Ovarian Torsion: How Does It Happen?

An ovary is held near the uterus by flexible supporting tissues. If the ovary becomes heavier or more mobile, it may rotate around these supports. The twist can first obstruct the veins that drain blood; as swelling increases, it may also affect the arteries supplying the ovary. Torsion can involve an ovary with a cyst or another enlargement, but it can also occur without a known ovarian growth. The pain may begin suddenly, settle briefly, or come in waves if the ovary twists and partially untwists. Nausea and vomiting can occur because the pain is intense. A diagnosis usually combines your symptoms and examination with pelvic imaging, but imaging cannot always exclude torsion.

Do not wait for the pain to become constant or severe before seeking help. Contact urgent medical services or go to an emergency department, especially when pelvic pain is accompanied by vomiting, marked tenderness, or feeling faint. A clinician may arrange an examination, pregnancy testing when relevant, blood tests, and ultrasound. If torsion remains a concern, treatment is usually surgical assessment to untwist the ovary and restore circulation where possible. A cyst or other cause of enlargement may be treated during the same procedure; one possible approach is [Laparoscopic Ovarian Cystectomy](/treatments/gynaecological-surgery/laparoscopic-ovarian-cystectomy/).

Seek urgent care for sudden one-sided pelvic or lower abdominal pain, particularly if it comes with nausea, vomiting, fever, dizziness, or pain that returns after easing. These symptoms can have several causes, so they do not confirm torsion, but delay can allow reduced blood flow to damage the ovary. If you are pregnant, recently had fertility treatment, or have a known ovarian cyst and develop abrupt pain, treat it as urgent. For more detail about the symptom itself, see [Pelvic Pain](/symptoms/pelvic-pain/).

Ask what findings make torsion more or less likely, whether an ultrasound is needed, and how quickly you should be reviewed if the pain changes. You can also ask whether an ovarian cyst, fertility medication, or prior pelvic surgery could affect your risk, and what procedure might preserve the ovary if torsion is found.