After your treatment for abnormal cervical cells

What are the side effects of treatment for abnormal cells?

Most people feel well after the procedure. You might have some period type pain and bleeding or discharge after treatment for abnormal cells.

What happens after treatment?

You should feel back to normal within 6 weeks. You will have another test 6 months after treatment. You will have more treatment if you have abnormal cells.

Can I have a baby after having treatment?

Treatment for abnormal cervical cells shouldn’t make any difference to you getting pregnant in the future. Some of the treatments can lead to a small increase in risk of pregnancy complications.

Most people feel fine after having treatment for abnormal cervical cells. Some may feel unwell and need to go home and rest.

You can go home the same day you have treatment, unless you've had a hysterectomy or a cone biopsy. But you shouldn't plan to do anything else that day.

Pain

You may have period type pains for the rest of the day. Simple painkillers, such as paracetamol or ibuprofen usually help. Your doctor or specialist nurse (colposcopist) will talk to you about this before you go home.

Bleeding or discharge

You should expect some vaginal bleeding or discharge for a few days after the treatment. It can carry on for 4 to 6 weeks. How long it lasts depends partly on the type of treatment you've had. You may have:

light bleeding for days or weeks
watery vaginal discharge

You are more likely to have bleeding, and it's more likely to be heavier, if you have treatment when your period is due. This is why doctors prefer to treat you between periods if possible.

See your GP, contact the colposcopy clinic or visit the accident and emergency (A&E) if you have:

discharge that smells unpleasant
heavy bleeding or the bleeding lasts longer than 4 weeks

If you have an infection, your GP can give you antibiotics.

Your emotions and feelings

Many people find that this type of treatment has an emotional effect on them. You may feel:

anxious
distressed
depressed
vulnerable

This is not surprising. Having treatment to the cervix is in a very private area of your body. The undignified position needed for cervical screening or treatment can upset many people. The colposcopy staff are aware that you can feel like this. So, they will try to make you feel as comfortable and at ease as possible.

Most people get over these feelings with a little time. But if you need help, you can talk to your GP about counselling.

Your privacy and dignity should always be protected when having these investigations and treatments.

If you feel your privacy or dignity was not properly protected, write to the unit's nurse manager. Your suggestions for improving things will help other people in the future. Writing it down can also help you get over your experience.

Some people find that needing treatment for abnormal cervical cells worries them. This condition is often confused with cervical cancer. But even if you are clear about the difference, the experience can make you more worried about cancer in general.

Your colposcopist or nurse can answer any questions and help reassure you.

Getting back to normal

You should have fully recovered from this type of treatment in about 6 weeks. If you have had a small amount of laser treatment, you will get over it quicker than that.

Until any bleeding or discharge has stopped, you should avoid:

using tampons for 4 weeks
having sexual intercourse for 4 weeks
swimming for 2 weeks
doing heavy exercise for 4 weeks (no running or weight lifting)
doing yoga or pilates for 3 weeks

Talk with your colposcopist if you are unsure about anything.

Follow up

You are invited back for a follow up screening test about 6 months after treatment for abnormal cervical cells. This is usually done at your GP practice.

It's very important that you go to this appointment. The chances are that you won't have any further problems. Treatment is successful in more than 95 out of every 100 (95%) women. If the abnormal cells return, you will need more treatment.

HPV

The NHS screening programme has brought in testing for the human papillomavirus (HPV) as part of follow up. If your cell sample is normal or shows borderline or mild cell changes, the sample will be checked for HPV:

if no HPV is found, you won't need to have another screening test for 3 years
if HPV is found, or you have moderate or severe cell changes, you go back to the colposcopy clinic to see if you need more treatment

Cervical screening after hysterectomy

You may still need follow up even if you have had a hysterectomy for abnormal cells. The cells for the test are taken from the top of the vagina, near where your cervix was. Your doctor may call this a vault smear.

Very rarely can the abnormal cells come back in this area. So, you will be offered tests 6 months and 18 months after your hysterectomy. If everything is fine, you won't need any more tests after that.

What happens if abnormal cells come back

Usually, you can have more laser treatment or a LLETZ. Or you may need to have a cone biopsy.

Your doctor may ask you to have a hysterectomy if:

the abnormal cells come back more than once
they think the risks are too great

This is to prevent you from developing cancer of the cervix in the future. Your doctor will talk through all the treatment options with you at every stage.

Your wishes will be taken into account when deciding what the best treatment is for you. Your decision may depend on whether you have had all the children you wish to have. Or whether you have reached the menopause.

Some people prefer to have a hysterectomy. This way, they can be satisfied that all the abnormal cells should have been removed.

It is usually possible for you to keep your ovaries if you're having a hysterectomy for this reason. So, the operation should not affect your hormones or send you into an early (premature) menopause. If your ovaries are removed before menopause, you may need hormone replacement therapy (HRT).

Pregnancy after treatment

Unless you have had a hysterectomy, no treatment for abnormal cervical cells should make any difference to you getting pregnant in the future. Some treatments can lead to a small increase in the risk of pregnancy complications.

For example, you may have a slightly increased risk of premature birth in future pregnancies. This means the baby might be born before the 37th week of pregnancy. This is more likely to happen if you've had repeated treatments or a lot of tissue removed.

You may be offered vaginal scans during pregnancy if this is the case. This is to measure the length of your cervix. You may be offered a cervical stitch to prevent it from opening early if the following apply:

you have had a baby born prematurely or a late miscarriage in the past
your cervix appears shortened on the scan