Ovarian cysts are common in females of reproductive age. Most of them are harmless, but some may rupture. A sudden, sharp pain in the lower abdomen, with nausea and vomiting in some cases, can indicate a ruptured cyst.

Ovarian cysts are not uncommon. Most of these are functional and do not require treatment.

However, complications can occur, such as cyst rupture, which may require prompt management.

This article discusses ruptured ovarian cysts, their symptoms, causes, diagnosis, and treatments. It also explores complications and other conditions related to ruptured ovarian cysts.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Ovarian cysts are fluid-filled sacs that form on one or both ovaries due to ovulation. When a person ovulates, a follicle that contains the egg ruptures to release the egg from the ovary.

Most cysts are functional and form from the follicles in the ovaries. There are two types of functional cysts:

  • Follicular cysts: These form when a follicle does not break open to release the egg and turns into a cyst.
  • Corpus luteum cysts: These develop after the follicle ruptures to release the egg.

Around 1 in 5 females develop at least one pelvic mass in their lifetime.

A person with polycystic ovary syndrome (PCOS) has enlarged ovaries with multiple follicular cysts. This happens due to hormonal imbalances.

Doctors refer to other cysts as complex ovarian cysts. They usually form from abnormal cell growth. Some types include:

  • Dermoid cysts: Also known as benign cystic teratomas, these cysts vary in appearance and come from cells present from birth. They may contain a range of tissues such as hair and teeth.
  • Fibromas: These are solid masses made of connective tissue. They are slow-growing and usually appear only on one side.
  • Cystadenomas: These cysts develop from the ovary’s surface and may contain some of the ovary’s tissues.

A ruptured ovarian cyst does not always cause symptoms. If it does, they are usually mild.

In some cases, the primary symptom is a sudden, severe, and sharp pain in the lower abdomen that may coincide with nausea and vomiting.

Other symptoms may include:

When might an ovarian cyst need medical attention?

A person who experiences abdominal or pelvic pain along with the following symptoms should seek immediate care:

These symptoms might indicate complications such as ovarian torsion, bleeding from a ruptured cyst, and infection, which require prompt medical attention.

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Most ovarian cysts are natural and occur as part of a person’s menstrual cycle. They are mostly benign and harmless. Rarely, ovarian cysts can be malignant, or cancerous.

Experts do not know the reason why some cysts rupture. Below are potential reasons:

A doctor will ask about a person’s symptoms and take their medical history. They may also perform a pelvic exam along with a physical exam.

If they suspect a ruptured ovarian cyst, doctors will usually first check if a person is pre-or postmenopausal to determine whether the cyst is pregnancy-related. They will also ask them to take a urine pregnancy test.

Doctors will also use ultrasound to check the quality of the cysts and whether they have ruptured.

They may conduct further tests to rule out conditions with similar symptoms, including:

The treatments a doctor recommends for a ruptured ovarian cyst will depend on the following factors:

  • age and menopausal status
  • size and appearance of the cyst
  • presence of symptoms
  • possible malignancy

Most people have noncomplex cysts. When these cysts burst but do not cause complications, doctors may recommend observation through a series of ultrasounds and blood tests, if needed, and prescribe pain medications. They may also recommend management techniques to try at home.

A person showing complications such as severe bleeding requires hospitalization and urgent care. Management may include:

In severe cases, surgery may be necessary to stop blood loss and bleeding. Other indications for surgery include:

  • persistent pain
  • large cyst
  • ovarian torsion
  • signs of possible cancer

Ovarian cyst rupture can cause complications if a person does not get immediate medical attention. This may include hemorrhage, especially if the cyst is large.


Some cysts can form in people with pelvic infections such as abscesses or PID.

If the cyst bursts, the contents may transmit the infection to other parts of the body and trigger sepsis, which is a potentially life threatening response.

Ovarian torsion

Cysts can also cause the blood vessels that supply the ovaries to twist, leading to a common gynecological emergency that doctors call ovarian torsion. This can cut blood flow to the ovary, which may need removing.

Undergoing surgery also poses risks of complications, including:

Symptoms of ruptured ovarian cysts may mimic those caused by other conditions.

Ectopic pregnancy

Healthcare professionals define a pregnancy as “ectopic” when a fertilized egg implants outside the uterus, usually the fallopian tube. Sometimes, it implants in the ovary.

It can cause vaginal bleeding and sharp pain in the pelvic area. This condition can be a medical emergency if untreated.


Endometriosis occurs when the lining of the uterus grows outside the uterus. It can affect fertility and increase the risk of ovarian cancer. A 2017 study notes that 1 in 200 females with endometriosis would have ovarian cancer.

Symptoms may include:

  • excessive and painful cramping pain in the abdomen and lower back
  • pain during sex
  • painful urination and bowel movements
  • heavy or irregular menstrual flow


A person with untreated sexually transmitted infections (STIs) may develop PID. But it can also develop from infections due to other causes.

PID is the inflammation of the reproductive organs. 1 in 8 females who have had PID may find it difficult to conceive.

Symptoms of PID include:

  • pain in the lower abdomen
  • fever
  • pain or bleeding during sex
  • vaginal discharge with a foul odor
  • burning sensation when urinating


Ruptured ovarian cysts usually cause lower abdominal pain in one side, a known symptom of appendicitis.

Appendicitis describes inflammation of the appendix. A person may feel pain at the lower right side of their abdomen, near the belly button.

The condition is a medical emergency. A ruptured appendix may cause widespread infection and can be life threatening.

Kidney stones

Kidney stones occur when minerals build up in a person’s kidneys.

Small stones may pass out of a person’s body unnoticed in their urine. But larger stones can cause severe pain when exiting the body.

When symptoms appear, they can include:

  • pain in the groin, the side of the abdomen, or both
  • blood in the urine
  • vomiting and nausea
  • fever and chills if there is an infection
  • an increased need to urinate
  • cloudy, foul-smelling urine

If a person experiences these symptoms, they should seek medical assistance immediately.

If kidney stones block the tube that connects the kidney to the bladder, urine may not be able to pass from a person’s body. This can cause a kidney infection.

Other causes

Alternative potential causes of severe abdominal pain include:

Below are some common questions and answers about ovarian cysts.

Should I go to the ER for a ruptured ovarian cyst?

If a person experiences the following symptoms alongside abdominal or pelvic pain, they should seek medical attention immediately: lightheadedness or weakness, fainting, heavy vaginal bleeding, fever, shortness of breath, or a rapid heart rate.

What will the ER do for ovarian cysts?

Healthcare professionals may manage severe bleeding and other complications of ruptured ovarian cysts by monitoring a person’s vital sign and using pain medications, repeated ultrasounds, IV fluids, or blood transfusions.

In some cases, they may recommend inpatient management or surgery.

What color is ovarian cyst discharge?

A ruptured ovarian cyst may cause vaginal bleeding. This may result in pink or brown discharge.

Is a ruptured ovarian cyst the same as appendicitis?

No, ovarian cysts are fluid-filled sacs that form on one or both ovaries due to ovulation. If these cysts break open, people refer to them as ruptured ovarian cyst.

Appendicitis refers to inflammation of the appendix.

Ruptured ovarian cysts are not uncommon and are a natural part of the menstrual cycle. Most do not require treatment, but some may cause pain and other symptoms.

People experiencing pelvic pain should immediately consult a doctor for thorough evaluation and treatment. Doctors treat most ruptured ovarian cysts with pain relief, but some may need surgical removal.