Ovarian torsion emergency: what to know

A twisted ovary may also twist the fallopian tube. Reduced circulation can injure ovarian tissue, and the pain may be severe, one-sided, or come and go. Nausea and vomiting can occur. A pelvic mass such as a cyst can make twisting more likely, but symptoms alone cannot confirm the diagnosis.

Clinicians may use an examination and ultrasound alongside your symptoms. Imaging can be helpful but does not always settle the question, so a reassuring result does not make new severe pain safe to ignore.

Seek emergency medical care for sudden or severe pelvic or lower abdominal pain, particularly if you are vomiting, faint, feverish, or unable to keep fluids down. Do not drive yourself if you feel faint. Tell the clinician when the pain began, which side hurts, whether it comes in waves, and whether pregnancy or a known ovarian cyst is possible.

Treatment is usually aimed at untwisting the ovary and addressing the cause. A gynaecological surgeon may discuss minimally invasive surgery, including [Laparoscopic Ovarian Cystectomy](/treatments/gynaecological-surgery/laparoscopic-ovarian-cystectomy/) when a cyst needs removal.

Go to an emergency department now for abrupt one-sided pelvic pain, repeated vomiting, collapse, marked weakness, or pain that is rapidly worsening. A milder episode that settles still deserves prompt medical advice because torsion can sometimes be intermittent. For background on pain patterns, see [Pelvic Pain](/symptoms/pelvic-pain/).

Ask what findings make torsion more or less likely, whether you need urgent ultrasound or surgery, how a cyst would be treated, and what symptoms should send you back to emergency care.