If abnormal cells are found, you will be advised to have treatment to remove these cells. Your doctor or nurse will advise you on the best treatment for you.
There's sometimes a risk these cells could become cancerous if left untreated. Removing them means they won't be able to turn into cancer.
The aim of treatment is to remove the abnormal cells. Your doctor will try and minimise 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. This is if it's obvious that some of the cells are abnormal.
But sometimes treatment can't be done on the same day.
For example, you may need to wait until you get your biopsy result a few weeks later. This is the case 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.
The most common treatment is large loop excision of the transformation zone (LLETZ). It involves removing the abnormal cells using a thin wire loop. This is heated with an electric current.
A LLETZ can be carried out at the same time as a colposcopy. It doesn't usually need an overnight stay in hospital. It is usually done while you're awake. Local anaesthetic is injected into your cervix to numb it during the treatment.
LLETZ is also called loop diathermy, loop cone, loop biopsy or loop excision. The tissue sample is sent to the lab for assessment.
Cold coagulation involves applying a heat source to the cervix. This burns away and removes the abnormal cells.
You may feel period-like pain during this treatment. The pain may last for a short time afterwards. A tissue sample is not taken.
A cone biopsy is a minor operation to cut out a cone-shaped piece of tissue containing the abnormal cells. It only tends to be used if a large area of tissue needs to be removed.
It can't be done at the same time as a colposcopy. It is usually done under general anaesthetic (where you're asleep). You may need an overnight stay in hospital.
You can often go home to rest 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 you'll usually be advised to avoid:
- using tampons for 4 to 6 weeks (use sanitary pads instead)
- having sex for 4 to 6 weeks
- exercising for at least a few days, or while there's still any bleeding or discharge. This includes golf and swimming
- doing heavy work such as vacuuming
- taking a bath for 6 weeks - you can have a shower instead
Results of your treatment
You will get a letter with the results of your treatment in about 6 weeks.
The letter will say what the results are and what your next recommended step is. It's usually a follow up appointment at the clinic in 6 months.
If you have any concerns about your results, phone your colposcopy clinic.
Follow-up after treatment
You'll be advised to have another cervical screening and HPV test 6 months after treatment. This is to check for abnormal cells and the human papilloma virus (HPV).
Most women return to have screening tests at regular intervals after treatment.
If HPV is detected after your treatment, you may need to have annual screening tests for up to 10 years. This will depend on the reason for the treatment.
Nine out of 10 women who have had a treatment at colposcopy will not need another treatment. But women who have had a treatment are 5 times more likely to have cervical screening tests that are not normal in the future.
Combined cervical screening and HPV test
You may have a combined screening test and HPV test done. This may be offered because:
- you have had a treatment at colposcopy and this test can help reduce the need for annual screening tests
- you are attending a colposcopy clinic due to low grade cell changes. This test can help reduce the need for a repeat colposcopy. It can show if you might need treatment
The lab will test your screening test sample for abnormal cell changes and HPV. The results of the combined test help the doctor to decide if further follow up at the colposcopy clinic is needed. If it is not, you will be advised to have your next cervical screening test when it is due.
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 it
- light vaginal bleeding and brown, watery vaginal discharge – this may last for 4 to 6 weeks
- heavier than usual first period after treatment - your periods will return to normal
There's also 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
An infection can cause heavy or persistent bleeding or smelly vaginal discharge. It can also cause a fever or constant tummy pain. You should contact the colposcopy clinic or see your GP immediately if you have these symptoms.
An increased risk of premature birth in future pregnancies is more likely if:
- you need repeated treatments
- a lot of tissue needs to be removed
In most cases, the benefit of treatment will outweigh these risks.
Talk to your GP or nurse if you have any concerns. If you would like to know more about the potential risks of treatment, they can tell you.
Risks to future pregnancy
Treatment is a balancing act for your doctor. They will try to remove abnormal cells in your cervix while minimising any possible harm.
But the more of your cervix that is removed, the less tissue remains to support future pregnancies. Your doctor will be aware of this.
They will try to remove as little tissue as possible. But they also need to make sure the treatment is successful. You should feel free to discuss any concerns with them.
If you have had multiple treatments and are pregnant or considering a pregnancy then you should inform your doctor or obstetrician (a doctor who delivers babies) about your treatment at the colposcopy clinic.