You should worry about a hemorrhagic cyst and seek medical attention if you experience any of the following symptoms:

• Sudden, sharp pelvic or lower abdominal pain, especially if severe and persistent.
• Heavy vaginal bleeding or unusual vaginal bleeding.
• Signs of internal bleeding such as dizziness, lightheadedness, fainting, weakness, or pale, sweaty, clammy skin.
• Nausea and vomiting.
• Fever or signs of infection.
• Pain accompanied by symptoms of shock such as cold, clammy skin or rapid heartbeat.

These symptoms may indicate cyst rupture, internal bleeding (hemoperitoneum), or ovarian torsion, which are serious complications requiring immediate care. If a hemorrhagic cyst ruptures, it can cause life-threatening internal bleeding and needs prompt medical attention. Smaller cysts (under 5 cm) without symptoms often resolve on their own, but severe or worsening symptoms are a cause for concern and medical evaluation is necessary.