Cervical cancer is the third most common genital cancer worldwide. The diagnosis of cervical cancer is performed with the cervical biopsy which is guided by the colposcopy. The colposcopy guided cervical biopsy creates pain and several methods have been reported to overcome the pain related with this procedure. Local anesthetic agent injection into the cervix has been studied and found to be effective and also, forced coughing was compared with local anesthetic injection and it is found to be more effective. In fact local injections can create the pain by itself.However no study compared the effect of forced coughing to local anesthetic spray. The study aims to evaluate the comparison of forced coughing with local anesthetic spray with respect to perceived pain during colposcopy guided biopsy.

Inclusion Criteria:

• Patients with age >18,
• Presence of cervix,
• Patients who need a diagnostic work up for abnormal cervical smear results.

Exclusion Criteria:

• Pregnancy,
• Presence of already known invasive cancer,
• Allergy to anesthetic agents.

The participants will be blinded to the methods used for pain relief.