LEEP Procedure: Your Guide to This Cervical Treatment

If you’ve just found out that you have an abnormal Pap smear test, you may feel like your nerves are on edge. And for treatment, a healthcare professional may have recommended a LEEP (loop electrosurgical excision procedure). 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. Here, we’ll cover 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 professional 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. 

How to prepare for a LEEP

A LEEP can take place in a medical 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.

Here are a few things that most professionals 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 the professional performing the procedure can see the parts of the cervix that need treatment.

• Tell your team 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 healthcare team if this is an option.

What happens during a LEEP?

Some steps in the process may vary a little by the 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.

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

• The professional performing the procedure 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.

• They’ll then 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 offices give light anesthesia through an IV (intravenous) line or face mask.

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

• They’ll 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 the healthcare professional 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 team will likely recommend or prescribe medication you can take for cramps.

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. 

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?

There are also alternative procedures that remove precancerous 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, a healthcare professional may also talk with you about waiting and repeating a colposcopy before going ahead with a LEEP or other procedure.

How much does a LEEP procedure cost?

Without insurance, the procedure alone can cost more than $1,000. The price can vary based on several factors:

• A LEEP in an office or surgery center can cost less than going to a hospital.

• You’re often billed separately for anesthesia.

• You may face a facility fee at a surgery center or hospital.

• You’ll likely have additional costs for lab fees to test the removed tissue.

The average cost in the U.S. for a LEED is over $11,000, according to MDsave, a price-shopping tool for people without insurance or those with high-deductible health plans. But the procedure costs $5,878 on average for people who use the MDsave platform and pay a bundled price upfront with participating healthcare professionals.

If you have a health plan, your procedure may be covered. You’ll be responsible for out-of-pocket costs, such as meeting your deductible and potential coinsurance and copays. 

With Medicare, the average cost for a LEEP can vary depending on where you have the procedure, according to the Medicare procedure price lookup:

• At a surgery center, the average cost is nearly $2,000, with about $400 out of pocket. 

• At a hospital, the average cost is about $3,500, with $700 out of pocket. 

These amounts include the cost of seeing a healthcare professional as well as the facility fees. The Medicare comparison notes that you may have additional costs.

Frequently asked questions

Why trust our experts?

Written by:

Anne Jacobson, MD, MPH

Anne Jacobson, MD, MPH has been a board-certified physician since 1999. She was 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