Ovarian torsion occurs when an ovary twists around the ligaments that hold it in place. This twisting can cut off blood flow to the ovary and fallopian tube, leading to symptoms such as nausea, vomiting, and pain.

Ovarian torsion can cause severe pain and other symptoms because the ovary is not receiving enough blood. If the condition continues for too long without treatment, it can lead to ovarian necrosis (tissue death), loss of the ovary, and, in rare cases, infertility.

Ovarian torsion usually affects only one ovary. Doctors may also call this condition adnexal torsion.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Learn more.

The ovaries are two small female reproductive organs on either side of the pelvis. They are roughlyTrusted Source 3.5 centimeters (cm) long, 2 cm wide, and 1 cm thick.

The ovaries contain eggs and release about one egg each month after maturing, in a process called ovulation. A person will start to ovulate during puberty. It is the part of the menstrual cycle that enables pregnancy.

The ovaries also produce hormones that facilitate a range of processes in the body.

Symptoms of ovarian torsion can includeTrusted Source the following:

However, diagnosing ovarian torsion can be challenging because the symptoms are similar to those of other conditions, including:

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Illustration by Alyssa Kiefer

Females of reproductive ageTrusted Source are most likely to experience ovarian torsion. However, those of all ages, from infancy to postmenopause, can experience ovarian torsion.

Sometimes, the presence of a cyst or other tissue mass in the ovary can displace it. The extra weight or mass on the ovary can cause it to twist and rotate around its supporting ligaments.

Another potential cause is a longer-than-usual ovarian ligament, which connects the ovary to the uterus and makes ovarian torsion more likely.

Assisted reproductive technologies (ART), such as inducing ovulation, are another factor that may increase the risk for ovarian torsion. A history of torsion also increases the risk.

Ovarian torsion can occur in pregnant and non-pregnant people with ovaries. A commonTrusted Source type of cyst is a corpus luteum cyst, which may occur during the first trimester and cause the ovary to twist.

Higher hormone levels during pregnancy can also relax tissues in the body, including the ligaments that hold the ovaries in place. If the ligaments are not taut, they may be more prone to twisting.

Ovarian torsion is a potential complication of ART. The elevated risk may be due to the hormones necessary for in vitro fertilization or ovulation induction.

These hormones may cause the ovaries to enlarge, develop multiple cysts, or both. While ovarian cysts are usually harmless, they may increase the riskTrusted Source of ovarian torsion.

ART can be an effective treatment when a person has issues conceiving. However, people always need to discuss the possible risks with a doctor and seek medical attention if they experience symptoms of ovarian torsion.

Surgery is the only wayTrusted Source to untwist an ovary. A doctor may also prescribe medications to reduce pain and nausea for comfort before the surgery.

A doctor may recommend performing surgery as quickly as possible. If ovarian torsion restricts blood flow for too long, the ovarian tissue may die, and a surgeon will need to remove the ovary. Surgical removal of one or both ovaries is known as oophorectomy.

Ideally, a doctor can perform the procedure using laparoscopy, which involves making small, keyhole-like incisions in the abdomen.

The doctor will insert several medical instruments, including a video camera, into the abdomen and pelvis and attempt to untwist the ovary.

Sometimes, if a doctor cannot see the ovary well enough or if the bleeding is severe, they may need to perform a laparotomy. This involves making a large incision under the navel to expose and untwist the ovary.

During surgery

A doctor will continue to observe the ovary to ensure that it has enough blood flow. The ovary should turn pink from purple or black after being untwisted. If it shows signs of tissue death after untwisting, the doctor may have to remove the ovary.

Aftercare

A person may be able to return home the same day after a laparoscopy. A doctor will recommend follow-up care, such as avoiding heavy lifting or intense physical activity for a few weeks.

People may be able to relieve pain and discomfort by taking over-the-counter (OTC) medications, such as ibuprofen (Advil) or acetaminophen (Tylenol). People need to check with a doctor before taking OTC medications following surgery.

Individuals also need to report signs of an infection or another complication to a doctor as soon as possible. Signs of an infection include:

  • fever
  • skin discoloration and inflammation at the incision sites
  • foul-smelling discharge
  • a wound that does not heal
  • increasing pelvic pain
  • bleeding

One possible complication ofTrusted Source ovarian torsion is ovarian necrosis, which refers to the death of ovarian tissue due to blood loss. A doctor will remove the affected ovary surgically if this occurs.

Surgery for ovarian necrosis can affect fertility, as the ovaries produce and release eggs for fertilization.

However, if a doctor does not remove the ovary, a person may be at risk of ovarian infections that can cause an abscess or peritonitis.

It is essential for anyone who experiences ovarian torsions to go to follow-up appointments to ensure the ovary is healing well and receiving enough blood.

Ovarian torsion can lead toTrusted Source ovarian necrosis and other complications without prompt medical intervention.

If someone seeks urgent medical attention and undergoes surgery to reduce the torsion, they may have no further complications.

However, if ovarian torsion restricts blood flow to the ovary for too long or the person has a cyst or tumor, they may require further treatment.

It is essential to seek medical attention if a person has any of the symptoms of ovarian torsion.

To diagnose ovarian torsion, a doctor may useTrusted Source the following tests:

  • a transvaginal ultrasound, which involves inserting a small ultrasound probe into the vagina
  • an abdominal ultrasound, which uses an ultrasound probe on the outside of the abdomen
  • other imaging tests, such as a CT scan or MRI scan
  • a complete blood count, which can measure the number of white blood cells in the body

However, a doctor cannot fully confirm the ovarian torsion without performing surgery to see the ovary.

Surgery is necessary to treat ovarian torsion. If a person does not seek immediate treatment, blood loss to the ovary may lead to complications, such as necrosis.

Doctors may rule out various other health conditions when diagnosing ovarian torsion, including:

No research suggests that exercise causes ovarian torsion. However, factors such as menstruation status, reproductive assistance treatments, and pregnancy may increase a person’s risk.

Ovarian torsion occurs when the ovary twists over ligaments. Without treatment, blood flow to the ovary can be restricted, leading to complications.

People need to seek immediate medical help if they have symptoms of ovarian torsion, such as severe pelvic pain, nausea, and fever.

Healthcare professionals use surgery to treat ovarian torsion. In some cases, they may need to remove the entire ovary.