Concerns After LEEP: Changes in Menstrual Cycle and Birth Control

The issue of contraceptive pills versus LEEP (Loop Electrosurgical Excision Procedure)?

Hello, doctor.
I have been taking birth control pills for two and a half years, and everything has been fine.
On March 4th of this year, I underwent a LEEP procedure.
Since then, my menstrual periods have been longer and heavier for two consecutive months.
In May, my period started in the middle of the third week of the birth control pack, and it lasted for nine days with a heavier flow.
In June, my period began on the first pill of the third week of the pack and lasted for two weeks.
Last week, I started a new pack of birth control pills, and I finally finished my period.
Yesterday, I went to the gynecologist for a Pap smear (my first follow-up after the procedure), and I experienced bleeding during the internal examination, which has continued today.
Should I be concerned about this situation? Do you think it could be due to insufficient estrogen in my birth control pills, and should I consider switching brands? Does the LEEP procedure affect menstrual cycles? I am currently in the United States.
Thank you very much for taking the time to answer my questions.

Ru, 40~49 year old female. Ask Date: 2020/07/09

Dr. Wu Xianghui reply Obstetrics and Gynecology

After a cervical smear, it is possible to experience light vaginal bleeding for 2-3 days.
You can monitor the situation yourself or visit a gynecologist for an examination.

Reply Date: 2020/07/09

More Info

After undergoing a LEEP (Loop Electrosurgical Excision Procedure), it is not uncommon for women to experience changes in their menstrual cycle. The LEEP procedure is often performed to remove abnormal cervical tissue, and while it is generally safe, it can lead to some temporary changes in menstrual patterns.
1. Changes in Menstrual Cycle: It appears that you have experienced longer and heavier menstrual periods following your LEEP procedure. This can happen as your body adjusts to the changes in the cervical tissue and the hormonal balance after the procedure. The hormonal fluctuations can also be influenced by the birth control pills you are taking. Birth control pills work by providing a steady level of hormones, and any changes in your body, such as those caused by surgery, can affect how your body responds to these hormones. It is essential to monitor these changes, as they can sometimes indicate that your body is still adjusting.

2. Bleeding After Pap Smear: The bleeding you experienced during your recent Pap smear could be due to several factors. After a LEEP, the cervix may be more sensitive, and the procedure itself can cause some irritation. Additionally, if you have been experiencing heavier periods, this could be a sign that your body is still adjusting. It is generally not a cause for alarm, but it is essential to keep your healthcare provider informed about any unusual bleeding. If the bleeding persists or becomes heavier, you should reach out to your doctor for further evaluation.

3. Birth Control Considerations: Regarding your concerns about the birth control pills, it is possible that the current formulation may not be providing sufficient hormonal support for your body post-LEEP. If you suspect that the estrogen levels in your birth control pills are inadequate, it would be wise to discuss this with your healthcare provider. They may recommend a different formulation or dosage that could better suit your needs.
4. Long-term Effects of LEEP: While LEEP can lead to temporary changes in menstrual cycles, most women return to their regular cycles within a few months. However, if you continue to experience significant changes or discomfort, it is crucial to follow up with your healthcare provider. They may want to perform additional tests to rule out any complications or underlying issues.

In summary, while changes in your menstrual cycle and some bleeding after a Pap smear can be concerning, they are often part of the body's adjustment process following a LEEP procedure. It is essential to maintain open communication with your healthcare provider, especially if you notice any persistent or unusual symptoms. They can provide guidance tailored to your specific situation and help ensure that your reproductive health remains a priority.

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