Ruptured Ovarian Cyst: 9 Signs You Shouldn’t Ignore

Even the wordsruptured ovarian cyst” might make you cringe, which makes sense because that doesn’t exactly sound pleasant. But the signs and symptoms of a ruptured ovarian cyst can actually be pretty varied. Sometimes you might not even know you have one because it successfully flies under the radar. (Good job to your body in that case!) But other times, your ruptured ovarian cyst will make itself known in a pretty unpleasant way. Here’s what you need to know about why ruptured ovarian cysts happen, the signs that you might have a ruptured ovarian cyst, and what treatment can entail.

What is a ruptured ovarian cyst, exactly?

A ruptured ovarian cyst is a fluid-filled, typically benign (non-cancerous) mass on an ovary that has broken open. “In most cases, cysts are harmless and go away on their own,” board-certified ob/gyn Pari Ghodsi, M.D., tells SELF. “In other cases, they may cause problems and need treatment.”

There are a few different types of ovarian cysts. Many ovarian cysts form in relation to ovulation (when an ovary releases an egg for potential fertilization), according to the Mayo Clinic. These are known as functional cysts, and there are two kinds.
Follicular cysts happen when a follicle (a sac that contains an egg) doesn’t burst to allow ovulation and instead keeps growing, the Mayo Clinic explains. Then there are corpus luteum cysts, which happen when fluid starts building up inside a follicle that’s already done its due diligence and released an egg.

These functional cysts typically go away on their own, usually within two to three menstrual cycles, according to the Mayo Clinic. “Often, women don’t even know they’re there,” Alyssa Dweck, M.D., an assistant clinical professor at the Mount Sinai School of Medicine coauthor of The Complete A to Z For Your V, tells SELF.

Problems are more likely to arise if you develop different kinds of ovarian cysts. What kinds of cysts, you ask? Great question.

When are you most likely to wind up with a ruptured ovarian cyst?

Certain ovarian cysts are more likely to become large, which can also make them more likely to rupture, the Mayo Clinic explains.

One example is cystadenomas, or surface-level ovarian cysts that can be filled with a water- or mucous-based substance, the Mayo Clinic explains.

Another type of cyst called a dermoid cyst may have solid material in it such as hair, teeth, and cartilage, says Dr. Dweck. Dermoid cysts can cause symptoms depending on where they’re located—one on an ovary can make the ovary twist on itself (ovarian torsion), leading to symptoms like pain, or it can rupture if it becomes big enough.

Blood-filled ovarian cysts called endometriomas can also be prone to rupturing, per the Merck Manual. These can happen due to endometriosis, a reproductive health condition that occurs when the uterine lining (or tissue similar to it) grows outside of the uterus, often causing otherworldly pain and other unfortunate symptoms. Keep reading to learn everything you need to know about ruptured ovarian cysts, plus the nine potential signs of them that you shouldn’t ignore.

What are the signs and symptoms of a ruptured ovarian cyst?

Ovarian cysts can rupture randomly, or they can break open due to intense physical activity like sex, the Mayo Clinic says. “We often see someone come to the ER at night with terrible pain that came on all of a sudden during intercourse [from a ruptured ovarian cyst],” Dr. Dweck says.

When an ovarian cyst ruptures, the fluid inside of it ends up in your pelvic cavity, where it’s usually reabsorbed over time, explains Jason James, M.D., medical director at Miami’s FemCare Ob-Gyn. If you’re lucky, you might not even feel a cyst as it bursts. Other times, though, you will.

Signs that you may have a ruptured ovarian cyst include:

  1. Dull or sharp pain on one side of your lower abdomen
  2. A feeling of fullness or heaviness in your abdomen
  3. Bloating
  4. Pain that comes with a fever
  5. Pain accompanied by vomiting
  6. Lightheadedness or weakness
  7. Breathing at a rapid rate
  8. Chilly, clammy skin
  9. Vaginal bleeding

Many of these symptoms aren’t anything to really worry about, Dr. Dweck says, like pain that isn’t too severe and a sensation of heaviness or bloating. But there are times when a ruptured ovarian cyst is a sign you should see a doctor ASAP, the Mayo Clinic says. That includes having a fever, vomiting, feeling weak, breathing too quickly, having clammy skin, and bleeding vaginally.

And Dr. Ghodsi’s rule of thumb: If you experience a sudden abdominal pain that isn’t relieved by over-the-counter medicine, call your doctor or go to the emergency room. There are so many different things that can be going on—it could be one of a variety of cysts or something entirely different, such as ovarian torsion—that it’s good to get checked out. From there, they’ll run any necessary tests, like a pelvic exam, and determine the next steps, the Mayo Clinic explains.

Here’s what treatment is like for a ruptured ovarian cyst.

It really depends on the cause of your cyst and your symptoms. For example, a doctor may give you pain medication for a follicular cyst that burst and continues to hurt even when you take OTC painkillers, but may recommend surgery for an endometrioma. The experts stress that it’s unusual to need surgery for an ovarian cyst rupture, but it can happen.

“When the underlying cause is known, such as it is with endometriosis, the decision to proceed with surgery may be more likely,” says Dr. James. Why? Endometriomas are more likely to cause ongoing bleeding, which can be painful, he says.

“Other reasons to surgically address cyst rupture in endometriosis include the desire to alleviate a patient’s ongoing chronic pain due to the endometriosis, as well as the potential to improve a woman’s reproductive potential, as endometriomas are known to potentially cause infertility,” says Dr. James. (You can read more about that here.)

If you do need surgery for a ruptured ovarian cyst, it may happen through laparoscopy (small abdominal incisions—this is typically an outpatient procedure) or laparotomy (larger incisions that might mean you need to stay overnight), the Merck Manual explains. It depends on the specifics of your case.

If you’re experiencing any kind of severe symptoms and worried they’re due to an ovarian cyst, it’s really best to play it safe and seek medical attention as soon as you can. That can be scary and frustrating and feel like overkill, but you deserve to know what’s going on with your body.

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