If a colposcopy examination finds abnormal cells in your cervix, you may be advised to have treatment immediately to remove these cells. This is to minimise the risk of developing cervical cancer.
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.
Not all grades of abnormal cell changes need treatment. In some cases, your colposcopist may not advise treatment immediately but may ask you to return in a few months. This is because 1 in 2 cases of abnormal cells return to normal without treatment.
Read more about the different grades of abnormal cells.
If you are advised to have treatment but decide not to have it, there's a risk that these cells could become cancerous.
9 out of 10 women who have treatment will not need another treatment. 1 in 10 will need to attend for more treatment.
When treatment is carried out
If it is clear to the doctor or nurse that you have abnormal cells that need treatment, they may remove those cells on the same day as your colposcopy. This usually takes 5 or 10 minutes.
Treatment usually takes place in the colposcopy clinic. In some cases, you may need to have treatment in a hospital operating theatre.
If it is not obvious that you have abnormal cells, you may have a biopsy. This is to help decide if you need treatment.
If your period is due
If you expect your period when your treatment is due, contact the colposcopy clinic. They can reschedule your appointment.
Types of treatment
There are a few ways abnormal cells can be removed from your cervix.
The most common ways are called:
- cold coagulation
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. In a small number of cases, a needle may be used to remove the cells instead of a loop.
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.
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.
- Local anaesthetic is injected into your cervix to numb it during the treatment. This means that you will not feel pain.
- Abnormal cells are removed using a heated thin wire loop
- A biopsy tissue sample is taken and sent to a lab for assessment.
You may notice a burning smell during this treatment. This is normal.
Cold coagulation involves applying a heat source to the cervix. This burns away the abnormal cells. It's sometimes known as ablative therapy or thermal ablation.
Cold coagulation can be done at the same time as colposcopy. It is normally done while you're awake.
- Local anaesthetic may be injected into your cervix to numb it during the treatment. This means that you will not feel pain. Your clinic will discuss this with you.
- Abnormal cells are destroyed with a heated instrument.
You may feel period-like pain during this treatment. The pain may last for a few minutes afterwards. A tissue sample is not taken.
You may notice a burning smell during this treatment. This is normal.
A cone biopsy is a minor operation to cut out a cone-shaped piece of tissue with the abnormal cells. It is not commonly done. You'll usually only have one if a large area of tissue needs to be removed or when a repeat treatment is needed.
It cannot be done at the same time as 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.
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
do not use tampons for 4 to 6 weeks - use sanitary pads instead
do not have sex for 4 weeks
do not swim or use a hot tub for 2 weeks
do not take a bath for 2 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
There are no results to review if you have cold coagulation treatment. This is because you do not have a biopsy.
If you had LLETZ treatment, you will get a letter with your biopsy results around 4 weeks after your treatment. You will also be told when you should come back for your next appointment.
Your results letter will include:
- the grade of abnormal cells from the samples sent to the lab (for example CIN 1, CIN 2, CIN 3 or CGIN)
- your next recommended step
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 6 to 9 months of treatment. This is to check for HPV infection and abnormal cells.
This screening test is often done in a colposcopy clinic, 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 colposcopy appointments every 6 months. If the result is HPV positive and abnormal cells you may need more treatment straight away.
Risks and side effects
Colposcopy is a safe procedure.
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 with a slight odour - this may last for 4 to 6 weeks
- a heavier than usual first period after treatment - your periods will return to normal after this
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
- narrowing or closing of the cervix (cervical stenosis)
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.
Urgent advice: Contact the colposcopy clinic, a GP or GP out-of-hours urgently if you have:
- heavy or persistent bleeding
- smelly vaginal discharge (yellow or green)
- signs of a fever, including flushed cheeks, tiredness or you feel warm to touch
- constant tummy pain
These can be a sign of an infection.
Go to an emergency department if you have heavy bleeding and cannot contact a GP.
Risks to future pregnancy
Treatment for abnormal cervical cells will not affect your chances of getting pregnant. Having a single treatment is unlikely to harm your baby during or after pregnancy.
If you need more than one treatment, 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
Talk to your doctor or nurse about any concerns you have.