LLETZ treatment

Like all treatments, LLETZ has risks. You may have some physical or emotional side effects from the treatment. LLETZ is usually successful at preventing or removing cervical cancer. This outweighs the risks for most people.
 
Common side effects
 
It is normal to have some bleeding and changes to your vaginal discharge after LLETZ. The bleeding and discharge may last up to four weeks. It will stop as the cervix heals. You may also experience some cramp-like pains, which can feel like period pain.
 
Bleeding is caused by a soft scab on the cervix where the cells were removed. This may bleed while it heals.
 
The bleeding is usually like a period. It may be a bit heavier than normal. About ten days after your treatment, the bleeding may get heavier. This is normal and a sign that the scab is healing. Your first period after your treatment may be slightly heavier or out-of-sync.  
 
If you are on blood thinning medication or you have a blood (haematological) condition, do tell your colposcopist. You may have a higher risk of bleeding.
 
A small number of people get an infection or experience haemorrhaging (heavy bleeding) after LLETZ. Tell your doctor or call 111 if out of hours if:
-You are bleeding heavily (needing to change your pad hourly)
-Your pain is severe
-You have a temperature
-Your vaginal discharge is smelly, yellow or green.
 
If you might have an infection, you will be offered antibiotics. If you have pelvic pain for more than four weeks, it is important to speak with a doctor. They can look into the cause of the pain and offer the right support.  
 
Cervical stenosis
 
A less common side effect is cervical stenosis. This is where the opening of the cervix (the os) can narrow or close and become scarred. If this happens, the passage between the womb and vagina may become partly or fully blocked. There is a low risk of this happening (2-14%).
 
You are more likely to develop cervical stenosis if you: 
Have been through menopause   
Have had more than one treatment   
Have had treatment that removes a large area of your cervix.  
 
You may not have any symptoms of cervical stenosis. If you have periods, they might become irregular or painful. If you are trying to become pregnant, the sperm may not be able to get to the womb. It may also be harder for your doctor or nurse to do cervical screening in the future. If this happens, you can be referred to colposcopy.
 
Cervical stenosis can sometimes be treated with cervical dilators to help widen the cervix. 
 
Impact on your feelings  
 
You may have strong feelings about what LLETZ means for your physical wellbeing and future. These feelings could be positive, such as relief that you have had treatment. But you may also feel worried about how your body will recover.  
 
All of your feelings and concerns are valid. Speak to your doctor or speak to our Ask Eve Nurses for free and confidential advice and information.
 
Rare effects 
 
There is a small chance you may get other side effects, like changes to your periods or how sex feels. If you experience these effects, or anything we don’t mention on this page, speak with your doctor or nurse. They will be able to offer you support.
 
Talk to your colposcopist before treatment if you are worried about any risks. They can answer your questions and give you support. After treatment, your GP or our Ask Eve Nurses will be able to help with advice.

It is unlikely that the LLETZ treatment will cause fertility issues. After a LLETZ most people who become pregnant will have a normal pregnancy. They can usually carry the baby to full term. 1 in 10 women and people who are pregnant may give birth before 37 weeks (prematurely), or have their waters break early. This is more likely if you have had more than one LLETZ or had more than 10mm of cervix removed. Most LLETZ treatments remove less than 10mm of cervix. 

It is often possible to give birth through the vagina after LLETZ. Always tell your midwife that you have had treatment for cervical cell changes. They may refer you to a specialist in preventing preterm birth.  

If you are worried or have any questions, talk to your doctor before your LLETZ. 

You may feel some discomfort when the local anaesthetic is injected. The LLETZ treatment should not be painful. You may feel some pressure. If you do feel any pain, tell the doctor. 

You may experience some pain after LLETZ. This tends to last between two days and four weeks. The pain varies from person to person but should not be too severe. It is usually a cramping pain, like a period. You can talk to your doctor about over-the-counter painkillers that can help.   

Some people may have pain for longer. It normally goes away within three months. If you are in a lot of pain or it is affecting your day-to-day life, talk to your GP. They can advise on pain medication, answer any questions, and check you are healing properly. 

You may have some physical effects like pain and bleeding or discharge after LLETZ. These tend to last up to four weeks. Until these have stopped, it is best to avoid: 
-Tampons or menstrual cups – you can use period pads
-Penetrative vaginal sex – like fingers, tongues and sex internal toys 
-Heavy exercise that causes you to sweat, like running or a gym workout 
-Swimming 
-Long baths – you can shower as normal
-Travelling- if you have any travel plans, speak to our colposcopist about them. They will be able to give advice.

If you have any questions about what you can and can’t do after LLETZ, you can ask your colposcopist. 

It is advised that you wait until all your bleeding and any unusual discharge has stopped before having sex. This can take about four weeks. This will help avoid any discomfort or infections. 

Sex and intimacy may feel a bit different after LLETZ. This can also affect your relationships. This can be from physical changes, the emotional effects, or both.  

After LLETZ treatment, some people have pain or bleed during or after sex. Most of the time this lasts less than three months. If the pain and bleeding doesn’t get any better, you can speak to your GP.

Nearly all women and people who have LLETZ (9 in 10) only need one treatment. It is safe and effective. The risk of cervical cancer after LLETZ treatment is very low. 

Six months after your LLETZ you will be sent a follow up appointment. This is called a ‘test of cure’. The test will be a cervical screening test, the same as your earlier ones. It will check whether the High-Risk HPV has cleared. This will be at your GP surgery or local colposcopy clinic.

Your nurse or doctor will be able to answer any questions about LLETZ and side effects. You can also speak to our Ask Eve Nurses for free and confidential information and advice.