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Other treatments for cervical cell changes

Laser therapy, cold coagulation and cryotherapy can be used to treat cervical cell changes (abnormal cells). These treatments use heat or cold to ‘destroy’ the affected cells.

We know that having treatment can be overwhelming, so we hope this page helps you feel prepared. If you need more support, remember that we are here for you in other ways too. You could give us a call on 0808 802 8000 or use one of our other support services.

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On this page:

About intimate examinations

The nature of gynaecological and obstetric care means that intimate examinations are often necessary. We understand that for some people, particularly those who may have anxiety or who have experienced trauma, physical abuse or sexual violence, such examinations can be very difficult. If you feel uncomfortable, anxious or distressed at any time before, during, or after an examination, please let your healthcare professionals know. If you find this difficult to talk about, you may communicate your feelings in writing. 

Your healthcare professionals are there to help and they can offer alternative options and support for you. Remember that you can always ask them to stop at any time and that you are entitled to ask for a chaperone to be present. You can also ask to bring a friend or relative if you wish. 

If you find intimate examinations difficult, we are here to support you. You can speak with our volunteers on 0808 802 8000 or you may prefer to contact us online.

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Making decisions about treatment 

Before you make a decision about treatment, it is important to understand the procedure, including benefits, risks and possible effects. Your colposcopist should explain these to you and give you the chance to ask any questions. You may also want to talk over your options with your family or friends.

It can help to write a list of questions and take it to your appointment. The form below suggests some questions you might like to ask and has space for you to write down any others you think of.

Questions you could ask 

  • What types of treatment can I have?
  • What does the treatment do?
  • What could happen if I choose not to have treatment?
  • How long will the treatment take?
  • Do I need to bring anything to the appointment?
  • Will I be able to get home by myself after treatment?
  • What physical effects might I experience after treatment?
  • What emotional effects might I experience after treatment?

Laser therapy

Laser therapy uses a laser beam to burn away cell changes. It is sometimes called laser ablation. 

You usually have this treatment as an outpatient. This means you have the treatment in hospital but can go home on the same day. 

You usually have a local anaesthetic for laser therapy. This means the area being treated is numb, but you are awake.

The laser treatment itself only takes a few minutes. Getting everything set up and having the anaesthetic takes a bit longer, so you may be on the examination couch for around 20 minutes altogether.

A laser beam is a very strong, hot beam of light. It burns away the abnormal area. You may notice a slight burning smell during the treatment. This just means that the laser is working and is nothing to worry about. 

Cold coagulation

Cold coagulation uses a hot probe to burn away cell changes. It is sometimes called diathermy. 

You usually have this treatment as an outpatient. This means you have the treatment in hospital but can go home on the same day.

Cold coagulation is done under local anaesthetic. This means the area being treated is numb, but you are awake. The treatment takes about 5 to 10 minutes. 

Cold coagulation uses a small, thin stick with a ball on top of it. The ball is heated with an electric current. The colposcopist will place the ball against your cervix to remove the cells.

Cold coagulation should not be painful. You may feel a cramping or ache, like a period pain, while it is being done.

Cryotherapy

Cryotherapy uses a cold probe to freeze off cell changes. It is sometimes called cryocautery. 

You usually have this treatment as an outpatient. This means you have the treatment in hospital but can go home on the same day.

Local anaesthetic is not always offered for cryotherapy, but you can ask to have it. If you would prefer this, talk to your colposcopist before your appointment.

Cyrotherapy usually takes about 10 minutes. It uses liquid nitrogen or liquid carbon dioxide, which is very cold. This is usually put on with a small, thin metal stick. 

Cryotherapy should not be painful. While it is being done, you may feel:

  • a cramping or ache, like a period pain
  • a warmth through your body, which should stop once the treatment is done.

After the treatment

You may have some bleeding after the treatment. This could be like a watery, blood-stained discharge or heavier.

Your colposcopist should offer you a period pad to use, but you might like to bring your own. Do not use tampons or menstrual cups that you put into your vagina.

What can and can’t I do after treatment?

You may have some physical effects after treatment. These usually last up to 4 weeks. Until these have stopped, it is best to avoid:

  • tampons or menstrual cups – you can use a period pad instead
  • penetrative vaginal sex – including fingers, tongues and other objects
  • heavy exercise that causes you to sweat, such as running or a gym workout
  • swimming
  • long baths – you can continue to shower as normal.  

If you have any questions about what you can and can’t do after treatment, speak with your colposcopist.

Follow up after treatment

You will be invited for a follow-up appointment at your GP surgery or the hospital in 6 months. At this appointment, you will have cervical screening (a smear test). This tests for high-risk human papillomavirus (HPV) that causes almost all cervical cancer.

If you don’t have high-risk HPV, you will usually be invited for routine cervical screening in 3 years, whatever your age.

If you result shows you have high-risk HPV, you will be invited back to colposcopy in about 6 weeks. This is just to make sure the treatment worked and there are no cell changes.  If there are cell changes, your healthcare team may offer you another treatment.

Risks of other treatments

Laser therapy, cold coagulation and cryotherapy are usually successful. The benefit of the treatment is that it can prevent potential cervical cancer from developing or remove cervical cancer which, in many cases, will outweigh the risks. However, like all treatments, cone biopsy has risks and you may have some physical or emotional effects because of the treatment. 

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 a specialist doctor will be able to offer support.

Bleeding 

It is common to have light bleeding for about 4 weeks after treatment. 

Important! If you are on blood thinning medication or you have a haematological condition, you must tell your colposcopist because you may have a higher risk of bleeding after treatment. If the bleeding is soaking through a period pad every hour, call the contact number given by your colposcopy team or call 111 out of hours. This is sometimes called delayed haemorrhaging. The hospital team or 111 will be able to advise you and make sure you get the right care. 

Pain

It is common to have some pain for between 2 days to up to 4 weeks after treatment. The pain varies from person to person, but should not be too severe. It is often described as a cramping pain, like a period. You can talk to your doctor about over-the-counter medication that should help.  

Important! Some people may experience pain for longer, but it usually goes away within 3 months. If you are in a lot of pain or find it is affecting your day-to-day life, talk to your GP. They can advise on pain medication, offer reassurance based on your medical history and, if needed, will be able to check you are healing properly.

Changes to vaginal discharge

Changes to vaginal discharge can last for about 4 weeks. This is usually more watery than usual and may have blood in it. 

Important! Some people get an infection after treatment. Talk to your GP if your vaginal discharge smells bad, or is a yellow or green colour. If there is a chance you have an infection, you will be offered antibiotics. 

Fertility and pregnancy

After laser therapy, cold coagulation or cryotherapy, there is no significantly increased risk to:

  • being able to get pregnant
  • carrying a pregnancy to term.

This is because these treatments rarely remove more than 10mm of the cervix. 

We know that risk to fertility can be one of the biggest worries about treatment for cell changes. If you feel this way, it’s important to tell your colposcopy team so they can talk through any risk and the different options with you. 

Remember that we are also here to support you, even if you just need someone to listen to how you’re feeling. Our trained volunteers are just a phone call away on 0808 802 8000 or you may prefer one of our other services.

Get support >

Other possible risks of treatment

Jo’s Cervical Cancer Trust has spoken with women and people with a cervix who have had treatment for cervical cell changes to understand their experiences. In most cases, they had LLETZ for high-grade cell changes – CIN2 or CIN3. The figures in this section are taken from that research to help you feel as prepared as possible.

It is important to remember that everyone heals at a different pace and will have a different experience after treatment.

Impact on your feelings 

You may have strong feelings about what treatment 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. 

For the women and other people with a cervix that we spoke with:

  • 86 in 100 (86%) had fears about cancer, while 14 in 100 (14%) did not
  • 71 in 100 (71%) had anxiety after treatment, while 29 in 100 (29%) did not
  • 45 in 100 (45%) had fears about their fertility, while 55 in 100 (55%) did not
  • 24 in 100 (24%) experienced depression after treatment, while 76 in 100 (76%) did not.

All of your feelings and concerns, including any we don’t mention in this guide, are valid and it is important you get the right support to deal with them. Here are some of the ways you could get support.

Get support from loved ones

Some people find that a support network of friends and family helps their emotional recovery after treatment. There are lots of ways they can help, from talking your feelings through, to offering a distraction and positive presence. 

Talk to your GP or another trusted doctor

Before, during and after treatment, you will be in the care of professionals who want to make the experience as good as possible for you. If you are worried about anything, talk to them so they can give you the right support and ease any concerns. Or, if you have another doctor you know and trust, ask to talk with them about any worries.

Get support from Jo’s Cervical Cancer Trust and other charities

There are many charities and organisations who offer support services so you can feel listened to and work through your feelings. These services can also signpost to other places that may be able to help. 

Get support >

Ask for a referral to counselling

If you feel that expert support would help, you can self-refer or ask your GP to make a referral for NHS counselling. You can also make an appointment privately, for a cost.

Search for a private counsellor on the British Association for Counselling and Psychotherapy website >

Sex and relationships

You may experience sex and intimacy differently after treatment. This may also have an impact on your relationships. These differences may be because of physical changes, emotional changes, or both. 

In the women and other people with a cervix that we spoke with, about 46 in 100 (46%) had changes to how they feel, while 54 in 100 (56%) did not. These changes included feeling less attractive or confident, as well as worries about passing on HPV.

Pain during or after sex

About 33 in 100 (33%) people had pain during or after sex, while 67 in 100 (67%) did not. In most cases, this pain lasted for less than 3 months. In some cases, pain during or after sex lasted for:

  • between 3 and 12 months in 5 in 100 (5%)
  • between 1 and 3 years in 6 in 100 (6%) 
  • between 3 and 5 years in 3 in 100 (3%) 
  • more than 5 years in 5 in 100 (5%).

Bleeding during or after sex

About 22 in 100 (22%) people had bleeding during or after sex, while 78 in 100 (78%) did not. In most cases, the bleeding lasted for less than 3 months. In some cases, the bleeding lasted for:

  • between 3 and 12 months in 3 in 100 (3%)
  • between 1 and 3 years in 3 in 100 (3%) 
  • between 3 and 5 years in 1 in 100 (1%) 
  • more than 5 years in 2 in 100 (2%).

Getting support

It is important to see your GP if you have any symptoms such as pain or bleeding. They can examine you and talk through ways to make it better, such as using more lubricant during sex to lessen any pain.

It may help to speak to a trusted person about any loss of confidence – whether that is a partner, family, friends, your GP, or other people who have had treatment. Talking through your worries might ease them or give you new ideas about how to handle them. 

If you and a partner are struggling to reconnect after treatment, you may want to consider couples counselling. An unbiased expert can help you start and explore conversations around sex and intimacy, so you can find solutions together. You can self-refer through local NHS services, speak with your GP, or search for a local counsellor yourself.

How we can help

We understand that waiting for or having treatment can be stressful, but you don’t have to cope with any emotions alone. Talking to your colposcopy team is a good place to start and we are also here to support you.

If you need some extra support, you can give our free Helpline a call on 0808 802 8000. Our trained volunteers can talk through the different pathways or simply listen to how you’re feeling.

Check the opening hours > 

Sometimes connecting with others who have gone through a similar experience can be helpful. Our online Forum lets our community give and get support. You can read through the messages or post your own – whichever feels most comfortable.

Join our Forum >

If you have general questions about follow up after treatment for cell changes, our panel of medical experts may be able to help. They can’t give you answers about your individual situation or health – it’s best to speak with your colposcopy team for that.

Use our Ask the Expert service >

Thank you to all the experts who checked the accuracy of this information, and the volunteers who shared their personal experience to help us develop it. 

References

 

  • Spitzer M et al (1995). The fertility of women after cervical laser surgery. Obstetrics & Gynecology. 86;4. pp.504-508.
  • Tadesse W G et al (2019). Effectiveness of cold coagulation in treating high-grade cervical intraepithelial neoplasia: the human papillomavirus evidence of cure. Journal of Obstetrics and Gynaecology. 39;7. pp.965-968.
  • Kyrgiou M et al (2017). Obstetric outcomes after conservative treatment for cervical intraepithelial lesions and early invasive disease. Cochrane Database of Systematic Reviews. 2;11(11). CD012847

We write our information based on literature searches and expert review. For more information about the references we used, please contact [email protected]

Read more about how we research and write our information >

Date last updated: 
14 Jan 2022
Date due for review: 
14 Jan 2025