The LEEP Procedure for Cervical Cancer Prevention

The Loop Electrosurgical Excision Procedure (LEEP) is used to remove abnormal or precancerous cells from the cervix. The cervix connects the body of the uterus (the upper part where a fetus grows) to the vagina (birth canal). LEEP is an effective way to prevent cervical cancer by removing unhealthy cells before they turn into cancer. It can also help find early-stage cervical cancer.

Can a LEEP procedure prevent cervical cancer?

Yes, LEEP can prevent cervical cancer by removing abnormal and precancerous cells before they become malignant.

Can LEEP results show cervical cancer?

Yes, LEEP results can sometimes detect cervical cancer. The removed tissue is sent to a lab where a pathologist (a doctor who examines tissue under a microscope) checks it for cancer. If cancer cells are found, the doctor will determine the next steps.

When is a LEEP procedure recommended?

Your doctor might recommend LEEP if:

• A Pap smear or colposcopy (a test that examines the cervix) shows abnormal cells
• A cervical biopsy shows moderate to severe dysplasia (abnormal cell changes), also known as cervical intraepithelial neoplasia (CIN 2 or CIN 3), which indicates precancerous changes
• An HPV test is positive, specifically for high-risk strains
• Abnormal cervical cells are still present after other treatments, such as cryotherapy or laser therapy

When might a LEEP procedure need to be delayed?

Certain medical conditions may affect the timing of LEEP. These include:

• Cervicitis (cervical inflammation): LEEP may be postponed until the inflammation has cleared.
• Acute pelvic inflammatory disease (PID): The infection may need to be treated before LEEP is done.
• Pregnancy: If possible, LEEP is usually avoided during pregnancy
• Menstruation: The procedure is usually scheduled when you are not having your period.

What to expect when having a LEEP procedure

Before the procedure

For 24–48 hours before LEEP, avoid:

• Having sex
• Using tampons
• Applying vaginal medication
• Douching

Tell your doctor about:

• Any medications you are taking, especially blood-thinners
• Any allergies you have

Fasting is not required before LEEP.

During the procedure

LEEP is usually done in a doctor’s office. The entire procedure typically takes about 10–20 minutes.

• You will lie back as you would for a regular pelvic exam, with your feet rested in stirrups.
• The doctor will insert a speculum to hold the vagina open so that the cervix can be seen. A colposcope (a magnifying tool to better see the cervix) may also be used.
• A liquid called acetic acid is applied to highlight abnormal looking tissue.
• A local anesthetic is injected into the cervix to numb it. This may feel like a pinch or bee sting.
• A thin wire loop with electrical current is used to remove the abnormal tissue.

After the procedure, the removed tissue is sent to a laboratory for a pathologist to review.

Is LEEP painful?

Your cervix will be numbed with local anesthetic medication. However, you may experience mild discomfort.

• When the numbing medication is given, you may feel a pinch.
• When the acetic acid is applied to the cervix, you may feel mild pressure.
• When the thin wire loop with an electrical current is used to remove abnormal cervical tissue, you may notice a warm feeling or cramping, but no pain since the cervix is numbed.

To minimize discomfort during a LEEP, you can:

• Take slow, deep breaths and keep your stomach and legs relaxed.
• Take pain medicine, like ibuprofen or acetaminophen, if your doctor recommends it.
• Listen to music or count to distract yourself and stay calm.
• Wear loose clothing to stay comfortable.
• Arrange for someone to drive your home.

Recovery after LEEP

It usually takes about 4 weeks for full recovery after the procedure. Side effects may include:

• Mild cramping that feels like menstrual cramps
• Light bleeding or spotting, which can last 1–2 weeks
• Vaginal discharge, which can last several weeks

What to avoid during recovery

Like any procedure, there is a risk of bleeding or infection afterward. To help prevent infection and promote healing, some activities should be limited.

For the first week after LEEP, avoid:

• Heavy lifting or strenuous activity
• Taking a bath (showering is fine)
• Swimming

For the first month after LEEP, avoid:

• Having sex
• Using tampons
• Douching

Can LEEP affect your menstrual cycle?

Yes, LEEP can temporarily affect your menstrual cycle for several months. It can:

• Change the flow: Your period may be heavier or lighter. You may also have spotting between periods.
• Change the timing: Your period may be delayed or start earlier.

Will my period go back to normal?

Yes, most women’s cycles go back to normal within a few months. If you keep having problems, check with your doctor.

When to call your health care provider

It is important to contact your health care provider if you have:

• Heavy bleeding (soaking more than 1 pad per hour)
• Abdominal pain that does not improve with pain relievers
• Fever over 100.4°F (38°C)
• Foul-smelling vaginal discharge

Follow-up and monitoring after LEEP

After having a LEEP procedure, it’s important to have regular follow-ups to be sure that abnormal cells have not grown back. A typical follow-up schedule after LEEP involves:

• A clinic visit for routine physical exam every 3–6 months
• A Pap smear and HPV test every 6–12 months for the next 2 years.
• If your results remain normal, you can go back to routine screenings every 3–5 years.

Regular Pap smears and HPV testing can help find new abnormal changes earlier, which lowers your risk of cervical cancer.

Can you get pregnant after LEEP?

Most people can still have healthy pregnancies after LEEP. However, in rare cases, LEEP may cause:

• Cervical scarring, which could make it harder to get pregnant.
• A slightly higher risk of preterm birth due to changes in the cervix.

If you plan to get pregnant, talk to your doctor about cervical monitoring to help ensure a healthy pregnancy.