Women's Health Community

Dear oceansun: From what you have shared it sounds like you had a partial ovarian torsion when seen in the ER. There are two types of small ovarian cysts which can be considered ?normal?. During the first half of the menstrual month (?follicular phase?) estrogen stimulates the growth of a dominant follicle. This follicle fills with fluid which is spilled out when the ready egg (?oocyte?) is ejected (?ovulation?). After the egg is released, its former follicle closes off and becomes the ?corpus luteum? which produces progesterone during the following two weeks (?luteal phase?).

If, in either of these phases, larger than normal amounts of fluid collect, one can develop ovarian cysts that will cause pain or menstrual bleeding changes. A normal ovary is about 2 x 3 cm (almond sized). A follicular ovarian cyst, if the egg is not ejected and the amount of fluid continues to increase, can reach sizes of up to 10 cm. Fortunately most follicular cysts are smaller and will resolve within one to three months. If the size is large (eg greater than 8 cm) the heavy cyst can prompt the ovary to twist on itself like a heavy flower on a too fragile stalk. This twisting (?ovarian torsion?) causes intense pain as it cuts off the blood supply to the ovary. While follicular cysts are the most common type of ovarian cysts, torsion is uncommon.

If the ultrasound had seen a complete torsion cutting off all the blood supply, you may have been sent to surgery to try and save the ovary. If a partial torsion was suspected then you may have been given follow up ultrasounds to be sure that the ovary was not twisting more.

PLEASE call your OB/GYN and get a follow up appointment. You need to be followed until the torsion is better (eg the ovarian cyst has resolved or shrunk).

In Concern, Jane

Hi I don't know if anyone is still looking at this post, it has been about 3 months old but if so I have a question. First of all, oceansun, I hope you got your situation resolved and all is well!! Secondly, J_Harrison, you sound very knowledgeable and this was the first I had also found on the subject. I have a question for both of you... What kind of pain were you having that first took you to the hospital? I have had these weird pains every so often in the ovarian area on both sides but usually on the left. Its kind of like a twisty, crampy feeling and it usually happens when I am lying down and quickly move to a sitting position. It is sometimes so painful that I need to lay back down and find a funny position to be in until the pain subsides which can be anywhere from 1 to 15 minutes!! When this happened tonight, I was reminded to think what could be causing it because right now I am having a really irregular menstrual flow and I thought maybe it could be ovarian torsion? I have an appointment with my OBGYN on the 30th. Does this sound like what it could be?

Hi howdydoo,

The best thing to do would be to start your own discussion for your questions so that more people will see them. Go to the main page and click on the orange Start Discussion button in the tan box at the top of the page.

Hope we can help!

Dorothea

Hi Howdydoo.

I just googled "how to prevent a twisted ovary" and came across your post, so I thought that I would respond with my story. On Friday, June 5th (yes, 2 weeks ago), I suddenly felt nauseous. I went to the bathroom were I made several softer than usual BMs and vomited. I then had a very intense cramping on my lower left side of my abdomen. About 45 minutes later, I made it back to my desk at work, and set up an appointment with a Family Medicine doctor as soon as possible. He asked all of the usual questions, had me do a blood test, urine test, and x-ray. They found nothing. He said, "It must be some gastrointestinal issue and it will either go away on its own or continue to bother you." (I want my $25 copay back from that visit.) Saturday, once again, sitting at my desk at work...I get the nauseous feeling, go to the bathroom, no BM of vomiting this time...just horrible cramping in my lower left abdomen. No changes in my diet....so I just ride it out with my heating pad. Sunday, once again, stting at my desk at work...I get the nausea feeling and cramp up for another 90 minutes. Once again...heating pad to the rescue. I'm no dummy...I know that something is wrong with me. I make an appointment to see my primary care doctor first thing Monday morning. (This dude actually listens to me.) I go in, explain what has been happening. He pokes and prods a bit on my belly. He determines that either I have an ovarian cyst (I have a history or growing them) or diverticulouses (or something like that that old people get in their colons.) He said that he doubted that I had that, and would rather I have my ovary checked out before sticking something up my butt. He asks me who my GYN is, and says that I must have an appointment that day. I get my appointment for that afternoon. I called to confirm and asked if I would be having an ultrasound. They tell me that the doctor will need to order it. I tell them to look in my chart and talk to the doctor. They neglect to do so, and I have no ultrasound appointment. I arrive for my appointment. The GYN does his exam, says that he speculates that I have another cyst, and will need an ultrasound. Go figure. They can't get me in until Tuesday. Meanwhile, I have had a "cramp attack" each day. I arrive Tuesday for the ultrasound...stick the wand up there sends me in some pain (but not as bad as usual), the ultrasound tech personally walked me into the GYN's office and waited until he was between appointments. He takes a look, says that my ovary is enlarged and that I have a cyst on it. Then, he tells me to take Ibuprofen, and call him if it is still bothering me 6 days later...on Monday. I say ok, and leave. Wednesday, another massive attack. Thursday at work, another one. This time, they almost called 911 because I looked so bad. However, by now, I have gotten smart. I called my GYN's nurse while I was cramping, and she could tell that something wasn't right. They tell me to come in right away, and I will be seen. However, while en route, somebody goes in to labor, and the GYN is called away. Everyone else was gone for the day. They make an appointment for Friday morning. I tell this lady GYN, something is wrong and I can't sit and wait it out anymore. I have had 2 major back surgeries, 2 abdominal surgeries, and the natural birth of a big headed baby and I have never been in such pain in my life! She agrees to do an exploratory laproscopic surgery to take a peak.....on Monday. They do a CAT scan just to confirm that I don't have diverticulosus, and find that the ovary is enlarged and thickened with multiple cysts and dermoids. Needless to say, I stayed home Saturday and Sunday laying on the couch, and had no flare ups. Monday finally arrives....before I go in she tells me that there are serveral things that may happen including the loss of my ovary (which is a big deal because I already lost the other one) or a hysterectomy. To make my long story even longer....what it turned out

Sorry to make this so long...what it turned out it was my left ovary was twisted with the bowel wrapped around it. To answer your question about what it feels like....as previously mentioned, I had never felt anything like it...and I've been through a lot. Typically, mine crept up on me with the nausea, and then I couldn't stand up. The pain would last 45 - 90 minutes. These instances all occured while I was sitting in a chair. I did have one occurence while changing my son's bedding. I felt like someone had run up to me and stabbed me with a really big knife and kept turning it. However, as long as I stayed curled up, it was tolerable.

As mentioned, I had the surgery on Monday, and was out of it most of Tuesday (it was an outpatient procedure). Each day a fill much better, and tomorrow, Friday, I am actually going back to work....only because I have a sit on my butt all day kind of job. I still can't lift anything and I hold my stomach like a 9 and a half month pregnant woman...but I tell you, the dull achiness that was there between my episodes of acute pain has completely disappeared...now I just feel like I did a million situps and it hurts to cough, laugh, or sneeze.

Good luck to you!

I know this has been 2 years since it's been posted on. For anyone out there having this issue. Don't give up, this should be treated with more respect. Can you image a guy with a twisted testicule? These are just as important!!! I actually had a ER even after telling them I had a partial "hystro" still thinking my uterus was there and everything looked fine and I was in pain so severe I couldn't hardly think straight, had to call 911 cause i was puking and doubling over and was sent home with pain meds and told to see my GP. I called my GP and they even acted like it was no big deal and made the appt for the next day. In the meantime I couldn't make it to that appt because the pain returned with a vengence and I took a taxi that time because at least I wasn't vomiting as I had no appetite. This time they did the altra sound instead of the CAT scan and the woman tech knew exactly what to look to for. She didn't say anything to me, but I knew by the way to she back to take more pictures that she found what was wrong and the attending came back in and admitted that the reader of the cat scan thought my tumor/cyst was my uterus when they knew in my histroy verbally and on the chart I had NO Uterus!!! It still makes me furiuos I had to go another day in pain when I could have had the operation earlier and had been free of the pain that was overtaking my life!!! Then I read this and see what others are going through and that makes me more furious. Like I mentioned I bet they wouldn't treat a man like this. Ovaries are just as important. The pain is would come and go through the years as I was prone to cysts, fibroids and endometriosis and that is why I had the partial hystro, left the ovaries so I wouldn't go through menopause early but now that I am 50 something I had them take the left one out, too this week. It was the right one that twisted and they told the blood supply was weak. I think the pain was there to prevent me from dying from it as it could have brust and caused a horrible infection and I am on Remicade for RA which reduces my immune system as it is.
The pain is constant to severe and stabs you from the front to back and when it really is going you can't even tell where it starting from!! It just takes over and you can barely think straight. It takes every bit of effort to get to the ER to hopefully be relieved from it. I was alone so I knew I had to make it to the ER or just croke. I had similuar pain throught the years but nothing compared to this week but I also had felt the twisting sensation before but then it would feel like it had resolved itself when I was younger. Maybe the tubes are more flexible when you are younger? Anyway...if you are having this issue make them listen!!! YOu know your body better than them. They just have book learning especially the younger ER docs, they need to communicate to the people reading the cat scans, x-rays and such, too. They need be on the top of their game and take every patients pain as their own.

I had to reply to this...I have been having the exact same problems for over 3 years! I get so frustrated with the doctors! I I have had cat scan and ultrasounds. They tell me there is nothing wrong...in otherwords,they mkae me feel like I am imagining my pain.My pain is throbbing,and feels like someone is stabbing me with a knife.It hurts when I sit and lay down...needless to say I have a rough time sleeping.The pain has usually come and gone with bad episodes here and there.For the past 2 weeks now it has gotten steady and worse.The pain is almost unbearable! I don't even know what to do anymore...I have no insurance...I'm guessing maybe that is why they didn't really seem to care?? I'm 54,had my tubes cut and burnt back when I was 32.I've been period free for almost a year now,with the full blown hot flashes. Life is miserable for me right now...I just want the pain to go away....HELP!!!!

I went to the ER from very painful right pelvic pain. I was diagnosed with an ovarian torsion (twisted ovary) and I was immediately brought into surgery not two hours after arriving to the ER. The dr thinks they were able to save my ovary since i came in so soon. i came to the ER an hour after the pain started. They made incisions in my tummy and went in thru my belly button for a laparascopy procedure. The DR made small incisions in my ovary to get the blood flowing and i am now pain free, besides the small incosions in my tummy hurt just a little. If they cant save it, you have to get it removed but if you have surgery immediately you may may be able to save it. 60% of ovarian torsions happen on the right side and that is where mine was at. Large ovarian cysts, fibroid tumors, and rarely cervical cancer can cause ovarian torsions. Also over stimulative meds like clomid, metformin, kratom and even ceetain pain meds can cause ovarian torsion.

When you have an ovarian torsion you need to be opperated on immediately. That was crazy that the ER just sent you home. Ovarian torsion is very painful and needs to be corrected immediately. If anyone else suspects this have an ultrasound - tummy ct which will usually show an over sized ovary. They should admit you right away and call an on call ob gyn or one that you have and they will opperate on a usual outpatient procedure. Dont let them release you. You want to save the ovary if possible, if that is what you want and they will usually try and save your ovary.

Dear brandy749: Thank you so much for adding your story. Hopefully another woman will find your post and push for imaging to rule out an ovarian torsion. It is considered a GYN emergency as decreased blood flow will gravely injure the ovary involved leading to an oophorectomy of that ovary. Thanks also for the list of possible risk factors.

In Appreciation,
Jane

I have been out of Hospital for nearly a month now and I was rushed in with abdomonial pain and I knew it was from the 2 cysts I knew I had already but I was in for a shock as there was more than 2 now and my right ovary was 8.3 CM and it had twisted and was practially told my ovary was dead! I missed surgery and was put on anti biotics! I go on the 20th to see if anything has changed. The pain was awful it made me vomit twice with the pain. I am only 21 and It is emotionally draining thinking this could be damaging and prevent me from having children

Dear Brit: Thank you for adding more important symptoms and predisposing factors to this description of ovarian torsion. I'm grieved to hear that you had a torsion with an 8.3 cm right ovary. This is our greatest concern with ovaries enlarged over 6 or 7 cm. Yes the pain is excruciating. Oxygen is being cut off from the area. Similarly, loss of oxygen to the heart muscle causes the crushing chest pain of a heart attack. Often morphine is needed for pain control.

We all hope that somehow it was a partial torsion such that the ovary is intact. If there was irreparable injury just know that women with one ovary can indeed conceive. A single ovary will take over the production of the same amounts of estrogen/progesterone, and monthly ovulations should continue.

Be sure and raise your important concern with your GYN when you return for your follow up visit. They can give you the most "for sure" answer as they know the rest of your GYN history.

Thanks again for writing. Feel free to write us back as you find out more.

In Support,
Jane