What is a colposcopy?

A colposcopy (pronounced ‘kol-pos-kuh-pee’) is an office procedure using a microscope-like instrument, a colposcope, to evaluate the cervix for abnormal cells. 

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Why do I need a colposcopy?

If your self-collected screening results are abnormal or positive for high-risk HPV (human papillomavirus), your doctor may recommend that you have further testing, such as a colposcopy. A colposcopy allows the provider to have a better, closer view of the cervix and potentially take small samples, called biopsies.

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Teal Health follows the most up-to-date medical guidelines on how to manage your follow-up care if you receive abnormal results after your self-collection. Teal medical providers will refer you for a colposcopy if your sample tested positive for HPV types 16 and/or 18, as these HPV types are most commonly associated with causing cervical cancer over time if they are left unaddressed. 

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How do I prepare for a colposcopy?

No preparation is necessary to have a colposcopy, but the provider conducting your colposcopy may offer some guidance or specific recommendations. 

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For example,  it is helpful to not be on your menses (period), or at least to not be bleeding heavily, at the time of your appointment to allow a clear view of the cervix. Your provider may also ask that you do not use tampons, vaginal products, or douches, and avoid vaginal intercourse for a day or two before your colposcopy. This also helps the provider get a clear view of the cervix and make sure any samples taken can be processed. Some women also find it helpful to take a pain reliever before their appointment, but this is not required.

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If you are feeling nervous, you can plan to bring someone with you to the appointment. This may also be helpful after the appointment, so you have someone to help you get home. 

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What to expect during a colposcopy?

The procedure will look and feel similar to a Pap smear, although this time, your doctor will use a magnifying lens to look for abnormal cells on your cervix. You may feel a little cramping or discomfort during the procedure.  

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Your doctor will soak the area with a dilute acetic acid solution using cotton swabs, which turns abnormal cells white.  If abnormal areas are identified, your doctor may take one or more small samples of tissue (biopsies) for testing. These cells will then be sent to a lab for analysis. It can take a week or two for the results to come back. 

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After the biopsies are taken, medicine is often applied to the cervix to stop any bleeding. It is normal to have some spotting or discharge for a few days after this procedure. 

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What does a colposcopy result show?

If you had samples taken from your cervix, these results will help determine if you have any abnormalities and classify any changes observed in your cervix by severity. The report may describe normal cervical tissue or various degrees of precancerous changes, also called cervical dysplasia. Very rarely, the biopsy could show cervical cancer.

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Abnormal cervical cell changes are classified as low- (LSIL) or high-grade (HSIL), and can be assigned a Cervical Intraepithelial Neoplasia (CIN) grade. 

• Low-grade or CIN1 are considered mild cell changes that usually resolve on their own, but still require surveillance to make sure they do not progress. 
• CIN2 and CIN3 are both high-grade and are considered moderate to severe precancerous changes. These require closer monitoring and, at times, preventive interventions to ensure they do not progress into cervical cancer. 

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Depending on the result, you may need an additional procedure to remove the abnormal cells or more frequent Pap smear/HPV testing to monitor for changes. Your healthcare provider will review the results with you and discuss any follow-up recommendations.

Today, the American Cancer Society (ACS) updated their cervical cancer screening guidelines to include self-collected samples, either done at-home with Teal or in the office, for Primary HPV (Human papillomavirus) testing. Their guidelines were last updated in 2020, when they recommended Primary HPV testing as the preferred test for cervical cancer screening, with co-test (Pap and HPV) as acceptable when Primary HPV testing is not available.

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The American Cancer Society stated: 

“Cervical cancer screening recommendations from the ACS and other organizations have changed over time, driven by improved understanding of the disease's natural progression, the recognized role of high-risk HPV infection, and advancements in screening technologies”

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Look for FDA Authorized Label

The ACS cervical cancer screening guideline includes only FDA-approved combinations of HPV assays (tests) and collection devices - this includes Teal Health’s FDA-authorized Teal Wand, which allows a woman to collect her own sample at home and mail it to the lab to test on an FDA-approved HPV test. The Teal Wand is the only FDA-authorized device for at-home cervical cancer screening. The Teal Wand self-collection device stood out in the guideline evidence as having the highest clinical sensitivity to detect cervical precancer at 96%, equal to that of clinician collection. 

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“This guideline update by the ACS is a huge leap forward in recognizing the importance of expanding options for women to get screened,” states Liz Swenson, MD, OBGYN and Medical Director at Teal Health. “Women look to the ACS as the leader in cancer prevention and research. And it's important for women to know that there is a trusted and accurate at-home option, Teal Health, that has gone through the FDA. We are honored to play our role in making cervical cancer screening more accessible and comfortable for women as we all work to eliminate cervical cancer.” 

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Below are the updated screening guidelines from the American Cancer Society:

• 25 to 65 year olds with a cervix (has not had a total hysterectomy) should screen every 3 years with self-collected samples or every 5 years with clinician-collected samples (using the speculum).
• The recommended test to be performed is the Primary HPV test. If this test is not available, the co-test is considered acceptable.

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In addition to adding self-collection to their guidelines, ACS also updated their guidance on when individuals can safely stop being screened for cervical cancer. 

• Individuals with an average risk for developing cervical cancer may stop screening after having normal results at the appropriate interval between the ages of 55-65. The last test should be done at age 65 or later.  
• This includes primary HPV testing every 3-5 years (preferred), a co-test every 5 years, or cytology every 3 years.

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You can see the ACS’ new guidelines here.
For a quick comparison of the updates between ACS’ 2020 and 2025 guidelines, see their news release and for more information on the move to self-collection, see the American Cancer Society’s paper here. 

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Please note that cervical cancer screening guideline recommendations apply only to average-risk individuals. Depending on your health history or screening history, your provider may advise you to screen at different intervals. Average risk individuals in this guideline are defined as (must fulfill all 3):

1. Has a cervix
2. Asymptomatic (i.e., does not have abnormal bleeding or other symptoms concerning cervical cancer for which a more thorough workup is required)
3. Screening for the first time or has a history of all normal cervical cancer screening results in the past; OR has a remote history of abnormal results that has been followed by a sufficient amount of normal testing that the individual fulfills criteria to resume routine cervical cancer screening based on follow-up recommendations from the Risk-Based Management Consensus Guidelines

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To order the Teal Wand at-home cervical cancer screening kit, visit www.getteal.com. It works with major insurance plans and is HSA/FSA eligible.

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Cervical cancer screening guidelines are developed by organizations like the American Cancer Society (ACS) as well as other leading organizations, such as the United States Preventive Services Task Force (USPSTF), the American Society for Colposcopy and Cervical Pathology (ASCCP), and the American College of Obstetricians and Gynecologists.

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Every so often, a moment comes along that makes you pause, take a deep breath, and think, Wow, we really did this.

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To see Teal Health featured in a publication like TIME feels surreal. For me, TIME has always represented something lasting, a place where the world’s defining ideas and innovations are captured. Growing up, it was the magazine you’d see on coffee tables, shaping how people saw the world. To see the Teal Wand among its pages now feels deeply meaningful. It’s the kind of moment that would’ve made my parents so proud, as that coffee table was our coffee table. 

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When we started Teal Health, our mission was simple but bold, make cervical cancer screening more comfortable and accessible for all women. What began as a single idea, that women deserve better options, has grown into a larger effort to redesign care to focus on the women’s experiences and perspective, one that builds trust and is welcoming.

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None of this would have been possible without the incredible team behind Teal. They are scientists, engineers, designers, clinicians, and perfectionists who show up every day driven by a shared purpose to make healthcare work better for women. They’ve spent years listening, iterating, and building with care.

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Being named one of TIME’s Best Inventions is not only a recognition of a product. It is recognition of a shift that is already underway in women’s health.

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For too long, women’s health has been underserved, underfunded, and overlooked. This moment signals that innovation in women’s health belongs right alongside the world’s most transformative ideas shaping the future.

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The Teal Wand is more than a device. It’s a symbol of what happens when science, empathy, and determination come together and when women’s experiences guide the design of their own care.

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This recognition is an incredible milestone for our team, and we’re just getting started. We are expanding quickly across the nation, and holding on to our mission to get every woman and person with a cervix screened for cervical cancer. Together, we can eliminate this disease. 

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Moments like this remind me why we started, why we keep showing up for the hard work, and how much more we can achieve when purpose leads the way.

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Truly, thank you. 

Kara Egan

CEO & Co-founder, Teal Health

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It is important to pay attention to your menstrual cycle (period) because your cycle and any deviations from usual patterns can signal changes in your body and help you understand where you are in your gynecological journey.

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This is also an easy area to become complacent about. After all, most of us have our period nearly every month, for many years (unless we’re on contraception that suppresses a period or are pregnant). 

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What is a normal menstrual cycle?

There are guidelines for what’s normal in terms of frequency and duration, but “normal” is also relative. The most important thing is to determine what’s normal for your own body and to discuss that with your provider. 

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Recent research suggests that menstrual cycles can vary by age, weight, race, and ethnicity. Generally, however, a “normal” menstrual cycle occurs every 21 to 35 days, and bleeding lasts between three to seven days. Women also experience pain, cramping, and other premenstrual symptoms (PMS) differently. Other factors like diet and exercise can also impact both your cycle and symptoms.

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Are you experiencing changes to your menstrual cycle? 

Changes to your body’s menstrual patterns may indicate that something else is going on:

• Could signal cancer or pre-cancer 
• Physical changes like polyps or fibroids, a shift in hormone balance, alongside metabolic changes, or even infections 
• Ongoing heavy or prolonged periods can also deplete iron in your body and lead to anemia 

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By openly discussing your menstrual patterns and pain levels, your provider can listen for red flags and recommend further testing. 

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Pain levels should not be downplayed

Research has proven over and over that there is a gender bias when it comes to women’s pain, and that our symptoms and complaints are not always taken seriously – sometimes to devastating effect. If pain levels are interfering with other activities and require medication, please tell your provider.

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Before your well woman visit, track your menstrual cycle

In preparing for your annual exam or well woman visit, it is great to have insight into the following questions:

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• How many days pass between your periods?
• How many days does your period last?
• How heavy is your period? For example, how many tampons or pads do you use in an hour, or over the course of a day?
• How painful are your cramps or other symptoms? Do they interfere with other activities? Do you take medication for the pain? What do you take, and how much?
• What PMS symptoms do you regularly experience leading into your period?
• Do you experience spotting (or other symptoms) between periods?

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There are multiple apps that can help you track your menstrual cycle and premenstrual (PMS) symptoms, including the Health app on the Apple iPhone. 

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Contraceptive advice can be a part of menstrual management 

Women may seek or may already be on birth control to prevent pregnancy. Women may also seek medical intervention to lighten or suppress their periods, which birth control can also help accomplish. Your provider can discuss these options with you. If your birth control method prevents a period, it’s still a good idea to track things like spotting or any other PMS symptoms you continue to experience throughout the month.

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Having a period every month can be a pain - both literally and figuratively - but as disruptive as it can be, it also gives regular insight into your health. Your cycle and any deviations from usual patterns can signal changes in your body and help you understand where you are in your gynecological journey.

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Abnormal uterine or vaginal bleeding is quite common, but there are many different causes. Therefore, it can take multiple discussions, tests, or procedures before finding the root cause. Below, we discuss the many causes, tests, and treatments for abnormal bleeding. You may also find it useful to read our article on the Importance of Tracking Your Menstrual Cycle, so you can identify what abnormal bleeding is and when it is happening. 

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What is abnormal uterine or vaginal bleeding? 

Abnormal bleeding can look different depending on where you are in your gynecological journey. 

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Abnormal bleeding does not mean spotting at the beginning or end of your normal period, bleeding from progesterone-only contraceptives, or bleeding from continuous birth control pills. 

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Rather, abnormal bleeding typically includes:

• Bleeding in between periods and/or more than 10 days per month
• Recurrent bleeding after sex (when not on your period)
• Bleeding after menopause (menopause is defined as no bleeding for twelve consecutive months)

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Below are some indications of abnormal bleeding based on your life stage: 

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Premenopause: For individuals who are premenopausal, abnormal bleeding is when bleeding is heavy, irregular (i.e., between periods), or happens when it shouldn’t (i.e., after sex). 

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Perimenopause: When reaching the age range for perimenopause (typically 45-50 years old, but can happen earlier), abnormal bleeding is often an early sign indicating this transition. This is due to the ovaries producing inconsistent amounts of estrogen, triggering new patterns of ovulation and bleeding, in addition to other symptoms.

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Menopause: After menopause (median age of menopause in the U.S. is 51 years old), any bleeding that happens a year or more after your last period is abnormal and should be discussed with your provider. Although there are several potential causes for bleeding during this time, this usually requires an evaluation to rule out precancer or cancer in the uterus (endometrial cancer). 

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What causes abnormal bleeding?

There can be many different causes of abnormal bleeding:

• Structural causes, i.e., uterine fibroids, adenomyosis, endometrial polyps
• Hormone changes, i.e., pregnancy, perimenopause
• Hormonal birth control
• Infection of the cervix or endometrium
• Cervical pre-cancer or cancer
• Endometrial cancer
• Medical conditions, i.e., thyroid disorder, PCOS (polycystic ovarian syndrome), or endometriosis

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What tests do I need to evaluate abnormal bleeding?

Based on your age, health status, and risk factors, your provider will help to determine what tests are needed, which may include:

• Physical examination (including a pelvic exam): to determine the location of the bleeding and assess for underlying structural causes
• Lab tests: depending on the suspected cause, this may include a pregnancy test, cervical cancer screening test, vaginal swab to test for infections, and blood tests which check for anemia, thyroid disorder, liver or kidney disorder, hormone tests, and more.
• Imaging: may include a transvaginal ultrasound or more advanced imaging like a pelvic MRI
• Endometrial biopsy: an office procedure that may be recommended based on your age and symptoms to rule out endometrial cancer
• Procedures: this could include a hysteroscopy, which uses a scope with a camera and sterile fluid to see inside the uterus, or a dilation and curettage (D&C) to sample and remove abnormal uterine/endometrial tissue

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How is the abnormal bleeding treated?

The treatment for abnormal bleeding will be based on the cause of the bleeding, your plans for future pregnancy, and your personal medical and surgical history.

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Treatment options may include:

• Hormonal treatments: birth control pills, vaginal rings, progesterone-only pills, progesterone arm implant, injections, or progesterone IUDs (intrauterine devices).
• Non-hormonal treatments: non-steroidal anti-inflammatory medications (NSAIDs) like ibuprofen or antifibrinolytic medications like tranexamic acid.
• Uterine artery embolization: a minimally invasive procedure that uses pellets to block the main blood supply to the uterus, used to shrink fibroids and/or reduce menstrual bleeding over time.
• Surgery: to remove and treat abnormal structural causes, i.e., fibroids, polyps, or the endometrial layer of the uterus.  
  
  • Hysteroscopy: uses a scope with a camera and sterile fluid to see inside the uterus and remove lesions (polyps or fibroids) if present.
  • A dilation and curettage (D&C): is done alone or in combination with a hysteroscopy to sample and remove abnormal uterine/endometrial tissue.
  • Endometrial (Uterine) ablation: a procedure that destroys the inner lining of the uterus using different energy forms (i.e., thermal, freezing, radiofrequency, or microwave energy), usually combined with a hysteroscopy.
  • Myomectomy: a laparoscopic or robotic surgery done to remove fibroids. 
  • Hysterectomy: a surgical procedure done to remove the uterus. This may or may not include the ovaries and cervix, depending on the underlying condition being treated.

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If you are having any abnormal uterine or vaginal bleeding, regardless of your age or menopause status, we recommend that you talk to a medical provider as soon as possible so you can get to the root cause of your symptoms.

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Quick Links to Sections:

• The Cervix
• Step 1: Collect and Mail a Sample
• Step 2: Talk with a Teal Provider
• Step 3: Follow-up Tests

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Cervical cancer screening is recommended to start at a younger age than any other cancer screening, and spans forty years of a woman’s life (ages 25-65, as recommended by the American Cancer Society). It is an integral part of preventive care for women and critical for detecting disease early. Cervical cancer is often asymptomatic in the early stages, so having the ability to screen and detect the disease early can save lives. 

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Let’s break down the 3 critical steps of screening to prevent cervical cancer, with support from the Teal Health team.

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Cervical cancer is a type of cancer that starts in the cervix. 

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The cervix is the lowest portion of the uterus which connects the uterus to the vagina. When using the Teal Wand, cells are collected from the vagina, up near the cervix and tested for high-risk HPV (human papillomavirus).

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According to the American Cancer Society, cervical cancer rarely occurs in people who have been screening routinely for cervical cancer. 

Screening has historically taken place in-person at your annual exam with your primary care provider or at your well-woman appointment with your OBGYN. And now, for the first time in the U.S., you can screen yourself at home, privately, using the Teal Wand. You will self-collect a sample and mail it to the lab to be tested on an FDA-approved primary HPV (human papillomavirus) test. 

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The Teal Wand is FDA-approved, and samples detect precancer 96% of the time, the same as samples from the clinician using a speculum. It is easy and comfortable, with over 98% of users collecting an adequate sample. 

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Cervical cancer screening using an HPV test means collecting cell samples and testing them for the presence of high-risk HPV. Detecting high-risk HPV is critical because it is the single most important risk factor in developing cervical cancer.

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How often should you screen?

According to the self-collection guidelines from the American Cancer Society:

• If you have a history of normal results, it is recommended that you screen yourself (self-collect) with a primary HPV test every 3 years. 
• If you have a history of abnormal results in the past 5 years, in most cases, you will be recommended to screen again in 1 year to keep an eye on the infection (which can be dormant). If you’d like, you can also connect with a Teal provider to discuss further.
• If your results are abnormal, you should connect with a Teal medical provider to discuss whether additional tests or procedures are needed. Follow-up care is critical to ensuring HPV infections do not progress.

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Once you have collected your sample, you will need to mail it to the lab, and within a week or so, you will be notified that your results are available to view in your Teal portal. All results are also reviewed by a Teal medical provider.

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If you received ‘abnormal’ results (HPV was detected in your sample), you need to schedule a virtual appointment with a Teal medical provider. 

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During the appointment, you and the provider will discuss your results in the context of your medical history and whether additional tests or treatments are recommended. Your Teal provider will give you a referral to a local provider for any recommended next steps. Please schedule this follow-up appointment with the Teal provider as soon as possible, as it is critical to take care of high-risk HPV infections before they cause cervical changes.

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If you received normal results (no HPV detected), your provider will indicate in the note accompanying your results when you should screen next. However, if you still have questions or want to discuss further for any reason, you can message your Teal provider via the portal or book a visit. 

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Even if your results were normal, please let your Teal provider know right away if you learn anything new about your screening history, as you may need to be screened sooner. 

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When talking with a Teal medical provider, they may recommend further testing, such as an in-clinic Pap smear or a colposcopy. If so, the Teal medical provider will refer you to a local provider. This is a very important step in the screening process, and we recommend you schedule and complete the in-clinic follow-up visit using your referral as soon as you can. We will check in to remind you to do this.

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Colposcopy‍

A colposcopy is an in-office procedure that usually takes about 15-20 minutes. It’s sort of like having a longer pap smear - after placing a speculum, your provider will apply a dilute vinegar solution to the area of concern, which turns any abnormal areas more white. Then, a magnifying device (a colposcope) is used to look for abnormal changes on your cervix. If abnormal areas are seen, your provider may take a small amount of tissue (a biopsy) for testing. This will then be sent to the lab for evaluation by a pathologist. Biopsy results are usually back within 1-2 weeks.

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Precancer Treatment

Most of the time, if they are routinely screening, people have early precancerous changes, which can range from mild to severe. Depending on your age, the severity, and how much of your cervix shows these changes, you and your doctor can decide to wait to see if the changes clear on their own, or whether it is beter to undergo a treatment to remove the abnormal cells (e.g., ‘LEEP,’ Loop Electrosurgical Excision Procedure) to help prevent progression to cancer. 

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Cervical Cancer Treatment

In the unlikely event that your biopsy results show cancer, the provider who performed the procedure will advise you on what steps to take in order to treat your cervical cancer. Cervical cancer is treated in a way typical of most cancers, with surgery to remove the cancer, medicine to treat the cancer cells (chemotherapy), and/or radiation therapy.

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Fortunately, cervical cancer is very treatable when caught early. You may be surprised to learn you have cancer because you may not be experiencing any symptoms. This is common when cervical cancer is detected early. More advanced cervical cancer can present with symptoms, such as abnormal bleeding or discharge after having sex, between periods, or after menopause.

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Screening is the MOST important thing you can do to ensure you stay healthy.

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If you need guidance or have questions at any point during your screening or follow-up care, please send us a message or make an appointment with a Teal provider. We are here to support you.

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