What to Know About Ruptured Ovarian Cysts

Medically Reviewed by Nivin Todd, MD on May 20, 2023
3 min read

Ovarian cysts are small sacs full of fluid that form on your ovaries. You have two ovaries, each about 3-4 cm in size. An egg develops each month in your ovaries, and this then passes through the fallopian tubes and into your uterus. It is usually during ovulation, when the ovary releases an egg, that small cysts form.

During ovulation, cyst-like structures called follicles produce estrogen and progesterone. These structures usually pose no health risk, cause no discomfort or pain, and go away on their own during your cycle.

An ovulation cyst that doesn’t disappear on its own is known as a functional cyst. If the cyst fails to release an egg and continues to grow, it becomes a follicular cyst. If the cyst does release the egg but continues growing, it is called a corpus luteum. None of these are harmful to your health, and they usually go away on their own in two to three menstrual cycles.

Other types of cysts that develop may pose health risks. These include the following:

  • Dermoid cysts. These cysts form from embryonic cells, so they may contain fetal tissue like hair, skin, or teeth. They are rarely cancerous but can be. 
  • Cystadenomas. These cysts develop on the outside of your ovary and contain fluid or a type of mucus.
  • Endometriomas. If you have endometriosis, uterine cells may grow outside of the uterus, causing a cyst to form on your ovaries.  

‌There are a few different ovarian cyst risk factors. Ovarian cyst risks are greater if you

  • ‌have hormonal problems
  • use the fertility drug clomiphene
  • are pregnant
  • have endometriosis
  • develop a severe pelvic infection‌ 
  • have previously had ovarian cysts

Most cysts don’t cause harm. However, it is important to know the symptoms of a ruptured ovarian cyst in case you need immediate medical attention:

  • abdominal pain that is sudden and severe
  • pain accompanied by fever or vomiting
  • feeling cold with clammy skin
  • fast breathing‌
  • lightheadedness or weakness

If you experience symptoms of a ruptured cyst, talk to your doctor right away. If you see a different doctor from the one you normally visit, make sure you tell them if you already know that you have a cyst. They will ask about your medical history and symptoms. They will also probably give you a physical exam, including a pelvic exam.

If your doctor suspects a ruptured cyst, you may need additional tests. Your doctor wants to rule out other health conditions like ectopic pregnancy, appendicitis, or a kidney stone. Additional tests may include the following:

  • Ultrasound. This gives your doctor a picture of the size and location of your cyst. 
  • Pregnancy test. Your doctor wants to see if pregnancy may be causing the cyst. If you’re pregnant, they will choose less invasive treatment options that don’t put your baby at risk. 
  • Blood tests. These provide information on your iron levels and also check for signs of cancer
  • Urine test. Your doctor looks for protein in your urine and other possible causes of your pain.
  • Vaginal culture. This helps to rule out or diagnose a pelvic infection. It is used to check for a pelvic infection.‌
  • CT scan. This uses a series of X-rays to provide a more detailed picture of your pelvis.

The rupture of an ovarian cyst usually isn't serious. 

If there is bleeding or torsion, you will be given IV fluids and pain medication. You may also need blood replaced if you’ve had a lot of internal bleeding. In the worst cases, internal bleeding can reduce blood flow to your vital organs, and you may be at risk of permanent damage.

If your condition is serious enough, you may need surgery for treating a ruptured ovarian cyst. After you have been anesthetized, a surgeon will make a small cut to control bleeding and remove clots or fluid. The surgeon will then remove the cyst or, in some cases, your entire ovary. You’ll need plenty of time to rest and recover after surgery.

It’s important to have dangerous cysts removed, but it is not without risks. You should be aware of the risks involved in getting surgery. Some of these risks are:

  • bleeding
  • infection
  • an incision site that doesn’t heal well
  • blood clots
  • damage to your blood vessels, nerves, muscles, or other nearby tissue
  • need for a larger incision than anticipated
  • scar tissue from the incision or from surgery