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Objective To elucidate psychosexual problems in women referred for colposcopy after an abnormal cervical smear and a 6-month and 2-year follow up.Design Prospective study.Setting Department of Gynaecology, Malmö University Hospital, Sweden.Population One hundred consecutive women referred for colposcopy for the first time subsequent to receiving notification of an abnormal cervical smear.Methods The women completed the State-Trait Anxiety Inventory, a psychosexual questionnaire and had one psychosocial interview prior to colposcopy at all three visits.Main outcome measures Depending upon the result of the cervical biopsy, women had either a loop electrosurgical excision procedure (LEEP) or not. Psychosexual variables, anxiety measures, and psychosocial variables were used to estimate sexual functioning at the beginning of the study and at follow up.Differences in sexual functioning between LEEP and non-LEEP groups were estimated.Results 'Spontaneous interest in sex', 'frequency of intercourse', and 'sexual arousal' were reported to be statistically significant lower at 6 months compared with the first visit, and at 2 years, 'spontaneous interest in sex' and 'frequency of intercourse' still remained low. There was no difference in sexual functioning between the LEEP and non-LEEP groups at follow up.Conclusions Two years after referral for colposcopy, women still had an effect on sexual functioning, that is, lesser 'spontaneous interest' and decreased 'frequency of intercourse'. We found no support for a relationship between treatment of cervical intraepithelial neoplasia by LEEP and deterioration in sexual functioning.Keywords Anxiety, cervical smear, CIN, colposcopy, HPV, LEEP, sexual functioning, STAI.Please cite this paper as: Hellsten C, Lindqvist P, Sjöström K. A longitudinal study of sexual functioning in women referred for colposcopy: a 2-year follow up.

Objectives To elucidate risk factors for high state anxiety in women referred for colposcopy.Design Prospective cohort study.Setting Department of Gynaecology, Malmö University Hospital, Sweden.Population A total of 100 consecutive women referred for colposcopy for the first time after an abnormal cervical smear.Methods Women in the study group completed prior to colposcopy the State-Trait Anxiety Inventory, the Montgomery-Å sberg Depression Rating Scale-self-rate, and were interviewed about their psychosocial situation.Main outcome measures Variables related to high state anxiety were determined in bivariate and multiple logistic regression analysis.Results High depression scores and the wording of the referral letter for colposcopy were related to high state anxiety in a multivariate analysis. Women with high depression scores had a nine-fold risk for higher levels of state anxiety and did not respond with lower state anxiety levels after information and examination. Women who received a letter stating 'some changes' were at a five-fold increased risk for high levels of state anxiety than those who received a letter stating 'light changes'.Conclusion A depressive mood and the wording of the referral letter for colposcopy after an abnormal smear were predictive of high state anxiety levels.