Every year, thousands of people remove abnormal cervical cells with a simple surgery called large loop excision of the transformation zone (LLETZ). In this procedure, a doctor or nurse uses a small electrical wire loop to remove the cells. Typically, it takes about ten minutes.
But in a feature by Hannah Smothers published yesterday, Cosmopolitan reports that some patients who undergo LLETZ (otherwise known as loop electrosurgical excision procedure, or LEEP) experience unexpected sexual side effects, including a loss of their ability to orgasm, a loss of sex drive, a reduction of vaginal sensation, and pain during penetrative sex. “You know that game where you put coins in the slot and a claw comes down to try and grab a teddy bear, but it can never grasp it?” a woman using the pseudonym Sasha told Cosmopolitan. “That’s how it felt. There was a sort of sensation in my clitoral area, but just as I was about to orgasm, it was suddenly nothing... I knew then. Holy shit, they broke me.”
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LLETZ is the most common treatment for abnormal cells to be removed from the cervix after a colposcopy. Statistically, around 5% of smear tests produce abnormal results; given that there are 32.2 million women (and cervixes) living in the UK, that works out at 1.6 million abnormal smears. If a doctor judges these cells to be high risk, they are often removed via LLETZ.
Patients who get LLETZ are typically not informed about potential sexual side effects. Most medical websites pages don’t include this information, either. For example, Johns Hopkins Medicine’s page on LEEP lists potential complications as infection, bleeding, changes or scarring in the cervix, difficulty getting pregnant, preterm birth, and low birth weight, but it does not mention sexual dysfunction.
Although there isn’t much medical research into the sexual side effects to LEEP, there is some. One 2010 study performed in Thailand found that LEEPs were "associated with small but statistically significant decreases in overall sexual satisfaction, vaginal elasticity, and orgasmic satisfaction." A 2004 Rutgers study theorized that some LEEPs may cut too deeply into the cervix, severing nerve endings. And a 2015 review in the American Journal of Obstetrics & Gynecology found that LEEPs may negatively affect sexual function, but concluded that more research is needed.
However, hundreds of women have shared their experiences of sexual dysfunction after LEEP in online communities and with reporters. "Afterwards, sex was always painful. I had no libido and I didn’t even feel like a sexual person anymore. Everything felt sore and painful and kind of broken. If I had an orgasm, it wasn’t really an orgasm. I could feel a muscle move, so I knew it was an orgasm, but I could hardly feel any sensation,” one woman told VICE in 2018. Another told Healthline that same year, “It was like something had been removed surgically from my body. It was so frightening. I can’t even begin to say how it affected me sexually… I had lost my entire sense of sexual identity and connection to my body. I was in a really terrible place. I couldn’t even cry. I was so numb.”
Many of the women speaking to reporters said that doctors do not take them seriously. “It’s dystopian to speak to so many doctors and have them not believe you,” Sasha told Cosmopolitan.
Some doctors who spoke to Cosmopolitan advocated for further study. One, Dr. Tami Rowen, explained that because of the potential side effects, she typically removes abnormal cervical cells with cryotherapy instead of LEEP. She also said that doctors need to tell their patients about this. “If people believe LEEPs cause sexual dysfunction — and I think there’s evidence to show it does — women should at least be told there’s a risk,” she said.