I have had a few ovarian cysts. THe first one ruptured and the pain was amazing. Worse than anything i had felt at that time (and now too). Occasional pain is fine, but if it is waking you from sleep or coming in waves, you should probably get some pain meds asap. Mine ruptured while I was in court and i thought I was dieing. I made my way to the ER and got some vocidin and was religated to the couch for 3 days after that. Then I had about 6 months iof pain afterin which i am pretty sure scar tissue was forming.
The next time i had one show up, it was found via U/S and was measuring about 4 cm. I was having intermetient pain and AF was late. Something about the hormones was keeping AF at bay. 2 days after the u/s I ended up demanding it be removed due to the pain. i didn't want to deal with the 6 months of after pain I had from the first one again. When they got it out it had doubled in size to over 8 cm. I was completely recovered and back at work in 3 days.
Now, most people don't have this situation I had. Many times a cyst comes then just goes w/o any pain or rupture. If it isn't affecting your fertility and you aren't in pain, it is probably best to just let it be. But, if you are in pain, please don't wait to get checked out. I had the pain building up for 2+ weeks before it ruptured. Everytime I complained about it, DH said it was just AF coming back (I had been on BC for a long time w/o AF at all) and to suck it up. Not a good idea.