Could an ovarian cyst rupture be causing your pelvic pain?

An ovarian cyst rupture often starts suddenly. A sharp feeling of discomfort or pain in your lower abdomen. A deep ache on one side that feels different from cramps. Maybe it stops you in your tracks or leaves you wondering if you should be concerned something is wrong.

Ovarian cysts are very common, and most don’t cause problems. But when a cyst ruptures, the experience can feel alarming, especially if it comes out of nowhere. Let’s walk through what an ovarian cyst is, why an ovarian cyst might rupture, what it feels like and when it’s time to seek medical care.

How ovarian cysts form and why they are so common

An ovarian cyst is a fluid-filled sac that forms on or inside an ovary. Your ovaries are part of the female reproductive system, responsible for releasing eggs and producing hormones like estrogen and progesterone.

Ovarian cysts often develop as part of normal reproductive function, especially during the menstrual cycle. These are called functional or physiologic cysts. While many cysts are harmless and temporary, certain conditions and factors can increase the likelihood that they form or persist.

Common causes of ovarian cysts include:

• Normal ovulation: Functional cysts can form when an egg doesn’t release as expected or when the sac that holds the egg doesn’t dissolve after ovulation.
• Hormonal changes or imbalance: Shifts in hormone levels, sometimes related to medications or underlying conditions, can interfere with ovulation and lead to cyst formation.
• Fertility medications: Drugs that stimulate ovulation can increase the chance of developing functional cysts as the ovaries respond to treatment.
• Endometriosis: This condition can cause cysts, called endometriomas, to form on the ovaries, sometimes leading to ongoing pelvic pain or fertility challenges.
• Polycystic ovary syndrome (PCOS): PCOS causes the ovaries to develop many small cysts due to hormone imbalance and may also be associated with irregular periods and difficulty getting pregnant.
• Pelvic infections: Severe infections that spread to the reproductive organs can trigger cyst formation in the ovaries or fallopian tubes.
• Pregnancy: Ovarian cysts may develop early in pregnancy and are often harmless, but they should be monitored by an OBGYN to ensure they don’t cause complications.

There are also less common types of ovarian cysts that are not related to the menstrual cycle, such as:

• Cystadenoma:  A benign tumor that forms on the outside of an ovary
• Dermoid cyst: A benign tumor that originates during early fetal development, when skin-related cells become trapped inside the body

Why does an ovarian cyst rupture?

An ovarian cyst ruptureoccurs when the cyst breaks open and releases its contents into the pelvic cavity. Sometimes that release is small and barely noticeable. Other times, it causes irritation, inflammation or internal bleeding.

The body often absorbs the fluid naturally over time. But the sudden change, especially if blood is involved, can trigger pain and other symptoms that feel intense and unfamiliar.

A rupture can happen due to internal pressure or during everyday activities like exercise or sex, but it can also occur while you’re resting. Abdominal trauma can also cause an ovarian cyst to rupture.

Shifts in hormones, pregnancy and other conditions such as endometriosis may increase the likelihood of cysts rupturing, although it’s not always clear why some cysts break open while others do not.

What does an ovarian cyst rupture feel like?

This is one of the most common questions women ask. Most describe an ovarian cyst rupture as sudden pelvic discomfort that feels different from typical menstrual cramps. It’s usually on one side of the lower abdomen and may be sharp and stabbing or deep and aching.

Some women say this discomfort comes on quickly and then fades over hours or days, while others experience lingering soreness or pressure that makes it uncomfortable to move, sit upright or exercise. It can feel like a deep ache or pressure that slowly builds and may spread to the lower back or thighs.

It’s also common to feel bloated or uncomfortable for several days after a rupture as the body absorbs the released fluid. Mild cramping or soreness can linger, even after the more intense discomfort fades.

Other symptoms of an ovarian cyst rupture may include:

• Bloating or abdominal swelling
• Feeling of pressure or fullness in the pelvis
• Nausea or vomiting
• Pain that worsens with movement
• Light vaginal spotting or bleeding

Because symptoms can overlap with other conditions, such as appendicitis, kidney stones or ectopic pregnancy, it’s important to note how severe your pain is and whether it’s getting worse. Always contact your OBGYN or your primary care provider if you have questions or concerns.

Is a ruptured ovarian cyst an emergency?

Not every ovarian cyst rupture requires a trip to the emergency room. Many resolve with rest and pain management. If your discomfort is mild to moderate and improves over time, you may be able to manage symptoms at home.

If you suspect you have an ovarian cyst, your doctor will likely use a pelvic ultrasound to confirm the presence of a cyst or signs that one has ruptured. Ultrasound can also show free fluid in the pelvis, which supports the diagnosis. Blood tests may be ordered to check for infection or blood loss.

Pain tolerance and cyst size vary, so no two experiences are exactly alike. If something feels suddenly off or unusually intense, it’s worth paying attention.

Certain symptoms associated with pelvic discomfort should never be ignored, and you should seek immediate medical care if you experience:

• Sudden, severe pelvic or abdominal pain
• Pain combined with fever or vomiting
• Dizziness, fainting or signs of blood loss
• Rapid heart rate or shortness of breath
• Heavy vaginal bleeding

Treatment for an ovarian cyst rupture

Treatment for a ruptured ovarian cyst depends on how severe your symptoms are and whether complications are present.

For many women, treatment is simple and supportive. Rest, heating pads and over-the-counter pain relievers are often enough while the body heals. Your symptoms usually improve within a few days.

However, if your pain is more intense, prescription medication may be needed. In some rare instances, such as ongoing bleeding or unstable vital signs, surgery may be required to stop bleeding or remove remaining cyst tissue.

Does a ruptured ovarian cyst affect fertility?

In most cases, an ovarian cyst rupture does not affect fertility. The ovaries usually continue to function normally after healing. However, repeated cysts or underlying conditions like endometriosis or PCOS may impact your reproductive health or lead to infertility, which is why follow-up care is so important.

Can you prevent an ovarian cyst rupture?

While there is no guaranteed way to prevent all ovarian cyst ruptures, there are certain steps you can take that may reduce your risk, especially if you experience frequent cysts.

• Hormonal birth control can help by preventing ovulation, which reduces the formation of functional cysts. This may be recommended if cysts repeatedly cause discomfort or disruption.
• Regular gynecologic care with your OBGYN also plays an important role. Monitoring cysts that are known to be large or persistent allows your doctor to intervene before complications arise.
• Most importantly, knowing your body and recognizing when pain feels unusual can help you seek care earlier rather than later. Prompt evaluation can bring relief, reassurance and appropriate treatment when needed. Sudden or severe pelvic pain is not something you should push through or dismiss.

Trust your instincts and your body

An ovarian cyst rupturecan feel frightening, especially when it happens without warning. While many ruptures are manageable and resolve on their own, some require medical care, and that’s when knowing the difference matters.

If you’re experiencing sudden pelvic pain, unexplained abdominal discomfort or symptoms that don’t feel normal for you, don’t hesitate to reach out to your healthcare provider. Getting clarity can help you heal faster and feel more confident about your health moving forward.

If you think you might have an ovarian cyst or be at risk of a rupture, talk to your OBGYN.

Don’t have an OBGYN? Find one near you today.