Ovarian Torsion Risk Factors

An ovarian cyst or other ovarian mass can add weight and make the ovary more likely to rotate. Fertility treatment may stimulate the ovaries and enlarge them, which can also increase mobility. Pregnancy can change the position and size of pelvic organs. A previous episode of torsion raises concern for recurrence, and some people have supporting tissues that allow greater movement. Torsion is more often considered when pain is sudden and one-sided, but a risk factor is not required and having one does not mean torsion will happen. Several other problems can cause pelvic pain, so assessment is needed rather than trying to diagnose the cause from risk factors alone.

If you have a known ovarian cyst, enlarged ovary, or recent fertility treatment, ask your clinician what symptoms should prompt immediate review. Keep a record of the side, onset, and pattern of any pelvic pain, along with vomiting or fever. Do not try to manage abrupt severe pain at home simply because you already know about a cyst. A clinician may use an examination and ultrasound to investigate, while remembering that a reassuring scan does not always rule torsion out. If an ovarian cyst needs removal, [Laparoscopic Ovarian Cystectomy](/treatments/gynaecological-surgery/laparoscopic-ovarian-cystectomy/) may be discussed.

Go to urgent care for sudden pelvic or lower abdominal pain, especially when it is one-sided or comes with nausea, vomiting, dizziness, faintness, or fever. Seek help even if the pain eases, because intermittent twisting can cause symptoms that fluctuate. If you are pregnant or undergoing fertility treatment, report new sudden pain promptly. These warning signs do not prove torsion; they signal that conditions affecting the ovary and other pelvic organs need timely assessment. You can read more about this symptom in [Pelvic Pain](/symptoms/pelvic-pain/).

Ask whether the size or appearance of a cyst changes your risk, what to do if pain starts at night, and whether fertility treatment needs monitoring. If you have had torsion before, ask how recurrence would be managed and which symptoms should take you straight to emergency care.