Vaginal Health

Diagnosis and Treatment of Ruptured Ovarian Cysts

September 6, 2018

An ovarian cyst is a fluid-filled sac that creates within or in addition to an ovary. Ovarian cysts are not all that uncommon and tend to go away on their own. However, they can occasionally rupture and cause extreme pain.

Causes and Symptoms

The huge majority of ovarian cysts are painless and will not cause complications of any type. There are instances, however, where the positioning of a uterus can cause irritation or discomfort in a bowel motion or when having sex.

This usually occurs when the cyst has grown so large that they begin to press on nerves or other organs.

If the cyst continues to grow even bigger, it may suddenly rupture, resulting in pain and bleeding. The pain will usually be sudden and sharp and be located to one side of the anus. A rupture will frequently occur during or immediately after strenuous exercise or gender.

If the bleeding is heavy, then the woman could experience nausea, lightheadedness, shortness of breath, and a rapid heartbeat. The ruptured tissues can raise risk for disease if left untreated.

Even if the cyst doesn’t rupture, it can sometimes make the gut to twist and then cut off the blood supply. This is a critical condition called ovarian torsion where the decreased circulation can cause ovarian cells to die. As with a rupture, the pain will probably be intense and situated to one side. Immediate surgical intervention will be necessary to uncoil the ovary and prevent necrosis (cell death).


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

While an ultrasound is the ideal method of evaluating a ruptured cyst, it has its limitations. To confirm the diagnosis, your doctor will need to rule out any other condition with similar symptoms such as an ectopic pregnancy, pelvic inflammatory disease (PID), or non-gynecological causes like appendicitis or a kidney stone.

It’s very important to note that ovulation itself may sometimes cause mild pain when the egg is discharged. We refer to this as mittelschmerz pain, the symptom of which is not inherently strange. However, in many women, the pain may be extreme and ought to warrant investigation to determine if there are any other possible causes such as endometriosis (the overgrowth of uterine tissue).


After a ovarian cyst has ruptured, there’s often no need for treatment assuming the female’s CBC and vital signs are stable. Pain medication may be prescribed to help manage the discomfort. Rest may be advocated for a day or 2 to permit the symptoms to fully resolve.

However, in some cases, a cyst may be found near a significant blood vessel, and its own blood may cause bleeding. With cases such as these, operation and hospitalization may be needed to halt the hemorrhage and protect against further blood loss.

If left untreated, the bleeding may cause a serious illness called hematoperitoneum where blood accumulates in the space between the internal lining of the gut wall and the internal organs.


There’s not any method to protect against an ovarian cyst from rupturing. With that said, if your doctor finds one through a routine examination, they may recommend a watch-and-wait approach to find out if the cyst increases in dimension or goes off by itself.

If the cyst is large and already causing distress, the health care provider might recommend laparoscopic (“keyhole”) surgery to remove the growth. It is an in-hospital procedure and one which should not be confused with a cystectomy (the removal of the bladder).

A Word From Verywell

Should you experience persistent or severe abdominal or pelvic pain, then you should have it appraised by your physician immediately or seek emergency maintenance. There is not any method to diagnose a condition by the location of this pain or type of pain experienced.

Though the rupture of an ovarian cyst is rarely life-threatening, an ectopic pregnancy may be. Delayed treatment can result in severe blood loss, shock, and sometimes even death.