Ovarian torsion occurs when an ovary twists on its supporting tissues, reducing or cutting off its blood supply. This page gives general information on common findings, initial emergency assessment principles, and specialist direction. It does not provide individualized diagnosis or treatment. If you have severe or rapidly worsening symptoms, seek emergency care promptly.
Torsion means the ovary (and sometimes the fallopian tube) rotates around its ligaments, impairing arterial and/or venous flow. Reduced blood supply can lead to tissue injury; when torsion is suspected, timely assessment matters because delays can increase the risk of permanent ovarian damage.
The most common symptom is sudden, intense lower abdominal pain usually on one side. Pain may be accompanied by nausea, vomiting, fever or localized abdominal tenderness. Some people report pain radiating to the groin or inner thigh, urinary discomfort, or intermittent episodes if the ovary twists and untwists. Symptom severity and accompanying signs guide urgency.
Emergency assessment begins with a focused history and physical exam. A pregnancy test is performed to rule out ectopic pregnancy. Pelvic ultrasound, often with Doppler, is used to assess ovarian size, cysts and blood flow, though imaging is not always definitive. Blood tests and urinalysis may be ordered and a gynecology consult is commonly requested. Clinical judgement integrates exam and imaging findings.
Go to the emergency department promptly for sudden, severe unilateral lower abdominal pain, persistent vomiting, fainting or signs of systemic illness (high fever, dizziness, low blood pressure). Ovarian torsion is a gynecologic emergency; the ED will arrange appropriate imaging and specialist assessment. If you have concerning symptoms, do not delay seeking care.
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