Severe Pelvic Pain: When to Suspect Ovarian Torsion

Ovarian torsion happens when the ovary and fallopian tube twist around their supporting ligaments and cut off blood supply — a surgical emergency. It causes sudden, severe pelvic pain, often with nausea and vomiting, lower-abdominal tenderness, back or flank pain, low-grade fever, abdominal swelling or dizziness. Go to the ER for pelvic pain that comes on suddenly, stops you walking or standing, or comes with a fever of 102F or higher, heavy bleeding, blood in urine or stool, or difficulty breathing.

Severe pelvic pain can be frightening, especially when it comes on suddenly and you’re not sure why.

While pelvic pain can stem from many conditions, it’s important to know when it signals a true medical emergency like ovarian torsion.

Knowing when pain is routine and when it’s a red flag could make all the difference in your health and fertility.

What causes severe pelvic pain?

Common pelvic pain causes can be gynecological, urinary, or pregnancy-related and include:

• Endometriosis.
• Fibroids.
• Ovarian cysts.
• Pelvic inflammatory disease (PID).
• Pelvic adhesions.
• Hernias.
• Ovarian torsion.
• Urinary tract problems (e.g., kidney stones, urinary tract infection, interstitial cystitis).
• Pregnancy-related issues (e.g., ectopic pregnancy or miscarriage).

When should you go to the ER for pelvic pain?

Are you wondering when to go to the ER for severe pelvic pain? If you or a loved one is struggling with one or more of the following symptoms, seek immediate emergency care for pelvic pain at Prestige ER:

• Severe pelvic pain that comes on suddenly.
• Severe pelvic pain that interferes with your ability to walk or stand.
• High fever (102°F or higher)
• Excessive bleeding.
• Blood in the urine or stool.
• Difficulty breathing.

These red flags may indicate an ovarian torsion emergency that requires urgent treatment.

What Is Ovarian Torsion?

According to the Cleveland Clinic, ovarian torsion is a medical condition that causes sudden and severe abdominal pain. It occurs when the ovary and fallopian tube become twisted around their supporting ligaments, cutting off blood supply.

This condition is considered a medical emergency and requires immediate surgical intervention, as it can quickly lead to tissue damage or death in the ovary.

What Does Ovarian Torsion Feel Like?

In addition to a sudden onset of severe pelvic pain, early ovarian torsion symptoms to watch for include:

• Nausea and vomiting.
• Tenderness in the lower abdomen.
• Back or flank pain.
• Low-grade fever.
• Abdominal swelling.
• Dizziness.

If you are experiencing one or more of these signs of ovarian torsion along with severe pelvic pain, seek immediate medical care to prevent complications and protect your fertility.

Who is at risk of ovarian torsion?

According to the National Center for Biological Information, ovarian torsion is more likely to occur in women with large ovarian cysts or masses (over 5 cm). Larger ovaries are more likely to move the ovary out of position.

Additional risk factors include:

• Pregnancy.
• Prior pelvic surgery (e.g., tubal ligation or previous torsion).
• Assisted reproductive technologies (e.g., in vitro fertilization, artificial insemination, preimplantation genetic testing, cryopreservation, and frozen embryo transfer).

Knowing these risk factors can help you and your doctor know when to suspect ovarian torsion and seek urgent evaluation.

ER Visit for Ovarian Torsion: What to Expect

If you need an ER visit for ovarian torsion, Prestige ER provides timely, expert care. Here’s what to expect:

• Symptom assessment.
• Pain medication.
• Physical exam.
• Blood and urine tests (including pregnancy testing).
• Transvaginal ultrasound imaging.
• Laparoscopy procedure (if ovarian torsion is confirmed).

Our board-certified physicians deliver emergency care for pelvic pain with the goal of protecting your gynecological health and fertility.

Diagnosis and Treatment of Ovarian Torsion

How Ovarian Torsion Is Diagnosed

There is no definitive test to diagnose ovarian torsion. Instead, our physicians use a combination of clinical evaluation, ultrasound imaging, and lab results. In some cases, computed tomography (CT) or magnetic resonance imaging (MRI) are also needed to confirm the diagnosis.

Treatment Options and Urgency

Ovarian torsion is a gynecological emergency that needs immediate medical care. Any delay can cut off blood flow, causing permanent ovarian damage and even infertility.

ER treatment for ovarian torsion usually involves a laparoscopic procedure to carefully untwist the ovary and restore blood flow.

The main goal is to preserve ovarian function and prevent tissue death. However, if the ovary is found to be severely damaged and nonviable, removal may be necessary.

Prestige ER’s Approach to Pelvic Pain Emergencies

The emergency experts and board-certified physicians at Prestige ER treat severe pelvic pain symptoms with skill and compassion. Our team is equipped to provide:

• Advanced imaging for fast and accurate assessment.
• Rapid diagnosis to quickly identify the cause of your pain.
• Immediate treatment to relieve symptoms and protect your health.

Whether you need ER treatment for ovarian torsion or emergency care for pelvic pain of another cause, we are here to help. Visit your nearest family-friendly Prestige ER location for a full range of emergency room services. We deliver the same high-level emergency medical care as a hospital ER in a comfortable setting and always provide personalized attention and timely treatment.

Frequently Asked Questions About Ovarian Torsion