Ovarian Cyst Rupture: Pain Symptoms From Burst Cyst

Some symptoms are an emergency, others are not

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A ruptured ovarian cyst is a fluid-filled sac on an ovary that breaks open. Sometimes this doesn't cause problems, but it can be dangerous and require hospitalization. If you feel severe pain around the ovaries, have excessive bleeding, tachycardia (rapid heartbeat), or lightheadedness, contact your healthcare provider right away.

An ovarian cyst in and of itself is not always a concern. An intact cyst typically doesn't cause symptoms, but risks of a ruptured ovarian cyst include infection, twisting of an ovary, or heavy bleeding. Why some ovarian cysts rupture and others don't is not known.

This article covers the causes and symptoms of ruptured ovarian cysts, along with a few possible complications that can come from them and when to seek care. It also explains how a ruptured ovarian cyst is diagnosed and treated.

An illustration with symptoms of a ruptured ovarian cyst

Illustration by Sydney Saporito for Verywell Health

Symptoms of a Ruptured Ovarian Cyst

A small- to average-sized ovarian cyst that ruptures is typically painless. However, larger cysts that burst can cause sharp, sudden pain in your lower belly or back. One way you can know if an ovarian cyst has ruptured is, partly, by what it feels like.

If a ruptured ovarian cyst causes pain, it is sudden, sharp, and often compared to the pain associated with appendicitis. The pain is typically strongest on one side.

Other symptoms of a ruptured ovarian cyst include:

  • Spotting or bleeding from the vagina
  • Abdominal bloating
  • Severe nausea or vomiting
  • Fever
  • Faintness or dizziness

When to Seek Immediate Medical Attention

See a healthcare provider right away if you experience any of the following:

  • Severe pain that does not resolve after a period of rest. 
  • Pain with vomiting and fever.
  • Heavy bleeding accompanied by lightheadedness, shortness of breath, or a rapid heartbeat.

Is a Ruptured Ovarian Cyst Dangerous?

A ruptured ovarian cyst is not, by itself, a life-threatening problem. Many even heal on their own without medical attention. However, there are times when a burst cyst can be a medical emergency.

Possible complications that can result from a ruptured ovarian cyst include:

Infection

Left untreated, a ruptured ovarian cyst can become infected. The risk of this is particularly high if the cyst developed due to gonorrhea, chlamydia, or another pelvic infection.

Sometimes, the infected cyst can trigger sepsis—the immune system's extreme response to infection. Sepsis is life-threatening and requires immediate medical attention.

Ovarian Torsion

An ovarian cyst, ruptured or not, can sometimes cause ovarian torsion. This occurs when the ovary twists and cuts off its own blood supply. It is a serious condition that can cause ovarian tissues to die.

The pain will be severe and situated on one side, just like that of the burst cyst itself. Immediate surgical intervention is needed to uncoil the ovary and prevent necrosis (tissue death).

Severe Bleeding

A cyst that is located near a significant blood vessel may cause severe bleeding if it ruptures. Left untreated, the bleeding can lead to a serious condition known as hemoperitoneum.

With this, blood accumulates in the space between the inner lining of the abdominal wall and the internal organs.

What Causes an Ovarian Cyst to Rupture?

There isn't one obvious cause of a ruptured ovarian cyst, but intense physical activity, vigorous sex, and strained bowel movements can increase the likelihood of this occurring.

The reason why the cyst formed in the first place depends on the type of ovarian cyst you have.

Types of Ovarian Cysts and Why They Occur

The most common type of ovarian cyst is called a functional ovarian cyst. These ovarian cysts only occur in those who have started to get periods but haven't yet reached menopause.

There are two types of functional ovarian cysts:

  • Follicular cyst: This is a cyst that forms when a follicle, located within an ovary, does not break open and release an egg, causing it to keep growing into a cyst. Most people develop a follicular cyst each month that usually self-resolves within a few menstrual cycles.
  • Corpus luteum cyst: A corpus luteum is a fluid-filled sac that normally grows on the ovary each month right after the egg is released. It normally dissolves before menstruation. If it doesn't, it will keep growing into a cyst.

Other types of ovarian cysts include:

  • Endometrioma: This ovarian cyst can develop in those who have endometriosis. The cyst occurs when endometrial tissue implants in the ovary and bleeds with menstrual cycles. This forms a fluid-filled collection, sometimes referred to as "chocolate cysts."
  • Dermoid: A congenital (present at birth) cyst, it forms from the reproductive cells within the ovary. It can contain teeth, hair, or fat within the cyst. Dermoids are common in people of childbearing age, though post-menopausal persons can also develop them.
  • Cystadenoma: A type of benign (non-cancerous) tumor, it grows on the surface of the ovary. Both pre- and post-menopausal persons can develop cystadenomas.

Diagnosis

The diagnosis of a ruptured ovarian cyst usually starts with an ultrasound. If the cyst has ruptured, the ultrasound will show fluid around the ovary and may even reveal an empty, sac-like ulcer. A complete blood count (CBC) may be used to check for signs of infection or other abnormalities.

While an ultrasound is the best method of evaluating a ruptured cyst, it has its limitations. To confirm the diagnosis, your healthcare provider will have to rule out any other condition with similar symptoms, such as:

It is important to note that ovulation itself may sometimes cause mild pain (known as Mittelschmerz pain) when the egg is released.

Mild pain during ovulation is normal. If your pain is extreme, you should be evaluated by a healthcare professional to check for other possible causes, like endometriosis.

In some cases, your cyst may be caused by an underlying condition like endometriosis or polycystic ovary syndrome. Both can cause difficulty getting pregnant. 

How Ruptured Ovarian Cysts Are Treated

Once an ovarian cyst has ruptured, there is often no need for treatment assuming that a person's CBC is normal and vital signs are stable.

Pain medication may be prescribed to help manage the discomfort. Rest may be recommended for a day or two to allow the symptoms to fully resolve.

If the ruptured ovarian cyst is causing severe bleeding, you may need to be hospitalized. Surgery may also be necessary to stop the hemorrhage and prevent additional blood loss.

The pain from a burst ovarian cyst can last for a few days. If over-the-counter pain relievers and rest do not relieve the symptoms, your healthcare provider may be able to prescribe you something to ease the pain.

Prevention

There is no way to prevent an ovarian cyst from rupturing. That said, if your healthcare provider finds one during a routine exam, they may recommend a watch-and-wait approach to see if the cyst increases in size or goes away on its own.

If the cyst is large and already causing discomfort, a medical professional may recommend laparoscopic ("keyhole") surgery to remove the growth. This is usually an outpatient procedure.

Summary

Ovarian cysts are not uncommon and they're not always a cause for concern. A ruptured ovarian cyst can, however, become a serious health issue and lead to complications. A related infection or severe bleeding can become life-threatening.

If you experience severe or persistent abdominal or pelvic pain, you should have it evaluated by your healthcare provider immediately or seek emergency care. It's important to receive the correct diagnosis and rule out other possible causes, like an ectopic pregnancy.

Treatment for a ruptured ovarian cyst will depend on the symptoms. Pain medication and rest may be enough in some cases, while others may require hospitalization.

9 Sources
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.
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Additional Reading
  • American College of Obstetricians and Gynecologists. Ovarian cysts.

By Nicole Galan, RN
Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book."