An Overview of Ruptured Ovarian Cysts

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 a ruptured, or burst, ovarian cyst can put you at risk for infection, twisting of an ovary, or heavy bleeding. Why some ovarian cysts rupture and others don't isn't 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.

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. 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

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
• Ovarian torsion
• Severe bleeding
  

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 is when the ovary twists and cuts off its own blood supply. This is a serious condition that can cause ovarian tissues to die.

The pain from this will be severe and situated to one side, just like that of the burst cyst itself. Immediate surgical intervention would be 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.

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 cysts are called functional ovarian cysts. 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: 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: An ovarian cyst that 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 that forms from the reproductive cells within the ovary. They 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 that 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:

• Ectopic pregnancy
• Pelvic inflammatory disease (PID)
• Appendicitis
• Kidney stone(s)

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

While 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.

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.

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.

A Word From Verywell

If you experience severe or persistent abdominal or pelvic pain, you should have it evaluated by your healthcare provider immediately or seek emergency care. There is no way to diagnose a condition by either the location of the pain or type of pain experienced.

While a ruptured ovarian cyst is rarely life-threatening, an ectopic pregnancy can be. Delayed treatment can result in severe blood loss, shock, and even death.