The 4 Signs Of Ovarian Cyst Rupture You Shouldn’t Ignore

Dr. Pari was featured as a guest contributor in the article below, originally posted for SELF by Korin Miller.

Girls star Lena Dunham was hospitalized over the weekend after suffering from a ruptured ovarian cyst. Dunham, who has publicly documented her battle with endometriosis, a painful disorder in which tissue that normally grows inside the uterus grows outside of it, will undergo surgery at an undisclosed hospital, her publicist told People.

Dunham wrote on her Facebook page last month that she’s taking a break from media—including missing a press tour for Girls—to rest due to her condition.

About 5 million American women suffer from endometriosis, according to the U.S. Department of Health and Human Services. The condition can cause cysts and scar tissue to develop, often resulting in severe pain.

But what is an ovarian cyst rupture, exactly? And can anyone develop it?

Unfortunately, yes, says ob/gyn Alyssa Dweck, M.D., an assistant clinical professor at the Mount Sinai School of Medicine. However, there are various types of ovarian cysts, and many go unnoticed by women.

“Most women will form a cyst with ovulation,” explains Dweck. Those cysts, known as follicular cysts, can rupture or regress on their own and go away. “Often, women don’t even know they’re there,” says Dweck.

When the cysts rupture, the fluid inside ends up in the pelvic cavity, where it’s usually reabsorbed over time, explains Jason James, M.D., medical director at Miami’s FemCare Ob-Gyn. “Simple fluid-filled cysts that rupture are usually of no significant concern,” he says.

However, a woman can also develop blood-filled cysts called endometriomas, which can cause “significant ongoing bleeding internally,” James says.

Another type of cyst, called a dermoid cyst, may have solid material in it such as hair, teeth, and cartilage, says Dweck, which may need to be removed with surgery. And, while most cysts are benign (not cancerous), some may turn out to be malignant (cancerous).

“In most cases, cysts are harmless and go away on their own,” says board-certified ob/gyn Pari Ghodsi, M.D. “In other cases, they may cause problems and need treatment.”

How do you know whether you need to seek medical attention for your cyst?

When a larger cyst bursts, it typically causes a sudden, sharp pain for a woman. If the pain regresses and isn’t accompanied by vaginal bleeding, it’s probably nothing to worry about, says Dweck.

But with endometriomas, the pain may continue—even if you take pain relievers such as ibuprofen or acetaminophen. It can also cause internal and external bleeding, says James. That blood inside the pelvic cavity can be irritating, and cause bloating, nausea, and gas-like discomfort, he says.

Pain plus bloating, nausea and bleeding that isn’t your period may signal a ruptured endometrioma. See your doctor and from there they’ll determine next steps. There are so many different things that can be going on—it could be one of a variety of cysts, or something entirely different, such as ovarian torsion—that it’s good to get checked out. They may give you pain medication for, say, a follicular cyst that burst and continues to hurt, but may recommend surgery for an endiometrioma. Experts stress that it’s unusual to need surgery for an ovarian cyst rupture, but say it can happen.

“When the underlying cause is known, such as it is with endometriosis, the decision to proceed with surgery may be more likely,” says James. Why? Endometriomas are more likely to cause ongoing bleeding, which can be painful, he says, and a woman with a ruptured endometrioma is likely to have it happen again.

“Other reasons to surgically address cyst rupture in endometriosis include the desire to alleviate a patient’s ongoing chronic pain due to the endometriosis, as well as the potential to improve a woman’s reproductive potential as endometriomas are known to potentially cause infertility,” says James.

One situation where you needn’t be as concerned: If you have an ovarian cyst rupture during sex, which Dweck says is pretty common. “We often seen someone come to the ER at night with terrible pain that came on all of the sudden during intercourse,” she says.

However, if you’re worried, it’s best to play it safe. Ghodsi shares her rule of thumb: If you experience a sudden, sharp abdominal pain that isn’t relieved by over-the-counter medicine, call your doctor or go to the ER.