What are cryotherapy (cryo) & LEEP?

They are treatments for abnormal growths on the cervix. They may be performed after abnormal cells are found during a Pap test, colposcopy, or biopsy.

• Cryo destroys abnormal tissue by freezing it.
• LEEP — short for loop electrosurgical excision procedure — removes abnormal tissue by cutting it away using a thin wire loop that carries an electrical current.

Cryo is also used to remove warts and other growths on other parts of the body. This article focuses on the use of cryo to treat abnormal cervical cells.

How does my clinician decide which treatment is right for me?

The severity and location of the abnormal cells on your cervix determine which treatment is best for you.

Your clinician may also choose a treatment based on whether it is necessary to test the cells after the procedure. During cryo, cells are destroyed, so no samples can be collected. LEEP provides a tissue sample that can be sent to a lab for testing.

Why is it important to diagnose and treat abnormal cervical cells?

Most of the time, abnormal cervical cells heal without treatment. But sometimes, abnormal cells can develop into cancer. Treatments for precancerous abnormal cells are highly effective at preventing cervical cancer. That is why it is so important to have regular Pap tests and to follow up on any abnormal results.

How effective are cryo and LEEP?

Cryo cures the problem about 85 to 90 percent of the time.
LEEP cures the problem about 90 percent of the time.

If your treatment does not cure your problem, you may have the same treatment again, or your clinician may recommend another treatment.

What should I do to prepare for cryo or LEEP?

Try to schedule cryo or LEEP for shortly after the end of your period. This will give your cervix time to heal before you have your period again.

You may want to take an over-the-counter pain reliever about an hour before your procedure to reduce the chance of discomfort. Ask your clinician in advance to recommend a pain reliever.

Are cryo and LEEP painful?

Most women feel mild cramping or pressure during cryo. Some also feel a cold sensation in their vaginas. A few women have no discomfort at all.

Women who are having LEEP get a small amount of numbing medication injected into the cervix. Some women feel mild cramping, but most do not feel anything.

How does cryo work?

• You lie down on an exam table in the same position used to have a Pap test.
• A speculum — a metal or plastic instrument — is inserted into your vagina to separate the walls.
• Usually, the clinician will perform colposcopy before cryo. Colposcopy allows your clinician to see the abnormal areas on your cervix more clearly.
• The clinician then inserts an instrument called a cryoprobe that rapidly freezes the abnormal tissue on the surface of the cervix.

What happens after?

After cryo, you will have a watery discharge that will last from a few days to several weeks. This is caused by the body getting rid of the dead cells on your cervix. The discharge may be extremely heavy and can be blood-tinged.

Your clinician may advise you to not douche or use tampons for several weeks after having cryo.

How does LEEP work?

During LEEP, the clinician will look through a colposcope to magnify your cervix.

• You lie down on an exam table in the same position used to have a Pap test.
• A speculum — a metal or plastic instrument — is inserted into your vagina to separate the walls.
• A local anesthetic will be injected into your cervix to numb it.
• A vinegar-like solution is applied to make the abnormal areas more visible.
• The clinician uses an electrical wire loop to remove the abnormal tissue.
• Blood vessels on the area are sealed to prevent bleeding. The clinician may also apply a special paste — Monsel's Solution — to prevent bleeding.

What happens after?

After LEEP, you may feel mild cramping for a day or so. You probably will have a watery discharge for several weeks. It may be heavy and may be mixed with a little blood. There also may be some odor to the discharge. In addition to normal bathing, wash your labia (lips of the vulva) with plain water for a few days if you need to.

Do not douche or use tampons for several weeks after having LEEP. Consult your clinician for advice.

How long do they take?

Cryo takes about five minutes.
LEEP takes about 10 minutes.

Are there any risks?

Most women do not have any serious side effects after cryo or LEEP.

Rare complications of cryo include

• excessive bleeding
• fainting
• a flare-up of a pelvic infection
• freeze burns on the wall of the vagina

Rare complications of LEEP include

• damage to other pelvic organs or the wall of the vagina
• excessive bleeding
• pelvic infection — particularly if you have sex before the cervix heals
• reaction to local anesthesia

You should call your clinician if you have

• abdominal pain
• fever or chills
• vaginal discharge that smells bad
• heavy bleeding

Will cryo or LEEP affect my ability to have a child in the future?

Cryo should not affect your fertility, unless a very rare complication occurs.

LEEP may increase the risk of preterm birth in future pregnancies. Talk with your clinician if you plan on getting pregnant in the future.

When can I have sex again?

Your clinician will help you decide how long you should wait to have sex again. In general, women should wait two to three weeks after having cryo, and three to four weeks after having LEEP before having vaginal intercourse. This allows the cervix time to heal and reduces the risk of infection. You can enjoy other sex play that does not involve inserting anything into your vagina.

Can I continue using contraception and other medications?

Yes. Continue taking your medications as usual — including the birth control pill. You can also continue to use any other method of birth control.

Can I have cryo or LEEP during pregnancy?

Clinicians usually try to wait to treat a pregnant woman's abnormal cervical cells. Delaying treatment is usually safe because it generally takes a long time for abnormal cervical cells to become cancerous.

Are there other treatments for abnormal cervical cells?

Yes. Other treatments include the following:

• A laser beam can be used to destroy or cut away abnormal tissue.
• Cone biopsy is used to diagnose and treat abnormalities that go deeper into the cervix. A cone-shaped wedge is cut out of the cervix and then tested in a laboratory. Cone biopsy is usually performed in an operating room under anesthesia.

Another way to manage abnormal cervical cells is to monitor them and see if treatment is necessary. Your clinician may recommend more frequent Pap tests and follow-up colposcopies to see if the cells heal themselves.