Investigators compared sexual function between 226 HPV-positive women seen at a tertiary clinic in Mersin, Türkiye, dividing participants into those with prior LEEP and those without. The primary outcome used the Female Sexual Function Index (FSFI). The cohort with prior LEEP had lower median FSFI scores than the no-LEEP cohort; the reported median difference and confidence interval indicated a modest but statistically detectable reduction. Multivariable regression analyses that adjusted for prespecified covariates left the association largely intact. The study team observed the same pattern when restricting analyses to women who were sexually active at the time of assessment, suggesting the difference was not driven solely by sexual inactivity in any subgroup.
Short sentences frame the key result. FSFI was lower after LEEP. The data reported a rank-biserial r pointing to a small-to-moderate effect size. The source supplied the median values and an adjusted difference with a 95% confidence interval, which the authors presented as evidence that sexual function scores were reduced in the LEEP group even after accounting for measured covariates.
The investigators examined FSFI domains individually. Desire, arousal, lubrication, and satisfaction were lower among women with prior LEEP and these domain-level differences survived Holm correction for multiple comparisons within prespecified families. Orgasm and pain domains did not show the same pattern after correction, according to the published results. The study team reported both unadjusted comparisons and multivariable regression estimates; adjusted models continued to show a decrement in overall FSFI score (the reported adjusted difference with 95% CI was provided in the source).
This paragraph describes domain-level effects. Short factual statements alternate with longer explanatory sentences to reflect the analytic approach and outcomes. The authors used nonparametric tests (Mann–Whitney U) and χ2 tests where appropriate, and complemented those with multivariable regression to account for covariates specified a priori.
Psychological distress, measured with the Hospital Anxiety and Depression Scale (HADS), did not differ significantly between the LEEP and no-LEEP groups in the analyses reported. The generic health-related quality of life instrument (SF-36) likewise showed no statistically significant differences across domains. Investigators reported these null findings alongside the FSFI results, noting that lower sexual function scores were not accompanied by measurable increases in anxiety or depression in the cross-sectional sample.
Keep in mind that these are group-level comparisons drawn from a single cross-sectional assessment. The authors reported use of Holm correction for multiple testing within families of outcomes; after that correction, anxiety, depression, and SF-36 domains remained non-significant.
A crucial baseline difference existed between groups: most women who had undergone LEEP carried higher-grade lesions (CIN2–3), a contrast not matched in the control group of HPV-positive women without LEEP. The study team acknowledged this imbalance and reported it as a limitation when interpreting whether LEEP itself accounted for lower sexual function. Time since LEEP was analyzed and, according to the report, showed no clear relationship with FSFI, HADS, or SF-36 scores.
This paragraph emphasizes that lesion severity and selection for treatment could confound the observed association. The authors did not report pretreatment sexual-function assessments, and that omission constrains causal interpretation. The source did not provide further stratified analyses that would fully disentangle lesion grade from treatment effects.
The cross-sectional design prevented within-subject before-and-after comparisons; the investigators explicitly stated that they could not attribute the observed association to LEEP itself. The absence of baseline (pretreatment) FSFI measurements was documented in the source as a major limitation. Group imbalance in lesion grade (CIN2–3 predominating in the treated group) introduced potential confounding by indication. The authors also noted that time since the procedure did not explain outcomes in their dataset, but they did not report long-term longitudinal trajectories or intervention-specific mechanistic data.
Practical implications that the authors mentioned included the potential value of incorporating sexual-health assessment into routine post-treatment follow-up for women undergoing LEEP. The report did not contain specific recommendations about timing, instruments beyond FSFI/HADS/SF-36, or therapeutic approaches for those with reduced sexual function. Future work, according to the documented limitations, would require prospective designs with baseline measures, balanced lesion-grade comparisons, and longer follow-up to determine whether changes persist or resolve over time.
Limitations listed in the article were concrete and should guide interpretation: cross-sectional sampling, lack of pretreatment assessment, and lesion-grade imbalance between groups. Those constraints prevent causal claims that LEEP causes lower sexual function. The study adds an observational signal and indicates clinical areas warranting targeted prospective research rather than providing definitive mechanistic or interventional answers.