An ovarian cyst is a common fluid-filled sac that develops on or inside an ovary. A rupture occurs when the sac breaks open, releasing its contents into the abdominal cavity. This event is often a natural consequence of the menstrual cycle, particularly with functional cysts like corpus luteum cysts. While many ruptures are harmless and cause only mild discomfort, the sudden release of fluid or blood can cause severe pain. Due to the potential for significant internal bleeding or infection, prompt medical evaluation is necessary.
Recognizing the Symptoms and Next Steps
The most distinct sign of a ruptured ovarian cyst is the abrupt onset of intense, sharp pain, typically localized to one side of the lower abdomen. This pain is caused by the irritating effect of the cyst’s fluid and blood on the lining of the abdominal cavity. The severity of the pain can vary widely, but a sudden, debilitating episode is a strong indicator that the cyst has burst.
Accompanying symptoms may include nausea, vomiting, and a feeling of fullness or bloating. If the rupture involves significant blood loss, a person might also experience dizziness, lightheadedness, or a rapid heart rate.
If you experience sudden, severe pain that does not resolve quickly, or if the pain is compounded by systemic symptoms, seek immediate medical attention. Signs of a medical emergency include lightheadedness, fainting, a rapid heartbeat, or a fever, as these can point toward severe internal bleeding or infection. Medical professionals can quickly assess the situation and rule out other serious conditions with similar symptoms.
How Doctors Confirm a Rupture
Once at the hospital, the medical team begins the diagnostic process by performing a physical examination, including a pelvic exam. A key step is to rule out other possible causes of acute pelvic pain, such as appendicitis, ectopic pregnancy, or kidney stones. A urine pregnancy test is always performed, as a ruptured corpus luteum cyst must be distinguished from a life-threatening ectopic pregnancy.
Imaging studies are the most definitive way to confirm a rupture and assess its severity. A transvaginal or abdominal ultrasound is the primary diagnostic tool used to visualize the ovaries and check for free fluid in the pelvis, which is consistent with a rupture. The ultrasound can also determine the size and nature of the cyst, such as whether it is a simple fluid-filled sac or a complex mass.
Blood tests are performed to check for internal complications. A complete blood count (CBC) helps determine if significant blood loss has occurred or if there is an infection, suggested by elevated white blood cells. If the diagnosis remains unclear or other complications are suspected, a computed tomography (CT) scan may be used to provide a more detailed view of the abdomen and pelvis.
Treatment Options Following a Burst Cyst
The management strategy for a ruptured ovarian cyst depends on the patient’s stability and the amount of internal bleeding observed. For the majority of simple, functional cysts that rupture, treatment involves expectant management. This approach prioritizes rest, close monitoring, and pain control, often utilizing non-steroidal anti-inflammatory drugs (NSAIDs) or prescription pain medication.
Expectant management is appropriate when the patient remains hemodynamically stable, meaning their vital signs are normal, and imaging shows minimal internal bleeding. The body reabsorbs the fluid and blood over time, and the pain usually subsides within a few days. Intravenous fluids may be administered in the hospital to support hydration and maintain blood pressure.
Surgical intervention is reserved for complicated or severe cases, such as heavy, uncontrolled internal bleeding, signs of shock, or suspicion of ovarian torsion. Surgery is most commonly performed using minimally invasive laparoscopy, where small incisions are made to insert a camera and instruments. The surgeon controls the bleeding, removes blood clots, and may remove the cyst, or in rare instances, the entire ovary.
Recovery and Follow-up Care
For those treated conservatively without surgery, pain typically improves significantly within one to three days, with a return to normal activity often occurring within a week. At home, patients should focus on rest and managing discomfort using prescribed or over-the-counter pain relievers. Applying heat, such as a heating pad, can help relax abdominal muscles and ease cramping.
Patients must monitor for signs that could indicate a complication after discharge. Worsening abdominal pain, the return of fever, or unexpected heavy vaginal bleeding should prompt a call to a healthcare provider for further evaluation. Activity restrictions are often temporary, requiring avoidance of strenuous exercise or heavy lifting until pain has completely resolved.
A follow-up appointment with a gynecologist is required following a rupture, regardless of the initial treatment. This visit allows the doctor to confirm complete resolution of the cyst, often with a follow-up ultrasound, and to discuss prevention strategies. For individuals who experience recurrent cysts, hormonal birth control may be recommended to suppress ovulation and reduce the chance of new functional cysts forming.