When an Ovarian Cyst Ruptures: Is It an Emergency

Size can be a factor. The bigger the cyst, the more likely it’ll pop, like an overfilled water balloon. Yet there can be huge cysts that are so slow-growing that they don’t rupture — as well as small, fast-growing cysts that do.

Symptoms of a Ruptured Ovarian Cyst

Monique Rainford, MD, is board-certified in obstetrics-gynecology, and currently serves as an Assistant Clinical Professor at Yale Medicine. She is the former chief of obstetrics-gynecology at Yale Health.

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Table of Contents

Ovarian cysts are fluid-filled sacs that often form on or in an ovary (a reproductive organ that produces eggs). It is normal for certain types of ovarian cysts called follicular cysts to rupture when ovulation occurs during the menstrual cycle. Ruptured ovarian cysts may cause no symptoms.

If there are symptoms, the most common is lower abdominal pain (usually on one side) when the cyst bursts. It may be followed by discomfort for several days. The pain is usually sharp. Vaginal spotting or bleeding may also occur.

Medical attention is required for serious symptoms, such as severe pain, fever, heavy bleeding, and nausea.

Preventable medical errors kill about 22,000 patients a year, according to research from the Yale School of Medicine. That’s much less than a previously reported number of 250,000 deaths a year where medical error is to blame.

This article will discuss ruptured ovarian cyst symptoms, from mild to severe. It will also provide information about potential complications and when you should seek medical care.

Common Symptoms

When an ovarian cyst ruptures, the most common symptom is sudden, severe pain in the lower abdomen.

In addition to pain, you may also have:

• Vaginal spotting
• Light to moderate vaginal bleeding
• Abdominal bloating

Most ruptured ovarian cysts heal on their own. Even so, let a healthcare provider know your symptoms so they can assess your need for medical attention.

A ruptured ovarian cyst may cause ongoing discomfort for several days. Mild pain or discomfort can be treated at home with over-the-counter (OTC) medication. You may also feel the need to rest and avoid strenuous activity.

Rare Symptoms

In some instances, a ruptured ovarian cyst may cause severe symptoms that indicate the need for immediate medical attention or hospitalization. While less common, these symptoms include:

• Severe lower abdominal pain
• Heavy vaginal bleeding
• Fever
• Nausea and vomiting
• Cold, clammy skin
• Feeling faint or dizzy

Complications/Subgroup Indications

Heavy bleeding in the abdomen is a potentially life-threatening symptom of a ruptured ovarian cyst. Excessive blood and fluid loss can result in low blood pressure.

Running a fever may indicate an infection in the ovary. If an infected ovarian cyst ruptures, sepsis may occur. Sepsis is an extreme overreaction of the immune system to the presence of harmful pathogens in the body. It is a potentially life-threatening medical emergency that requires immediate attention.

You are more likely to have an infected cyst if you also have pelvic inflammatory disease (PID). PID is typically caused by a sexually transmitted infection (STI), such as chlamydia or gonorrhea.

Severe nausea and vomiting accompanied by intense lower abdominal pain may indicate ovarian torsion. Ovarian torsion is a separate condition that’s caused by twisting of the ovary around the ligaments that hold it in place.

Ovarian torsion can occur with or without an ovarian cyst rupture. This condition cuts off the blood supply to the ovary, which can damage fertility (the ability to become pregnant). Surgery is often required to “untwist” the ovary and restore blood flow to the area. Untreated ovarian torsion can result in loss of the ovary and fallopian tube.

Ovarian cysts may rupture during pregnancy. If you’re in your first trimester, the symptoms of an ovarian cyst may be confused with an ectopic pregnancy (a nonviable fertilized egg implanting in a place other than the uterus). Both conditions require immediate medical attention.

If you’re pregnant and experience mild or severe symptoms similar to those of a ruptured ovarian cyst, contact a healthcare provider immediately.

Ruptured ovarian cysts are most likely to occur in people who still have a menstrual cycle. If you seek medical evaluation of your symptoms, you will most likely have an ultrasound (a type of imaging using sound waves) to determine the cause of your symptoms.

When to See a Healthcare Provider/Go to a Hospital

Ruptured ovarian cysts are common. Complications from this condition are rare but can occur. Contact a healthcare provider immediately if you experience intense pain, fever, or other symptoms.

Untreated complications earmarked by symptoms like heavy bleeding and fever are potentially life-threatening medical emergencies. Prompt treatment is essential to stop complications, including loss of the ovary.

Summary

Ovarian cysts are common and typically don’t cause a problem if they rupture. A ruptured ovarian cyst may be asymptomatic or cause mild symptoms.

Most ruptured cysts go away on their own without the need for medical intervention. In rare instances, serious symptoms and complications can occur. Symptoms such as intense pain, fever, and nausea may indicate serious or life-threatening complications that require immediate medical attention.

A Word From Verywell

If you suddenly have intense abdominal pain, your first reaction may be fear. That is understandable. Keep in mind that if the pain is due to a ruptured ovarian cyst, in most cases it will self-resolve without needing treatment. However, call a healthcare provider and let them know what’s happening.

If the symptoms don’t go away, or if they get worse, you need to take action fast. Acting quickly can significantly reduce your chances of unwanted complications.

Frequently Asked Questions

What should you expect after an ovarian cyst ruptures?

When an ovarian cyst ruptures, you may be aware of pain in your lower abdomen that ranges from mild to very intense. Vaginal spotting and light bleeding are to be expected. You may also feel bloated. If you have more serious symptoms, contact a healthcare provider

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Johns Hopkins Medicine. What risks are associated with a ruptured ovarian cyst?
2. University of Rochester Medical Center. Management of ruptured ovarian cyst.
3. Johns Hopkins Healthcare. Ovarian cyst.
4. Centers for Disease Control and Prevention. What is sepsis?
5. Yale Medicine. Ovarian torsion.
6. Radiopaedia. Ruptured ovarian cyst.
7. American Academy of Family Physicians. Ovarian cysts.

By Corey Whelan
Corey Whelan is a freelance writer specializing in health and wellness conntent.

When an Ovarian Cyst Ruptures: Is It an Emergency?

Chances are, if you’re a woman with a period, you’ve had an ovarian cyst at some point. Ovarian cysts — fluid- or tissue-filled pouches in or on your ovaries — are extremely common and usually don’t mean anything is wrong, even when they burst.

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“Normal, physiologic cysts can grow, rupture and bleed every month, as part of your normal menstrual cycle,” says Cara King, DO, Director of Benign Gynecologic Surgery.

But then there are other ovarian cysts that aren’t so normal. These types — which Dr. King calls pathologic cysts — include dermoid cysts, cystadenomas and endometriomas.

“These are rare,” she says. “And cancerous cysts are even more rare. However, when these pathologic cysts rupture, it can be an urgent situation.”

Why do ovarian cysts burst?

Usually we don’t know what makes a cyst burst, Dr. King admits.

Size can be a factor. The bigger the cyst, the more likely it’ll pop, like an overfilled water balloon. Yet there can be huge cysts that are so slow-growing that they don’t rupture — as well as small, fast-growing cysts that do.

Sex and intense exercise also can cause a cyst to rupture.

“Some ovarian cysts cause pain in your lower abdomen and other symptoms,” says Dr. King. “But there’s no specific warning sign that a cyst is about to rupture.”

Besides intense pain, watch for infection and bleeding

For many women, a ruptured cyst can be excruciating. Some say it feels like an attack of appendicitis, especially since ovarian cysts are more common on your lower right side, near your appendix.

However, the pain can be on either or both sides of your abdomen. And it may come with:

• Nausea and/or vomiting. Depending on the cyst, contents that leak into your abdomen can make you really sick.
• Fever. This is a sign that you may have an infection of an ovarian cyst.
• Dizziness. This can indicate there’s a lot of bleeding in your belly. Other symptoms of hemorrhage include vision changes and a racing heartbeat. Not all ruptured cysts cause excessive bleeding, but you’re at a higher risk if you take blood thinners or have a bleeding disorder.

“If you have any of these symptoms, get to a doctor right away,” says Dr. King. “Excessive bleeding or an infection is an emergency that may require surgery or antibiotics.”

Typically, the surgery is minimally invasive. The gynecologic surgeon will use a laparoscope to find the area that’s bleeding, take out the cyst, and remove all the blood and infection-causing material.

Where do the contents go?

Most of the time, a ruptured cyst doesn’t require surgery. If you can manage the pain with over-the-counter pain relievers and don’t have any signs of heavy bleeding or infection, you’ll likely recover on your own.

Your body will absorb whatever bursts out of the cyst. That varies by the type of cyst it is, but can be blood, mucus or other fluid. Dermoid cysts can have all kinds of surprising stuff in them, including hair, skin and teeth.

Absorbing the fluid from normal, physiologic cysts happens pretty quickly — within 24 hours. Other content can take longer. For example, thickened blood from an endometrioma may take weeks to absorb. And the pain can linger while unabsorbed blood continues to irritate your abdominal lining.

“Most ovarian cysts are no cause for concern,” says Dr. King. “Even if they rupture, your body usually takes care of the healing and cleanup. It’s really only when you have sudden severe symptoms that you should seek medical care.”

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