Ovarian cysts can be painful when they burst. When do you need to see a doctor?

Cysts are small pockets of fluid that form inside the body. Ovarian cysts are common, affecting around one in ten women. But sometimes they can cause pain – especially when they burst.

You can usually manage the pain at home. However, persistent pain can be the sign of something more serious, such as polycystic ovary syndrome (also known as PCOS).

Here’s what you should know about ovarian cysts: why they form, how to manage the pain if they burst, and when you should talk to a doctor.

How do cysts form?

The ovaries are two small almond-shaped organs on either side of the uterus. They have two main jobs: to release the eggs and produce hormones that help regulate the menstrual cycle.

Every month, one of the ovaries releases an egg. This process is called ovulation. A small sac containing the egg – called a follicle – releases it into the fallopian tube, where it waits for fertilisation by the sperm.

This sac usually dissolves after the follicle is released. But if the follicle isn’t released properly, or doesn’t dissolve, the fluid within the sac starts to fill and form a cyst.

Can you feel an ovarian cyst?

This is quite common and most of the time the cyst goes away on its own. We don’t even know it is there.

But sometimes a cyst can grow and start causing pain.

This might be a constant and dull pain, or it may be a sensation of fullness, pressure or heaviness. You’ll usually feel this to one side in the area below your belly button, but the pain can also radiate to the back and hips. A cyst can also cause discomfort and pain during sex.

Ovarian cysts tend to be categorised into three groups: small (under 2cm), medium (2–5cm) and large (above 5cm).

Doctors generally watch for cysts that are large, grow rapidly or have an irregular shape or appear solid on an imaging scan. These characteristics may indicate a higher risk of complications.

What about when it bursts?

You can think of the cyst like a balloon. When you fill it up a little bit and leave it alone, it will eventually deflate on its own.

But if you keep filling the balloon more and more, it may burst. That’s what happens when an ovarian cyst continues to fill with fluid.

If a cyst bursts, you will generally feel a sudden, sharp pain. Depending on its size – and how much fluid the cyst releases into the pelvic area around the ovary – this may ease into a dull ache or cramp, or it may continue to cause significant pain.

The released fluid can irritate the nearby tissues and organs and may make you feel nauseated. Some people may also experience weakness, dizziness, rapid breathing, vaginal bleeding or vomiting.

How do I know if it’s a cyst bursting?

The symptoms of a ruptured ovarian cyst can be similar to other serious conditions, such as appendicitis, ectopic pregnancy or kidney stones. These require very different treatments.

It is important not to self-diagnose.

You should seek care if you experience sharp, intense pain that comes on quickly, especially if it feels different from your usual period pain or doesn’t settle. It could be a sign that a cyst has burst or twisted, known as ovarian torsion.

Other signs to watch out for include pain accompanied by:

• fever or chills

• dizziness or fainting

• rapid breathing or racing heartbeat

• heavy vaginal bleeding not related to your period

• nausea or vomiting

• a sudden increase in pressure or discomfort in your lower abdomen.

The only way to know for sure what’s going on is through a proper medical assessment. Ultrasound imaging is the most common way to diagnose ovarian cysts, but other methods such as blood tests or other scans may be used in some cases.

If you’re not sure whether you should see a doctor, you can also check your symptoms (online or over the phone) using the Australian government’s free health advice website. In an emergency, always call 000.

How should you treat the pain?

Once you know you’re dealing with a burst cyst, treatment is very similar to managing period pain.

One of the best home remedies is heat therapy, such as using a hot water bottle, heating pad or a warm compress. Heat helps by improving the blood circulation to the area, allowing muscles to relax and reducing tension in surrounding tissues.

Heat also helps your body remove the fluid from the burst cyst and this reduces inflammation. Warmth stimulates the release of endorphins – sometimes known as “natural painkillers”.

Rest, hydration and warm baths may also help relieve the pain.

When pain is intense, over-the-counter pain medications are recommended. The best options are non-steroidal anti-inflammatory drugs – such as ibuprofen – and pain-reducing analgesics, such as paracetamol.

These drugs target different steps in how the body processes pain, which is why they can be used at the same time. Ibuprofen reduces inflammation, while paracetamol tackles pain (but has no influence on inflammation).