How To Tell If You Have A Ruptured Ovarian Cyst

Photographed by Megan Madden.
You've no doubt heard that ovarian cysts can be serious business. Serious enough to send Lena Dunham to the hospital last year, in fact. But even though they sound scary, they're usually barely perceptible — until they rupture.
In reality, most ovarian cysts are actually a surprisingly common product of your normal monthly cycle, explains Veronica Lerner, MD, a gynecologist at NYU Langone Medical Center.
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When you ovulate, an egg is released from a follicle on one of your ovaries to take its little journey through your fallopian tubes and into your uterus. But sometimes the egg doesn't release, and instead grows into a fluid-filled cyst on your ovary. Other times, the egg does get released, but the follicle closes up behind it, which forms another kind of cyst.
For the most part, these "functional" cysts are small and go away without you ever knowing about them. In fact, nearly everyone who menstruates will get an ovarian cyst at some point in their life, whether they're aware of it or not. The problem is when a cyst gets especially large or starts to leak blood and other fluid, which can be "irritating to the abdomen," Dr. Lerner says. At that point, it might cause some mild pain if the cyst is on the smaller side or only releases a little bit of fluid.
But if the cyst is big and ruptures, which can be triggered by exercise or intercourse, you could find yourself with some very severe, stabbing pain. "[People] may think they have appendicitis," Dr. Lerner says, "And that will prompt women to go to the emergency room."
If you find yourself in this boat, it's good to know that a ruptured ovarian cyst usually doesn't come with the nausea, vomiting, and fever that are characteristic of appendicitis. Also, the pain of appendicitis is almost always felt most severely on the right side of lower abdomen. But there's a chance that your cyst could have been on the ovary on the left side of your body and is, therefore, causing pain on that side. So — while your right ovary can definitely make a cyst — if you do feel it on the left side, that's another sign that you're probably dealing with a cyst rather than a busted appendix.
However, if you're in that much pain, Dr. Lerner says you should still get medical attention ASAP just in case. "You don’t want to miss that emergency," she says. Plus, even if it's a ruptured cyst rather than appendicitis, there are cases in which cysts still require medical attention. For instance, you might leak a lot of blood and start feeling lightheaded, which means you might need IV fluids. And in rare instances you might need surgery to drain some of the irritating fluid released by your cyst.
So, if you're at all concerned, this is one case where we'll in...cyst you see your doc. (Sorry.)
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