LEEP: What Is It, and Why Do I Need One?
Scary? Yes.
Life-saving? Also yes.
If your doctor mentioned a LEEP after your Pap smear or colposcopy, you're not alone — and you're not in danger. A LEEP is a simple outpatient procedure that removes abnormal cervical cells before they turn into cancer. That’s right: this little procedure is done to prevent cancer, not treat it.
So what exactly is a LEEP? And why might you need one?
Let’s break it down.
What is a LEEP?
LEEP stands for Loop Electrosurgical Excision Procedure — which, we know, sounds like a lot. But here’s the gist: a thin wire loop, shaped a bit like a tiny eyelash curler, is used to gently scoop away the abnormal area of your cervix. The loop is heated with a mild electrical current, which helps it cut precisely while sealing off tiny blood vessels as it goes.
Think of it less like surgery and more like high-precision sculpting — the goal is to remove only the tissue that’s not behaving, and leave the healthy stuff behind.
The piece removed is usually about the size of a bottle cap — wider than a biopsy and a bit deeper, but still small in the grand scheme.
Why do I need one?
Like any procedure, LEEP comes with some risks — but they’re rare and manageable.
• Bleeding: Most people have light bleeding or discharge. But heavier bleeding can happen, especially if the healing scab is dislodged too early.
• Infection: Less common, but worth watching for (especially if you develop fever or foul-smelling discharge).
• Cervical scarring (cervical stenosis): Scar tissue on the cervix can lead to irregular or painful periods, and in rare cases, block menstrual blood. If not identified and treated, it can also make it harder to get pregnant. Sometimes, the scarring is even noticeable during labor, when the cervix struggles to dilate. If your periods seem off after a LEEP or you're having trouble conceiving, it's worth checking in with a provider. The good news? Treatment can fix it.
• Pregnancy considerations: For most people, LEEP doesn’t affect fertility or pregnancy. But if a large portion of the cervix is removed — or you’ve had multiple LEEPs — your cervix may be a little shorter or weaker, which can slightly raise the risk of preterm birth. It’s not a reason to avoid the procedure, but it is a reason to make sure your future OB care includes good follow-up and cervical length monitoring in pregnancy. Most people who’ve had a LEEP go on to have perfectly healthy pregnancies.
How is a LEEP done?
LEEPs are typically done in a clinic setting and take about 10 to 20 minutes. Here’s what happens:
1. First, a colposcopy is usually performed to re-identify the abnormal area.
2. Then, your cervix is completely numbed with lidocaine, injected directly into the face of the cervix in a circle all the way around.
(The most effective method is injection into the actual cervix itself — not just a paracervical block.)
3. The lidocaine usually contains epinephrine (aka adrenaline), which helps reduce bleeding. But it can also make your heart race, your skin flush, or give you a wave of anxiety. This is a normal reaction to the medication — and it passes quickly.
4. Once numb, the provider uses the wire loop to remove the abnormal tissue — usually about the size of a bottle cap.
5. The area is then cauterized and treated with Monsel’s solution to help stop bleeding.
This can be done in the office, and with the numbing, most people tolerate it well. Often, the anxiety is worse than the pain — as long as the numbing is done properly. However, if you have a history of trauma, chronic pain, anxiety around pelvic exams, or just a personal preference, your provider can and should offer the procedure in the operating room under anesthesia to make the experience more comfortable and affirming
What to expect after
Compared to a colposcopy, LEEP has a bigger scab and a longer recovery. Here’s what to expect/do:
- You may have dark brown/black discharge for a couple of weeks — that’s the healing tissue and medication doing their job.
- Light bleeding or spotting is common.
- If your bleeding looks like your usual period or is darker in color (like old blood), it’s usually okay.
- But if you start having bright red bleeding, soaking more than a pad every 1–2 hours, or passing large clots, that’s a reason to call your provider or get checked out.
- Avoid sex, tampons, pools, and baths for 4 weeks while your cervix heals.
- Some providers will schedule a follow-up exam; others will have you monitor symptoms on your own. Ask what their plan is.
Is a LEEP the same as a cone biopsy?
Not quite — though they’re similar.
- A LEEP uses a wire loop and is usually done in clinic.
- A cold knife cone biopsy removes a deeper section of the cervix and is usually done in an operating room under anesthesia.
If your provider recommends a cone biopsy, it may be because the abnormal cells go deeper, or your results after LEEP weren’t clear.
You’re not alone!
Getting told you need a LEEP can feel overwhelming. But this procedure is one of the best tools we have to stop cervical cancer before it starts. It’s fast, effective, and for most people, recovery is smooth.
So if your body is sounding the alarm — this is the part where you get to answer it.
And you’re doing exactly what you need to do.
