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After your treatment for abnormal cervical cells

Women discussing cervical cancer

This page is about how you will feel after your treatment for abnormal cervical cells and about follow up care. You can find information about

 

A quick guide to what's on this page

After your treatment for abnormal cervical cells

Most women feel fine after having treatment for abnormal cervical cells. But some may feel quite ill and need to go home and rest. You may have period type pains for the rest of the day. You should expect to have some bleeding or discharge for some days after you are treated. How long it lasts depends partly on the type of treatment you have had. Many women find this type of treatment does have an emotional effect on them. You may feel traumatised, depressed, vulnerable or invaded. Usually you get over these feelings with time. But if you feel you need help you could talk to your GP about counselling.

You shouldn't have sex for 4 weeks after your treatment because of the risk of infection. Treatment will not affect your enjoyment of sex in the future. It is very important to go back to the hospital or clinic for check ups after treatment for an abnormal smear. Treatment is successful in 4 out of 5 women. But if the abnormal cells come back you will need more treatment.

What happens if abnormal cells come back

Usually you can have more laser treatment, diathermy or loop excision. You may need to have a cone biopsy. But if the abnormal cells come back more than once, or if your doctor thinks the risks are too great, you may be asked to have a hysterectomy. Your doctor will talk through all the treatment options with you at every stage, and take your wishes into account.
 

CR PDF Icon You can view and print the quick guides for all the pages in the treating abnormal cervical cells section.

 

 

Physical effects of treatment

Most women feel fine after having treatment for abnormal cervical cells. But some may feel quite ill and need to go home and rest. Unless you have had a hysterectomy (or possibly a cone biopsy) you will be able to go home from hospital the day that you are treated. But you shouldn't plan to do anything else that day.

 

Pain

You may have period type pains for the rest of the day. About 1 in 3 women report having some pain after this type of treatment. Having pain seems to be more likely in women who haven't had any children. Simple painkillers, such as paracetamol or ibuprofen usually help.

 

Bleeding or discharge

You should expect to have some bleeding or discharge for some days after the treatment. It can carry on for up to 4 weeks. How long it lasts depends partly on the type of treatment you have had. You may have

  • Light bleeding for days or weeks
  • Watery vaginal discharge

Light bleeding or discharge can go on for a couple of weeks after treatment. You are more likely to have bleeding, and it is more likely to be heavier if you are treated when your period is due. This is why doctors prefer to treat you between periods if possible. There is no need to worry unless the

  • the discharge starts to smell bad
  • the bleeding starts to get heavier

Sometimes the bleeding gets heavier 10 to 12 days after your treatment. This is probably nothing to worry about. But if it seems heavier to you than a heavy period, you must either go back to the clinic, contact your GP or go to your local accident and emergency department (A & E). You will need a check up to make sure nothing is wrong. Your doctor may be able to give you something to help control the bleeding. If you have a discharge that starts to smell, you may have an infection and should go back to your doctor.

 

Your emotions and feelings

These are often overlooked. But many women find this type of treatment does have an emotional effect on them. About 1 in 4 women say that after treatment to their cervix they feel

  • Traumatised
  • Depressed
  • Vulnerable
  • Invaded

This is not really surprising. This is a very private area of your body. The undignified position needed for cervical screening or treatment can upset many women. Usually you get over these feelings with a little time. But if you feel you need help, you can talk to your GP about counselling.

If you would like to talk to someone outside your own friends and family, look in our coping with cancer section for counselling organisations. To find out more about counselling look in the counselling section.

Your privacy and dignity should be protected at all times when you are having these sorts of investigations and treatments. If you feel your privacy or dignity were not properly protected, write to the nurse manager of the unit where you were treated. Your suggestions for improving things will help other women in the future and writing it down can also help you to get over your experience.

Some women find that needing to have treatment for abnormal cervical cells really worries them. This condition is often confused with cervical cancer. But even if you are clear about the difference the experience can make you more worried about cancer of any type.

 

Getting back to normal

You should have fully recovered from this type of treatment in about 6 weeks at the most. If you have had a small amount of laser treatment, you will get over it quicker than that. You shouldn't have sex before 4 weeks because of the risk of infection. But after any of these treatments, you should be able to have sex and do any work or exercise you wish to within six weeks. None of these treatments will make any difference to your enjoyment of sex in the future.

 

Follow up

It is very important that you continue to go back to the hospital or clinic for check ups after treatment for abnormal cells. The chances are that you will not have any further problems. Treatment is successful in 4 out of 5 women. But if the abnormal cells come back you will need to have more treatment.

At your first follow up appointment, you may have a colposcopy or just a liquid based cytology (LBC) test (smear). Cell samples will be sent to the lab to be checked. How often you have appointments and what you have done will depend on how abnormal the cells were and whether they were completely removed. You should expect to have a repeat test about 6 months after your treatment (it may be sooner than that) and then a further test about 12 months after your treatment. Then you will be asked to have

  • Another test one year later, if you had CIN 1
  • Yearly tests for 9 more years, if you had CIN 2 or 3

After that you should be able to go back to 3 or 5 yearly tests (depending on your age) if you haven't had any problems.

The NHS cervical screening programme is starting to test for the human papilloma virus (HPV) as part of follow up care. If the result from your first follow up test is normal or shows borderline or mild cell changes, your sample will be tested for HPV. If HPV is not found, you will not need to be screened for 3 years. If HPV is found or you have moderate or severe cell changes, you will go back to colposcopy for further follow up and treatment if needed. HPV increases the risk of having more severe cell changes.

This HPV test should be available across England and Northern Ireland by the end of 2012. It is already in place in Scotland.

 

Cervical screening after hysterectomy

You will still need follow up even if you have had a hysterectomy for abnormal cells. The cells for the test are taken from the top of the vagina, near where your cervix was. Your doctor may call this a vault smear. Very rarely, the abnormal cells can come back in this area, so you will be offered tests at 6 months and 18 months (you may have one sooner than this) after your hysterectomy. If everything is fine, you won't need to have any more tests after that.

 

What happens if abnormal cells come back

Usually you can have more laser treatment, diathermy or loop excision. You may need to have a cone biopsy.

But if the abnormal cells come back more than once, or if your doctor thinks the risks are too great, you may be asked to have a hysterectomy. This is to prevent you from developing cancer of the cervix in the future. For a time you will continue to have screening for abnormal cells after hysterectomy. Your doctor will talk through all the treatment options with you at every stage.

Your wishes will need to be taken into account in order to decide what is the best treatment for you. Your decision may depend on whether you have had all the children you wish to have. Or whether you have reached your menopause. Some women prefer to have a hysterectomy because they can then be satisfied that all the potentially cancerous cells should have been taken away. It is usually possible for you to keep your ovaries if you are having a hysterectomy for this reason so the operation should not affect your hormones or send you into an early (premature) menopause. If your ovaries are removed before the menopause you may need hormone replacement therapy (HRT).

 

Pregnancy after treatment

Unless you have had a hysterectomy, no treatment for abnormal cervical cells should make any difference to you getting pregnant in the future. Some of the treatments can lead to a small risk of pregnancy complications. There is more about this in the section about treating abnormal cervical cells in pregnancy.

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Updated: 6 September 2012