Ruptured ovarian cyst: Causes, symptoms and treatment

Ovarian cysts are fluid-filled pockets in or on one of the ovaries. They are a common occurrence among women, especially in the reproductive phase. They can be harmless, show no symptoms, and resolve on their own without going to a doctor. But sometimes, complications such as a ruptured ovarian cyst can arise. While it may seem like a problem that needs immediate attention, that may not always be the case. However, you should know the signs of a ruptured ovarian cyst like sharp, severe pain in the abdomen, fainting, and rapid heartbeat. If you notice these symptoms, it is critical to reach out to a doctor.

What is an ovarian cyst?

“It is a fluid-filled sac that develops on or within the ovary, and is typically benign,” says gynaecologist, laparoscopic surgeon and infertility specialist Dr Vaishali Sharma. It can occur at any age, but is more common in reproductive years of a woman, according to research published in StatPearls in 2023. Some of the common types of ovarian cysts are:

• Follicular cysts that form when the follicle that releases an egg fails to open.
• Corpus luteum cysts occur when the follicle closes after releasing an egg and fills with fluid.
• Dermoid cyst form from the cells that produce eggs, and start when tissues from teeth, hair or skin collect inside the ovary.
• Cystadenoma can be formed by the cells that cover the ovary, and usually contains watery fluid or mucus.

What are the causes of a ruptured ovarian cyst?

“A ruptured ovarian cyst occurs when the sac containing the fluid breaks open,” says the expert. This can happen due to several reasons, including:

• High-impact exercises or sudden movements can cause a cyst to rupture.
• Hormonal changes during the menstrual cycle can make cysts more prone to rupture.
• Sexual intercourse can occasionally lead to the rupture of an ovarian cyst.
• Larger cysts are more likely to burst.

“When a cyst splits, it releases fluid and sometimes even blood into the abdomen, leading to pain or discomfort,” says the expert.

How does a ruptured ovarian cyst feel like?

You will not feel anything if the cyst does not split. Ovarian cysts usually only cause symptoms if they split or rupture, according to the UK National Health Service. Symptoms of a ruptured ovarian cyst can vary depending on its size and whether there is bleeding or infection. Big ruptured cysts can cause heavy vaginal bleeding, according to the US Department Of Health And Human Services.

You may also experience the following symptoms of ruptured ovarian cyst:

• Sudden, intense pain typically on one side of the lower abdomen.
• Abdominal swelling or tenderness, so the area around the cyst may feel tender to touch.
• Nausea or vomiting.
• Dizziness or fainting indicating significant blood loss.

“While small cysts may rupture without causing significant harm, larger cysts can lead to severe complications such as internal bleeding and infection,” says Dr Sharma. Also, if a ruptured cyst results in sharp, severe pain, fainting, or signs of shock like rapid heartbeat or sweating, seek immediate medical care.

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Complications associated with a ruptured ovarian cyst

Yes, complications can arise depending on the severity of the rupture:

• Hemorrhage: Significant blood loss can lead to anemia or even shock.
• Infection: The contents of a ruptured cyst may cause an infection in the abdominal cavity.
• Scar Tissue Formation (Adhesions): Repeated ruptures can lead to adhesions, which might affect fertility.

How to diagnose a ruptured ovarian cyst?

A doctor will ask you if you experienced any of the symptoms and look into your medical history. A pelvic exam may be performed, and ultrasound may help to check whether the cyst has ruptured.

The following tests may be done to ensure you don’t have any other health condition with similar symptoms:

• Urine test to make sure you don’t have kidney stones and urinary tract infection (UTI).
• Blood tests will give a complete blood count, which can help to check if you have anemia.

How to treat a ruptured ovarian cyst?

Treatment options for a ruptured ovarian cyst depend on its severity and symptoms:

• Observation: Small cysts with mild symptoms often resolve without any medical intervention. “The pain typically subsides within a week with proper rest and care,” says the expert.
• Pain management: Prescription painkillers may be necessary for intense discomfort. “Medications like ibuprofen or acetaminophen can help with mild pain,” says the expert. Using a heating pad on the lower abdomen can ease cramping.
• Antibiotics: To treat or prevent infections.
• Surgical intervention: For significant complications, surgery may be required to remove the cyst or control bleeding. During a 2022 study published in the Postgraduate Medical Journal, women who had surgical intervention were more likely to have ovarian cysts greater than 20 cm in size. “Cysts with solid components or those suspected of being cancerous may also need surgery,” says the expert. After surgery, recovery can take 2 to 4 weeks.

Ovarian cysts are common and often they are harmless. But a ruptured ovarian cyst can lead to severe or persistent abdominal pain, and heavy vaginal bleeding. If you experience these symptoms, it is best to check with a doctor.