One of the clinical symptoms of Polycystic Ovary Syndrome (PCOS) is the formation of a large number of follicular cysts on the ovaries. Surprisingly, given the name of the condition, not all women with PCOS will have ovarian cysts, some will present with signs of androgen excess and anovulation instead. In fact, ovarian cysts in isolation are insufficient grounds on which to base a diagnosis of PCOS and it is possible for cysts to form on the ovaries of otherwise healthy females.
Follicular cysts are a subtype of functional cysts. They arise when the ovary does not release an egg, causing the follicle to keep growing and form a cyst. These cysts are fluid-filled sacs; they are usually painless and symptom-free. They can be detected using ultrasound and will often be identified during routine screening for other conditions. It is not uncommon for cysts to grow, rupture and bleed each month as part of the normal menstrual cycle. However, in some cases ovarian cysts rupture without warning, causing pain and discomfort to the abdominal region.
What causes an ovarian cyst to rupture?
Nobody really knows why some cysts rupture. Large cysts are more likely to burst than smaller ones, but small, rapidly growing cysts also seem to be at increased risk of rupturing.
Whilst there is usually no trigger for cyst rupture, strenuous exercise and intercourse have both been implicated.
What complications can occur when an ovarian cyst ruptures?
Often a cyst will rupture without causing any significant issues; in these instances, any pain that is experienced can be easily managed using over-the-counter pain relief medications. In some cases however, a ruptured cyst causes more severe symptoms, including:
- Intense pain, sometimes described as excruciating.
- Fever. A sign of possible infection.
- Dizziness. May indicate haemorrhage/internal bleeding.
- Rapid breathing/racing heartbeat. Another warning sign of internal bleeding.
- Nausea and/or vomiting. An indicator that cyst contents have leaked into the abdomen.
Internal bleeding and infection can both be very serious and will require prompt medical attention.
How is a ruptured cyst managed?
Usually the body absorbs the contents (blood, mucus and fluid) of a ruptured cyst without the need for medical intervention. When surgery is required it will normally involve a laparoscopic procedure to remove the cyst and ruptured contents. If there are signs of infection, antibiotics will be recommended; and, pain relief medication can be used to alleviate abdominal discomfort. In many cases, however, ruptured cysts will rectify themselves and the only treatment strategy required is short-term observation/monitoring to ensure no additional complications develop.
- “Management of Ruptured Ovarian Cyst.” Johns Hopkins Medicine, https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/management-of-ruptured-ovarian-cyst.
- “When an Ovarian Cyst Ruptures: Is It an Emergency?” Health Essentials, Cleveland Clinic, 12 Nov. 2019, https://health.clevelandclinic.org/when-an-ovarian-cyst-ruptures-is-it-an-emergency/.