You’re sitting in that crinkly paper gown, and the doctor says it’s time for a LEEP. It’s "routine," they say. "Quick." They’re right—it usually is. But once the immediate cramping stops and the weird coffee-ground discharge disappears, a lot of women start wondering what happens next. Not next week, but next year. Or five years from now.
Honestly, the medical brochures usually breeze past the "forever" part of this.
A Loop Electrosurgical Excision Procedure (LEEP) is basically using a high-voltage wire to shave off a piece of your cervix. It saves lives by stopping cervical cancer before it even starts. That’s the big win. But when you’re talking about leep procedure long term side effects, the reality is a bit more nuanced than a three-sentence pamphlet.
The Scar Tissue Problem: Cervical Stenosis
Most people have never heard the term cervical stenosis until they’re trying to figure out why their periods suddenly feel like a literal torture session.
Basically, the cervix can scar over.
Think of it like a piercing that heals shut. If the opening of your cervix becomes too narrow or closes up entirely from scar tissue, the blood from your period has nowhere to go. It backs up. This leads to intense, "get me to the ER" cramping. Doctors often see this in about 6% of LEEP cases, though some studies suggest it could be higher if a larger chunk of tissue was removed.
It’s not just about pain, though. If the "door" is shut, sperm can’t get in.
✨ Don't miss: Why the Some Work All Play Podcast is the Only Running Content You Actually Need
While it’s rare, this can make getting pregnant a lot more frustrating than it needs to be. The good news? A doctor can usually dilate the cervix to open it back up. It’s a fixable problem, but it’s one that catches people totally off guard.
Pregnancy After LEEP: The Preterm Birth Debate
If you google this, you’ll probably panic. Stop.
Most women who have a LEEP go on to have perfectly healthy, full-term babies. But we have to be real about the data. Studies, including a major meta-analysis published in The BMJ, have shown that having an excisional procedure like LEEP does slightly bump up your risk for preterm birth and low birth weight.
Why?
- Cervical Length: If the procedure removed a significant portion of the cervix, it might be shorter or "weaker."
- Mucus Changes: The cervix produces a mucus plug during pregnancy that acts as a bacterial shield. Removing those glands can sometimes disrupt that defense.
Doctors like Dr. Dana Baras from Johns Hopkins emphasize that the risk is "small." It’s often linked to how much tissue was taken. If you had a "deep" LEEP (more than 15mm), the risk is higher than if they just grazed the surface.
There’s also a weird twist: some researchers think the reason you needed the LEEP (like smoking or high-risk HPV) might be the actual cause of the preterm birth risk, rather than the surgery itself. It’s a "chicken or the egg" situation that the medical community is still arguing about.
🔗 Read more: Why the Long Head of the Tricep is the Secret to Huge Arms
The "Taboo" Side Effect: Sexual Function
This is the one that gets buried.
Most surgeons will tell you that a LEEP doesn't affect your sex life because the cervix "isn't a sexual organ." Ask a lot of women, and they’ll tell you that’s a load of garbage.
The cervix is packed with nerves. Some of these nerves—like the vagus nerve—connect directly to the brain’s pleasure centers. When you cauterize and remove a piece of that tissue, some women report a "muffled" feeling during sex.
What the studies say vs. what patients say
A 2024 study in MDPI found that while many women experience a "transient" dip in sexual satisfaction, things usually return to baseline after a year.
But "usually" isn't "always."
Some women report:
💡 You might also like: Why the Dead Bug Exercise Ball Routine is the Best Core Workout You Aren't Doing Right
- Reduced lubrication: The glands that make you wet can be damaged.
- Inability to reach deep orgasms: If your orgasms were "cervical," they might feel different or disappear.
- Psychological baggage: It’s hard to feel "sexy" when you’ve had a part of your reproductive system burned away due to a cancer scare.
It’s not all in your head. If things feel different, they probably are. But for most, the body adapts.
The Persistent Shadow of HPV
The biggest "long term" reality is that a LEEP is a treatment, not a cure.
It removes the damaged cells, but it doesn't always kill the HPV virus living in the surrounding tissue. You can’t just walk away and forget it happened. About 10% of women will have abnormal cells return.
This is why the "long term side effect" is often just... more doctor visits. You’re in the "high-risk" club for a while. Usually, you’ll need co-testing (Pap + HPV) every year for several years before you can go back to the standard 3-to-5-year window.
Actionable Steps for Your Recovery
If you’ve had a LEEP or are about to, you aren't powerless. There are ways to manage the "long term" of it all.
- Ask for the "Cone Depth": Seriously. Ask your doctor exactly how many millimeters of tissue they removed. Keep this in your permanent medical records. If you get pregnant later, your OB-GYN will need this number to decide if you need extra cervical monitoring.
- Pelvic Floor Therapy: If sex feels weird or painful six months out, don't just "deal with it." Scar tissue can cause the surrounding muscles to tighten up. A pelvic floor physical therapist can work wonders on breaking down that tension.
- The "Wait and See" for Pregnancy: Most experts suggest waiting at least 6 to 12 months after a LEEP before trying to conceive. This gives the cervix time to regenerate as much tissue as possible.
- Track Your Periods: If your cramps suddenly become unbearable or your flow stops but the pain remains, call your doctor immediately and mention the word "stenosis."
The LEEP is a trade-off. You’re trading a small piece of tissue and a few potential side effects for the certainty that you aren't going to develop cervical cancer. For the vast majority of people, it’s a trade worth making. Just don’t let anyone tell you it’s "nothing." It’s your body, and knowing the long-term landscape is the only way to navigate it properly.