Treatments - Colposcopy

If a colposcopy finds abnormal cells in your cervix, you may be advised to have treatment to remove these cells.

9 out of 10 women who have treatment will not need another treatment.

Removing these abnormal cells means they will not be able to turn into cancer. An area of cells about the size of a fingertip is usually removed.

If you are advised to have treatment, and do not have treatment, there's a risk that these cells could become cancerous.

In some cases your colposcopist will advise you to return in a few months. This is because 1 in 2 cases of abnormal cells return to normal without treatment.

When treatment is carried out

During your colposcopy, it may be clear to the doctor or nurse that you have abnormal cells. If it is, they can sometimes remove the cells at the same time. This usually takes 5 or 10 minutes.

If it is not obvious that you have abnormal cells, you may have a biopsy. This is to help decide if you need treatment.

Types of treatment

There are several ways abnormal cells can be removed from your cervix.

LLETZ

The most common type of treatment is LLETZ (large loop excision of the transformation zone).

LLETZ is also called loop diathermy, loop cone, loop biopsy or loop excision.

It involves removing the abnormal cells using a thin wire loop. This is heated with an electric current. A LLETZ can be done at the same time as a colposcopy.

You do not usually need to stay overnight in hospital after this treatment. It's normally done while you're awake. Local anaesthetic is injected into your cervix to numb it during the treatment. This means that you will not feel pain.

You may notice a burning smell during this treatment. This is normal.

The tissue sample is sent to the lab for assessment.

If you have this treatment and become pregnant in the future, it is important to tell your GP or doctor that you have had a LLETZ. This is because there may be a small risk to future pregnancies.

Cold coagulation

Cold coagulation involves applying a heat source to the cervix. This burns away the abnormal cells.

It can be done at the same time as a colposcopy. It is normally done while you're awake. Local anaesthetic is injected into your cervix to numb it during the treatment. This means that you will not feel pain.

You may feel period-like pain during this treatment. The pain may last for a few hours afterwards. A tissue sample is not taken.

You may notice a burning smell during this treatment. This is normal.

Cone biopsy

A cone biopsy is a minor operation to cut out a cone-shaped piece of tissue with the abnormal cells. It is usually only used if a large area of tissue needs to be removed.

It cannot be done at the same time as a colposcopy. It is done under general anaesthetic (where you're asleep). You may need to stay the night in hospital.

If you have this treatment and become pregnant in the future, it is important to tell your GP or doctor that you have had a cone biopsy. This is because there may be a small risk to future pregnancies.

After treatment

In most cases you can go home soon after the treatment. Most people feel well enough to return to work and carry out normal activities the next day.

It takes 4 to 6 weeks for your cervix to heal after treatment.

To reduce the risk of infection

Don't

  • do not use tampons or menstrual cups for 4 to 6 weeks - use sanitary pads instead

  • do not have sex for 4 to 6 weeks

  • do not swim or use a hot tub for 4 to 6 weeks

  • do not take a bath for 6 weeks - have a shower instead

  • do not exercise for at least a few days, or while there's still any bleeding or discharge - this includes light exercise, such as walking, jogging, yoga, golf

  • do not do anything physically tiring or heavy housework such as vacuuming for 3 to 4 days or while there is still bleeding or discharge

Results

You will get a letter with your biopsy results and when you should come back for your next appointment. You will get this in around 6 weeks.

Your results letter will include:

In most cases, the next step is a follow-up appointment at the colposcopy clinic in 6 months.

Follow-up screening test

You may need another cervical screening test within a year of treatment. This is to check for HPV infection and abnormal cells.

This screening test is often done in colposcopy, not with your GP.

Once your follow-up test is clear of HPV and abnormal cells, your next screening appointment will be in 3 years time. It will be in 3 years even if other people your age are getting their test every 5 years. This is to monitor any new cell changes that may happen before your next test.

If the result is HPV positive and your cells are normal, you might have colspocopy appointments every 6 months. If the result is HPV positive and abnormal cells you may need more treatment straight away.

Risks and side effects

Common side effects of treatment include:

  • mild pain, like period pain - this should pass in a few hours, you can take paracetamol or ibuprofen for the pain
  • light vaginal bleeding and brown, watery vaginal discharge - this may last for 4 to 6 weeks
  • a heavier than usual first period after treatment - your periods will return to normal after this

Serious complications

There's a small risk of more serious complications, such as:

  • an infection
  • a slightly increased risk of premature birth (before the 37th week of pregnancy) in future pregnancies

Urgent advice: Contact the colposcopy clinic or your GP if you have:

  • heavy or persistent bleeding
  • smelly vaginal discharge
  • a fever
  • constant tummy pain

These can be a sign of an infection.

In most cases, the benefit of treatment will outweigh these risks.

Talk to your GP or nurse if you have any concerns. They can tell you more about the potential risks of treatment.

Risks to future pregnancy

Treatment for abnormal cervical cells will not affect your chances of getting pregnant.

You may be at increased risk of a miscarriage or give birth prematurely. This is not common.

An increased risk of premature birth is more likely if:

  • you need repeated treatments
  • a lot of tissue needs to be removed

But the benefits of early treatment and prevention of cervical cancer far outweigh this risk.

Tell your doctor or obstetrician (a doctor who delivers babies) about your treatment at the colposcopy clinic if you:

  • have had multiple treatments
  • are pregnant
  • are considering a pregnancy
  • have had a cone biopsy

Removing tissue around the cervix

The more tissue that needs to be removed, the less you will have to support future pregnancies.

Your doctor will try to remove as little tissue as possible. But they need to make sure the treatment is successful.

Talk to your doctor or nurse about any concerns you have.

Page last reviewed: 19 December 2022
Next review due: 19 December 2025