Ovarian cysts are sacs of fluid that grow inside or on the ovary. There are different types of ovarian cysts, many of which are normal. In fact, before women reach menopause, a small ovarian cyst forms each month as part of the normal menstrual cycle. Cysts may also be caused by medical disorders, such as polycystic ovarian syndrome. They are occasionally due to cancer. When an ovarian cyst breaks open, or ruptures, fluid and sometimes blood are released into the ovary or surrounding tissues. This often causes no symptoms, but pain may occur. Less commonly, nausea, vomiting or even symptoms of severe blood loss develop.
Abdominal pain is the most common symptom of a ruptured ovarian cyst. The pain occurs in the lower abdomen and is generally located on the left or right side, depending on which ovary contains the cyst. The pain typically begins suddenly. According to a review article published in “Best Practice & Research: Clinical Obstetrics & Gynaecology" in October 2009, a woman with pain due to a ruptured cyst will often prefer to lay still, as the pain generally worsens with movement.
In pre-menopausal women, a normal cyst ruptures each month around the middle of a woman’s menstrual cycle. This type of cyst is small and releases only a small amount of fluid -- it causes little or no pain when it ruptures. Other cysts tend to release more fluid or blood, so they often produce more pain. When a large amount of fluid or blood is released, the pain can be severe.
Nausea and Vomiting
Nausea, and even vomiting, may sometimes occur with a ruptured ovarian cyst. These symptoms are more common when a large amount of fluid or blood is released into the abdomen. Severe pain itself may cause nausea or vomiting in some people. In other instances, these symptoms are due to irritation of tissues in the abdomen.
If a large amount of blood is released into the abdomen when an ovarian cyst ruptures, symptoms of blood loss will occur. These symptoms may include lightheadedness or dizziness, weakness, confusion or fainting. The contents of some cysts, such as those caused by endometriosis or a tumor called a teratoma, are very irritating. Rupture of these cysts can cause not only severe pain but also generalized signs of inflammation such as an increased body temperature.
When to Seek Medical Attention
Mild lower abdominal pain due to a ruptured ovarian cyst will often resolve on its own. However, if your pain becomes worse or is accompanied by other symptoms such as nausea or vomiting, seek medical attention. Obtain immediate medical care if you have any symptoms of blood loss. Emergency surgery may be necessary.
Reviewed by: Mary D. Daley, M.D.
- Best Practice & Research: Clinical Obstetrics & Gynaecology: Diagnosis and Management of Ovarian Cyst Accidents
- Information From Your Family Doctor: Ovarian Cyst
- Saint Luke’s Health System: Management of Ruptured Ovarian Cyst
- PloS One: Successful Conservative Management of Ruptured Ovarian Cysts with Hemoperitoneum in Healthy Women
- American Family Physician: Evaluation of Acute Pelvic Pain in Women
- Practical Gynecology: A Guide for the Primary Care Physician; Janice Ryden, et al.