What is a LEEP, and How Might It Affect Sexual Health?

A Loop Electrosurgical Excision Procedure (LEEP) is a common treatment used to remove abnormal cells from the cervix, often following an abnormal Pap smear. This procedure is typically recommended when a woman has cervical dysplasia, which refers to the presence of precancerous cells that could develop into cervical cancer if left untreated.

How Does a LEEP Procedure Work?

LEEP is performed using a thin wire loop heated by an electrical current to excise abnormal tissue from the cervix. The procedure is usually done in a doctor’s office with local anesthesia. The removal of abnormal cells allows for further examination to determine if any additional treatment is necessary. Most women recover within a few weeks, though some may experience light bleeding and mild cramping.

Potential Effects on Sexual Health

While LEEP is an effective treatment for cervical abnormalities, it can have some short-term and potentially long-term effects on sexual health. These effects vary depending on factors such as the amount of tissue removed and individual healing processes.

Short-Term Effects

1. Temporary Sexual Activity Restrictions: Clinicians typically advise avoiding vaginal intercourse, tampons, and douching for about four weeks after the procedure to allow proper healing and reduce the risk of infection.
2. Pain and Discomfort: Some women may experience mild cramping, spotting, or a watery discharge, which can make sexual activity uncomfortable in the immediate recovery period.
3. Changes in Vaginal Sensation: Although uncommon, some women report temporary changes in vaginal sensitivity following the procedure, possibly due to nerve irritation or mild inflammation.

Long-Term Effects

1. Cervical Stenosis: In rare cases, LEEP may cause scarring that leads to cervical stenosis, a narrowing of the cervix that can make penetration uncomfortable or lead to menstrual irregularities.
2. Changes in Cervical Mucus Production: The cervix plays a role in producing mucus that aids in natural lubrication. If a significant portion of the cervix is removed, some women may experience reduced lubrication, which can lead to vaginal dryness during intercourse.
3. Psychological Impact: Some women report anxiety, reduced sexual desire, or emotional distress after LEEP due to concerns about cervical health or future fertility. Supportive counseling and open communication with a partner can help manage these feelings.

Managing Sexual Health After LEEP

Most women can resume a healthy sex life after healing from LEEP. To promote sexual well-being, consider the following:

• Follow Post-Procedure Guidelines: Adhering to the recommended healing time reduces complications that could affect sexual function.
• Use Lubrication: If vaginal dryness occurs, water-based lubricants can help improve comfort during intercourse.
• Address Emotional Concerns: If anxiety or fear about sexual activity persists, discussing concerns with a healthcare provider or therapist can be beneficial.
• Attend Follow-Up Appointments: Regular check-ups ensure proper healing and help detect any recurrent cervical abnormalities early.

Conclusion

LEEP is a safe and effective procedure for removing abnormal cervical cells, but it may temporarily affect sexual health. Most women recover fully and resume normal sexual activity within a few weeks. Understanding potential changes and taking proactive steps to maintain comfort and emotional well-being can help ensure a positive recovery experience. If persistent sexual health concerns arise, discussing them with a healthcare provider can provide reassurance and solutions.

References:

American College of Obstetricians and Gynecologists. (2022). Loop electrosurgical excision procedure (LEEP). Retrieved from https://www.acog.org

Baras, D. C. (n.d.). Fertility and pregnancy after a LEEP. Johns Hopkins Medicine. Retrieved from https://www.hopkinsmedicine.org/health/wellness-and-prevention/fertility-and-pregnancy-after-a-leep

Centers for Disease Control and Prevention. (2024). Screening for Cervical Cancer. Retrieved from https://www.cdc.gov

Saslow, D., Solomon, D., Lawson, H. W., et al. (2012). American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA: a cancer journal for clinicians, 62(3), 147–172. https://doi.org/10.3322/caac.21139

Sikorska, M., Pawłowska, A., Antosik-Wójcińska, A., Zyguła, A., Suchońska, B., & Dominiak, M. (2023). The Impact of HPV Diagnosis and the Electrosurgical Excision Procedure (LEEP) on Mental Health and Sexual Functioning: A Systematic Review. Cancers, 15(8), 2226. https://doi.org/10.3390/cancers15082226

Silver, M. I., Gage, J. C., Schiffman, M., Fetterman, B., Poitras, N. E., Lorey, T., Cheung, L. C., Katki, H. A., Locke, A., Kinney, W. K., & Castle, P. E. (2018). Clinical Outcomes after Conservative Management of Cervical Intraepithelial Neoplasia Grade 2 (CIN2) in Women Ages 21-39 Years. Cancer prevention research (Philadelphia, Pa.), 11(3), 165–170. https://doi.org/10.1158/1940-6207.CAPR-17-0293