact or fiction? The Pelvic People. Retrieved April 10, 2025, from https://thepelvicpeople.com/blogs/journal/debunking-the-cervix-fact-or-fiction

7. MobileODT. Colposcopy explained: What is it, what to expect, and how to prepare. Retrieved April 10, 2025, from https://www.mobileodt.com/resources/colposcopy-explained-what-is-it-what-to-expect-how-to-prepare/

8. American Society of Anesthesiologists. Biopsy. Retrieved April 10, 2025, from https://madeforthismoment.asahq.org/preparing-for-surgery/procedures/biopsies/

9. The Newcastle Upon Tyne Hospitals. (2021, July). The Colposcopy Clinic – Women’s Health Unit, New Victoria Wing, Royal Victoria Infirmary [PDF]. NHS. Retrieved April 10, 2025, from https://www.newcastle-hospitals.nhs.uk/wp-content/uploads/2020/10/Colp-information-for-pts-July-2021.pdf

10. National Library of Medicine. Equipment for a colposcopic examination. NIH. Retrieved April 10, 2025, from https://www.ncbi.nlm.nih.gov/books/NBK568371/

11. Cleveland Clinic. Speculum. Retrieved April 10, 2025, from https://my.clevelandclinic.org/health/drugs/24238-speculum

12. Oregon Clinic. (2023, July). What to expect and frequently asked questions [PDF]. Retrieved April 10, 2025, from https://www.oregonclinic.com/wp-content/uploads/2023/07/what_to_expect_and_frequent_questions.pdf

13. World Health Organization. Cervical cancer. Retrieved April 10, 2025, from https://www.who.int/news-room/fact-sheets/detail/cervical-cancer

14. McDowell, S. Cervical cancer leads cancer deaths for women in 37 countries. American Cancer Society. Retrieved April 10, 2025, from https://www.cancer.org/research/acs-research-news/cervical-cancer-leads-cancer-deaths-37-countries.html

15. Hartman, M. (2023). Cervical cancer is preventable. Johns Hopkins Bloomberg School of Public Health. Retrieved April 10, 2025, from https://publichealth.jhu.edu/2023/cervical-cancer-is-preventable