A loop electrosurgical excision procedure (LEEP) is a common treatment for precancerous cervical lesions and early stage cervical cancers. During a LEEP, a thin wire loop heated by electric current is used to remove abnormal tissues from the cervix. This procedure is typically done in a doctor’s office and only requires a local anesthetic. While LEEP is effective at removing abnormal cells, it does impact the cervix itself. Here is an overview of what happens to the cervix after having a LEEP procedure.
The Cervix Heals Quickly
One of the most common concerns women have after a LEEP is how long it will take their cervix to heal. The good news is that the cervix heals relatively quickly from this minimally invasive procedure. Here’s a look at the healing timeline:
- Immediately after the procedure, the treated area will be pink and swollen. This is normal.
- Within a few days, a scab will form where the abnormal cells were removed.
- After about 2-3 weeks, the scab will fall off as the new skin underneath heals.
- By 6 weeks post-op, the cervix should be completely healed with very little evidence that a procedure was done.
While the cervix heals rapidly, it is important to avoid sex, douching, tampons, and anything else that could introduce bacteria during the healing process. Follow all of your doctor’s post-op instructions to ensure proper healing.
The Cervix May Look Different
Since a LEEP removes abnormal precancerous cells from the surface of the cervix, the treated area will look somewhat different after healing. Here are some of the changes you may notice:
- The skin may appear lighter or pinker where tissue was removed.
- Scarring can occur, which may look like white patches or bands on the cervix.
- The cervix may look smaller or reshaped if a significant amount of tissue was removed.
- There may be some residual crater-like divots or irregularities.
While the appearance of the cervix can change, this will not affect function. The cervix should still be able to dilate normally during childbirth.
Discharge Is Common Post-LEEP
You may experience some discharge from the vagina after having a LEEP procedure as the cervix heals. This is normal. Discharge may be watery or somewhat bloody at first. As the scab forms, discharge may become thicker and darker.
Here’s a quick overview of what to expect:
- Week 1: Spotting/light bleeding common
- Weeks 2-3: Thicker, dark brown or black discharge as scab forms
- Weeks 4-6: Light pink, yellow, or white discharge may persist
- After 6 weeks: Discharge should resolve as healing completes
While discharge is typical, contact your doctor if you have heavy bleeding that soaks a pad in an hour or foul-smelling discharge, as these can indicate infection.
Period Changes May Occur
Some women notice changes in their monthly period after a LEEP procedure. Here are some of the possible effects on menstruation:
- Periods may be a bit heavier or longer due to inflammation of the cervix.
- Cramping during periods can increase for the first few cycles post-LEEP.
- Spotting may occur mid-cycle as the cervix continues to heal.
- Future periods may lighten due to the removal of endocervical tissue.
Your period should gradually return to normal over the next 3-6 months. Let your doctor know if you experience severe cramping, heavy bleeding, or changes that concern you.
Cervical Stenosis is a Risk
One potential complication of LEEP is cervical stenosis. This refers to an abnormal narrowing of the cervical opening that occurs as a result of scarring. Symptoms of stenosis include:
- Painful cramping during periods
- Inability to properly pass menstrual blood flow
- Spotting or bleeding between periods
- Pain during sexual intercourse
Minor stenosis often resolves on its own within a few months. But severe stenosis may require additional procedures to open the cervical canal. Let your doctor know if you experience any concerning symptoms post-LEEP.
Pregnancy Is Still Possible After LEEP
Many women wonder if getting pregnant is possible after having their cervix undergo a LEEP. The good news is that this procedure should not impact fertility.
Here are some key points about pregnancy after LEEP:
- You may try to conceive as soon as 3-4 months after the procedure once healing is complete.
- Scarring and changes to the cervix typically will not prevent conception.
- During pregnancy, the cervix should still be able to dilate for delivery.
- Those with severe stenosis may need to deliver by C-section.
- The risk of miscarriage or preterm birth does not increase after LEEP.
Talk to your doctor about when it is safe to try getting pregnancy after your LEEP. But for most women, it is possible to have a healthy pregnancy and delivery after this procedure.
Follow-Up Exams Are Crucial
Since LEEP removes precancerous cells but does not treat the underlying HPV infection, follow-up is extremely important. Guidelines recommend:
- Pap test every 6 months for the first 2 years post-LEEP.
- HPV testing along with each pap test.
- Annual pap tests for at least 10 years after the procedure.
Following this monitoring schedule allows any recurrence of abnormal cells to be detected early. Committing to regular exams helps ensure the success of the LEEP procedure long-term.
The Cervix May Feel Firm or Hard
Some women report that their cervix feels firmer, harder, or less pliable after healing from a LEEP. This can occur as a result of scarring beneath the surface of the skin.
Signs that the cervix may have become firmer after LEEP include:
- Discomfort during pelvic exams when the doctor grips the cervix.
- The cervix does not feel as soft during self-exams.
- Sexual discomfort when the cervix is touched.
In most cases, the firmness gradually improves over several months as the scarring softens. But the cervix may never feel quite as supple as before. Discuss any concerns with your gynecologist.
Risk of Preterm Delivery May Increase Slightly
Some studies have found a small link between LEEP procedures and increased risk of preterm birth in future pregnancies. The latest research suggests:
- Risk of premature delivery before 37 weeks rises by 70% after LEEP.
- Risk of delivery before 32 weeks quadruples.
- Deeper excisions further increase risk.
However, the overall risk is still low. Talk to your OB-GYN about monitoring cervical length during pregnancy to help prevent early labor.
Conclusion
While LEEP causes changes to the cervix, it is still a highly effective treatment for precancerous lesions. With proper healing and follow-up care, most women go on to have a normal cervix, regular cycles, and healthy pregnancies after the procedure. Stay in close contact with your gynecologist throughout the healing process and report any concerns that arise. With time, your cervix should return to functioning normally.