Recognizing the Immediate Symptoms of a Ruptured Ovarian Cyst
If you have an ovarian cyst and suddenly feel a sharp or intense pain in your lower belly, you might wonder if the cyst has ruptured (broken open). A ruptured ovarian cyst can cause a range of symptoms, from mild discomfort to severe pain, and knowing the signs and symptoms can help you understand when to seek medical care.
A ruptured ovarian cyst is when a cyst on the ovary bursts or breaks open.Ovulation itself involves a type of natural cyst rupture when the follicle that holds the egg breaks open to release it. “In many women, these events may go unnoticed,” says June Hou, MD, associate professor of obstetrics and gynecology at Columbia University Irving Medical Center in New York City.
You might feel a brief pain or twinge (called “mittelschmerz”) as the egg-containing follicle enlarges and then ruptures, says Janet Choi, MD, double board-certified reproductive endocrinologist and obstetrician-gynecologist and chief medical officer at Progyny, who is based in New York City. This mild discomfort during ovulation is normal and typically passes quickly.
But certain pathological ovarian cysts, like endometriomas (cysts formed from endometriosis) and dermoid cysts (which contain materials similar to hair or skin), can grow very large and rupture, says Dr. Hou. This can cause the fluid and other materials in the cyst to spill into the lower belly and pelvic area. In these cases, the release of the cyst’s contents can cause irritation, leading to more noticeable and sometimes severe symptoms, she adds.
You may not notice any symptoms if an ovarian cyst ruptures. But, depending on its size and whether complications occur, you may experience certain symptoms, according to Dr. Choi and Pamela Berens, MD, professor and board-certified obstetrician-gynecologist with UTHealth Houston. These include:
Sudden, sharp pain often felt on one side of the lower belly
Pain that may spreads to your lower back or thighs
Shoulder pain, which can occur with internal bleeding
Fever, low body temperature, or fast heart rate, if infection is present
Vaginal bleeding or spotting (unrelated to your normal period)
Ovarian cyst rupture pain from ovulation (mittelschmerz) typically lasts less than 24 hours and can be treated with over-the-counter pain medication like ibuprofen, says Dr. Berens. This type of pain is usually mild to moderate and occurs mid-cycle.
Larger cysts can sometimes cause symptoms like pressure on your bladder or constipation due to their size and location, notes Choi. These symptoms can also occur right before they rupture, she says.
What to Do if You Suspect a Cyst Has Ruptured
If you notice sudden, severe abdominal pain that comes on without warning, especially with lightheadedness, vomiting, or fever, go to an emergency room or urgent care center right away, says Hou. These symptoms could indicate complications like internal bleeding or ovarian torsion.
In the case of internal bleeding, your healthcare provider may need to monitor you to ensure that the bleeding stops and your blood count remains stable so you don’t become anemic, says Berens. “In extreme cases, you may need surgery to stop the bleeding, but this is very rare,” she explains.
For less severe symptoms, Choi recommends rest and over-the-counter pain relievers. Applying a heating pad to your belly may also help manage the discomfort, she adds. But it’s important to contact your healthcare provider for guidance and avoid strenuous activity until you feel better, Choi says.
Ovarian cyst rupture and ectopic pregnancy (a medical emergency) can have similar symptoms, so if you’re in the first trimester of a pregnancy, it is especially important to seek medical care when experiencing abdominal pain or nonperiod vaginal bleeding.
While some ovarian cysts break open naturally during ovulation, others can rupture for different reasons. In some cases, trauma, sexual intercourse, or strenuous exercise can put pressure on an ovarian cyst and cause it to burst, says Berens.
But not all ovarian cysts will rupture, and experts aren’t exactly sure why that happens.
Although most ruptured ovarian cysts are harmless and heal on their own, Choi notes that some can become problematic and cause complications, such as:
Internal Bleeding This can occur if an endometrioma fills with blood and ruptures or if a follicle bleeds into a cyst.
Infection If an infected ovarian cyst ruptures, you may develop sepsis, a life-threatening condition that needs immediate medical care.
Severe Pain Some ruptured cysts cause intense pain that may require medical attention or hospitalization.
Ovarian Torsion Larger cysts can sometimes cause the ovary or fallopian tube to twist, which can block blood flow.
It’s not always possible to prevent ovarian cysts or ruptures, but you can take steps to lower your risk, including having regular checkups and making lifestyle changes.
Regular Checkups
The best way to avoid an ovarian cyst rupture is to prevent cysts from forming in the first place, says Hou. Regular checkups with your gynecologist can help catch problematic cysts early during a pelvic exam. Berens notes that certain cysts, like those caused by endometriosis, teratomas (dermoid cysts), or cancer, tend to grow slowly and can often be found before they rupture.
If you frequently experience ovulation-related pain, talk with your healthcare provider about treatment options. Birth control pills can help prevent ovarian cysts because they stop ovulation, which is when most cysts develop.
Lifestyle Changes
Maintaining a healthy weight and exercising regularly may help reduce your risk of developing certain types of ovarian cysts, says Choi. This is especially true for ovarian cysts related to polycystic ovary syndrome (PCOS). But she cautions that if you have a known large cyst, you should avoid overly strenuous activities that could increase the risk of rupture.
Stress management techniques, such as yoga or meditation, may also be helpful, as stress can affect hormone levels and potentially impact cyst development, Choi adds.
Most ovarian cysts are linked to routine ovulation and go away on their own. But some can grow large and break open (rupture).
A ruptured ovarian cyst can cause sudden, sharp pain in your lower belly. If you also have symptoms like dizziness, fever, or heavy bleeding, seek medical attention right away.
Serious complications like internal bleeding, infection, or twisting of the fallopian tube or ovary can occur with a ruptured ovarian cyst.
Not all ovarian cyst ruptures can be prevented, but regular gynecological checkups and certain lifestyle changes can help lower your risk.
