January was Cervical Cancer Awareness month. Happily, the number of new instances of cervical cancer each year was falling throughout the 2000s. We now have the HPV vaccine to prevent cervical cancer-causing viruses, early diagnosis via regular Pap smears, and early treatment options.
I had the opportunity to discuss one of these treatment options — LEEP (loop electrosurgical excision procedure) — for Giddy. As a gynecological surgeon, it is important to me that patients know all their treatment options — as well as the benefits and risks.
The Pros and Cons of LEEP
Why get a LEEP?
“Abnormal Pap smear” are three words you don’t want to hear when getting your Pap results. If you do get that result, the likely follow-up is a colposcopy, a procedure that closely examines your cervix. Then, if there’s still some concern, you may be advised to get a LEEP.
“If your doctor finds precancerous cell changes in your cervical tissue, also known as cervical dysplasia, the area around the tissue may need to be surgically removed to reduce the risk and spread of cancer,” said Thais Aliabadi, M.D., a board-certified OB-GYN and founder of Trimly, a medical weight-loss practice based in Los Angeles.
While LEEP can sound like a no-brainer, some patients experience side effects. Here’s an in-depth look at the pros, cons and what you can expect from a LEEP procedure.
The side effects of LEEP according to doctors
A LEEP is a relatively quick procedure that can be done with local anesthesia and usually causes less scarring and removes less tissue than other methods. Side effects include discomfort and bleeding that typically resolves itself. There is a risk of infection similar to what you’d experience from any other procedure. In some cases, LEEP can cause cervical scarring and can lead to a higher risk of having a preterm baby, explained Christine Greves, M.D., an OB-GYN at Orlando Health Winnie Palmer Hospital for Women & Babies in Florida.
“The LEEP has more pros than cons,” Aliabadi said. “If you are getting rid of precancerous cells on the cervix and treating HPV [human papillomavirus], you are also preventing yourself from getting cervical cancer. Cons include pain, discharge and discomfort during the procedure. And you’ll need to have more frequent Pap smears to ensure there are no more abnormal cells.”
There will be blood
“There was some bleeding for a few days afterward, and I had to wear pads for the first time in probably 15 years. But otherwise, it was fine,” said Elisa, 33, who had a LEEP done by Ruth Cousineau, M.D., and nurse practitioner Rachel Murray at Women’s Care of Beverly Hills in California.
“For me, the pros were that my LEEP led to me having no HPV or cervical cancer, which is a really big deal,” Elisa added. “As for the cons, I think there may be a very slight risk of pregnancy complications, but as my OB-GYN and nurse practitioner explained, the risks are very low, especially compared to the benefits of not having cervical cancer.”
Jennifer, 34, underwent a LEEP about 10 years ago in the United Kingdom and has had no issues since the procedure.
“The worst part was the bleeding; that was fairly heavy and did last three weeks or so,” she said. “A couple of times, some scar tissue—looked like a scab—came out, which freaked me out, but again, wasn’t painful. I was 23 at the time, so using pads for a prolonged period was inconvenient but, obviously, something I just got on with.”
During the loop electrosurgical excision procedure, your cervix is numbed.
“This procedure is referred to as a cervical block and it may be combined with oral or intravenous pain medication. Additionally, in order to significantly reduce both pain and anxiety during this treatment, I sometimes use nitrous oxide, also known as ‘laughing gas,'” Aliabadi explained.
“The worst part of the actual procedure I remember was the local anesthetic being injected into the cervix. I found that to be so painful,” Jennifer recalled. “But I genuinely didn’t feel a thing after that and was able to return to work the next day with little to no pain…I believe some women think it sounds very invasive, which was not my experience at all. It was, for me, quick and relatively pain-free. I would hope this to be the same for most women.”
If you need LEEP, does that mean you have cervical cancer?
If you have to get a loop electrosurgical excision procedure, it does not mean you have cervical cancer, Greves pointed out. In fact, the whole point of a LEEP is to decrease your chances of cervical cancer.
“The LEEP instrument is a narrow wand with an electrified wire loop at the end. The loop passes through the cervical tissue and removes a sample. We want to remove the abnormal cells to decrease the patient’s chances of cancer,” Aliabadi explained.
Both Jennifer and Elisa have had clear Pap smears and tested negative for HPV since their LEEPs.
Have questions about cervical cancer? Talk to Dr. Aliabadi
From HPV to Pap smears to LEEP, Dr. Aliabadi is an expert in all areas of gynecological health and surgery. Her surgery center, the Outpatient Hysterectomy Center, focuses on minimally-invasive surgery, getting patients back on their feet with minimal pain or downtime.
We invite you to establish care with Dr. Aliabadi. Please make an appointment online or call us at (844) 863-6700.
We take our patients’ safety very seriously. Our facility’s Covid-19 patient safety procedures exceed all CDC and World Health Organization recommendations. Masks are required in our office at all times during the coronavirus pandemic.
The practice of Dr. Thais Aliabadi and the Outpatient Hysterectomy Center is conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.