Treatments

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

There's sometimes a risk these cells could become cancerous if left untreated. Removing them means they will not be able to turn into cancer.

The aim of treatment is to remove the abnormal cells while minimising damage to healthy tissue. Usually an area about the size of a fingertip is removed.

When treatment is carried out

Treatment to remove abnormal cells from your cervix can be done at the same time as a colposcopy if it's obvious that some of the cells in your cervix are abnormal.

But sometimes treatment cannot be done on the same day.

For example, you may need to wait until you get your biopsy result a few weeks later if it's not immediately clear whether you have abnormal cells in your cervix.

Types of treatment

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

LLETZ

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

• involves removing the abnormal cells using a thin wire loop that's heated with an electric current
• can be carried out at the same time as a colposcopy
• is usually done while you're awake – local anaesthetic is injected into your cervix to numb it during the treatment
• does not usually need an overnight stay in hospital

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

Cone biopsy

A cone biopsy is done less often than LLETZ. It:

• is a minor operation to cut out a cone-shaped piece of tissue containing the abnormal cells
• only tends to be used if a large area of tissue needs to be removed
• cannot be done at the same time as a colposcopy
• is usually done under general anaesthetic (where you're asleep)
• may require an overnight stay in hospital

Other treatments

Abnormal cells in the cervix can also be treated with:

• cryotherapy – the abnormal cells are frozen and destroyed (this is only used to treat minor cell changes)
• laser treatment – a laser is used to pinpoint and destroy abnormal cells on your cervix
• cold coagulation – a heat source is applied to the cervix to burn away the abnormal cells
• hysterectomy (removal of the womb) – this will only be considered if abnormal cells on your cervix have been found more than once, if they're severely abnormal, you're past childbearing age, or you do not want to have more children

After treatment

You can often go home to rest soon after the treatment is finished. Most people feel well enough to return to work and most normal activities the next day.

You'll usually be advised to avoid:

• driving for at least 24 hours if you had a general anaesthetic – you can drive straight away if a local anaesthetic was used
• using tampons or menstrual cups for 4 weeks (use sanitary pads instead)
• having sex for 4 weeks
• exercising, including swimming, for at least 2 weeks, or while there's still any bleeding or discharge 

You'll also be advised to have another cervical screening test 6 months after treatment, to check for abnormal cells and the human papilloma virus (HPV).

If HPV is not found, you will not need to be screened again for another 3 years. But if HPV or significant cell changes are found, you'll be referred for another colposcopy.

Risks and side effects

Common side effects of treatment include:

• mild pain, similar to period pain – this should pass in a few hours and can be relieved with paracetamol or ibuprofen
• light vaginal bleeding and brown, watery vaginal discharge – this may last up to 4 weeks

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

• an infection – this can cause heavy or persistent bleeding, smelly vaginal discharge and persistent stomach aches; see a GP if you have these symptoms
• a slightly increased risk of premature birth (before the 37th week of pregnancy) in future pregnancies – this is more likely if you need repeated treatments or a lot of tissue needs to be removed

In most cases, the benefit of treatment will outweigh these risks. Talk to a doctor or nurse if you have any concerns or would like to know more about the potential risks of treatment.

Page last reviewed: Fri Dec 2022 Next review due: Wed Feb 2020