I just had a cone biopsy done for mild dysplasia on my cervix. How long should I wait before I return to working out in the gym and doing cardiovascular activity? Also, is four weeks enough time to wait before having sexual intercourse?

--L.A.

A "cone biopsy" is so named because it involves removing a cone-shaped portion of the cervix. It is usually done after other tests, such as a Pap smear, have shown moderate or severe cervical dysplasia, a condition in which cells of the cervix are abnormal. Cone biopsy is both a diagnostic procedure (as the portion removed is sent to the lab for further study) and a therapeutic one (as it eliminates the abnormal area).

Traditionally, cone biopsy was done in an outpatient hospital setting, using a scalpel (a procedure called cold-knife cone). Today it is more often done in the doctor's office using electrocautery (in which case it is called LEEP. Using electrocautery decreases bleeding significantly and also shortens recovery time. Today, cold-knife cones are most often reserved for cases of carcinoma in situ (a localized early cancer) to rule out the possibility of invasive cancer.

After a cone biopsy, some women experience cramping, which can last a few hours or a few days. Bleeding is also very common. (Bright red or heavy bleeding must be reported to your doctor.) You may feel "blah" for a few days after the biopsy, especially if you had general anesthesia, so I recommend a couple of days of rest and always follow your doctor's advice after any procedure.

As to returning to your usual activities, you should always follow the advice of your own doctor. In general, though, after a LEEP activities such as exercise can be resumed in only a day or two. I do recommend pelvic rest -- no sex, no tampons, no douching (in other words, nothing in the vagina) -- until you have been seen for a follow-up exam in two weeks. By that point, in most women, the cervix has healed well enough to allow resumption of normal sexual relations. In the case of a cold-knife cone, activity should be restricted for 10-14 days and pelvic rest maintained for closer to four weeks.