LEEP: Your Guide to This Cervical Procedure

If you’ve been talking to your healthcare provider about an abnormal Pap smear, you may feel like your nerves are on edge. And your provider may have recommended a LEEP (loop electrosurgical excision procedure) for treatment. Now, you’re trying to process your test results and figure out what this procedure means. 

Facing something like a LEEP can be stressful. But understanding the procedure can help to relieve some of that stress. So we are here to walk you through what a LEEP is, what it’s used for, and what you can expect before, during, and after the procedure.

What is a LEEP, and what is it used for?

LEEP is short for “loop electrosurgical excision procedure.” A LEEP is done after a Pap smear or colposcopy suggests precancer of the cervix. 

To remove layers of cells from the cervix, a healthcare provider uses a small wire loop that’s charged with an electrical current. Then a lab examines these cells for precancer and cancer. Removing precancerous cells also prevents them from turning into cancer. 

What to expect with a LEEP

A LEEP can take place in a healthcare provider’s office or an outpatient surgery center. The procedure itself doesn’t take very long — usually 10 to 20 minutes. But there are some things to know that can help you prepare for it.

How should you prepare before the procedure?

When you discuss a LEEP with your healthcare provider, they’ll likely provide some instructions. It’s a good idea to review those 1 to 2 days before the procedure. 

Here are a few things that most providers recommend to prepare for a LEEP:

• Let your healthcare team know if you have your menstrual period on the day of the LEEP (when it’s more than a little spotting). Bleeding may affect how well your provider can see the parts of the cervix that need treatment.

• Tell your provider about all of the medications you take, especially aspirin or blood thinners. These could make bleeding more likely after the procedure.

• Don’t put anything in your vagina for 24 hours before the LEEP. This includes tampons, douching, creams, and vaginal sex.

• You may be able to take a pain reliever shortly before to help with cramps. Ask your provider if this is an option.

What happens during a LEEP?

Some steps in the process may vary a little by the provider’s practice or location. But here are some common things to expect during a LEEP:

• The medical team will review your health information and have you sign a consent form before the procedure. They’ll also want to make sure all your questions are answered, so don’t hesitate to bring up anything that feels unclear.

• You may need to give a urine sample before your procedure. This is for a routine pregnancy test.

• The provider will place a grounding pad on your thigh. This protects you from the electricity they use during the LEEP.

• The provider will use a speculum to open the vagina and see the cervix. This will feel similar to what happens during a routine pelvic exam or Pap smear.

• The provider will put a mild vinegar solution on the cervix. It might sting a little. This is so they can see what the cervix looks like with a colposcope (a device that magnifies the cervix).

• They’ll numb the cervix with a local anesthetic like lidocaine. This part might feel like an unpleasant pinching or burning. To make this part more comfortable, some providers give light anesthesia through an IV (intravenous) line or face mask.

• The provider will use an electric loop to remove thin layers of cervix. They’ll send these to a lab to examine the cells.

• The provider will check the cervix for bleeding. They may apply a paste to the cervix that helps to stop bleeding. 

Is a LEEP painful?

You may experience some brief discomfort when your provider injects the numbing medication. But, after that, you shouldn’t feel anything sharp or burning from the procedure. 

Sometimes there’s some cramping or pressure during or after a LEEP. Your provider will recommend or prescribe medication you can take for cramps.

What’s the recovery process like?

In the first couple of days after a LEEP, you may have:

• Pink discharge or light bleeding

• Mild cramps

• Discharge that looks light brown, dark brown, or black. This is actually the paste used to stop the bleeding. It usually has a thicker consistency than blood.

You may notice your bleeding increases in the second week after your procedure. This can happen when most of the paste has fallen off, which protects your cervix right after the procedure. Your bleeding may feel more like a heavy period.

The heavier bleeding will likely improve quickly. But you might have watery discharge or light bleeding for a few weeks. Contact your provider right away if you have:

• Heavy bleeding or clots, especially if you’re soaking more than one pad per hour

• Severe cramps or abdominal pain

• Fever or chills

• Discharge with a very strong odor

While your cervix heals, your provider will likely recommend a few restrictions to prevent infection or excess bleeding. They’ll likely recommend:

• Nothing in the vagina, including tampons, douches, or vaginal sex

• No hard exercise, like running or riding a bike (more gentle physical activity like walking is usually fine after a couple days)

• No swimming or baths

These restrictions are usually in place for a few weeks. But your provider will give you guidance for your specific circumstances. 

And don’t forget about your emotional health. It’s common to feel anxious or worried when having a procedure like a LEEP. Work with your healthcare team to have your questions answered, and take time for self-care. It can also help to surround yourself with supportive people. 

How effective is a LEEP?

In most cases, a LEEP is effective in removing precancerous cells from the cervix. This prevents them from turning into cancer. 

But you may still have HPV (human papillomavirus) in your body that affects your cervix. This may cause more precancerous changes over time. Fortunately, this only happens about 8% of the time after a LEEP. Your healthcare provider will design a plan with you to keep a close eye on any changes.

Is there any special follow-up after a LEEP?

You’ll likely have a follow-up visit a couple of weeks after your procedure. This is to make sure your cervix is healing, to review the results, and set up a plan for future screening tests. 

Most people repeat a Pap smear in 6 months to 1 year. Once a series of Pap smears remains normal, you may be able to go back to having a test every 3 years. 

Are there risks with a LEEP?

Although a LEEP is generally safe, there are risks for any type of surgery or procedure. The risks associated with a LEEP include:

• Heavy or prolonged bleeding after the procedure

• Infection

• Narrowing of the opening of the cervix

• Premature birth in future pregnancies (more common if a LEEP is needed more than once or if a greater amount of cervix is removed)

Are there any alternatives to a LEEP?

A LEEP uses an electrical current to remove precancerous tissue. There are also alternative procedures that remove this tissue in different ways, including: 

• Laser treatment

• Cryotherapy (freezing)

• Cold knife conization (using a scalpel to remove abnormal tissue)

Depending on your health status and level of risk, your provider may also talk with you about waiting and repeating a colposcopy before going ahead with a LEEP or other procedure.

Why trust our experts?

Written by:

Anne Jacobson, MD, MPH

Anne Jacobson, MD, MPH has been a board-certified family physician since 1999. She worked as a full-scope family physician (inpatient, outpatient, obstetrics, and office procedures) in the Cook County Ambulatory Health Network for 15 years.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

Our editorial standards

Meet our experts