A twisted ovary, or ovarian torsion, occurs when an ovary flops down and rotates, cutting off its own blood supply in the process. If that happens, you'll probably know that something has gone horribly wrong: think sudden, excruciating pain on one side of your lower abdomen. Here are seven things you should know about who's at risk for a twisted ovary and what to expect if you're unlucky enough to experience it.
Ovarian torsion is most common among women of childbearing age, so if you're postmenopausal you can relax a little. "With young women, the tissue is more flexible, and the ovary can move and twist with hormonal changes," says Mike Hoaglin, MD, an emergency room physician at Duke University Hospital. After your fertile years, "the ovaries get smaller and are less likely flip unless there's a cyst or mass," adds Janet Choi, MD, medical director at Colorado Centre for Reproductive Medicine in New York City.
That said, it's not impossible for this problem to occur in postmenopausal women or in prepubescent girls. There have even been a few cases of female foetuses being diagnosed in utero.
Though it's possible for cyst-free ovaries to become twisted, having a cyst or a mass makes it far more likely for torsion to happen. The reason: A cyst can place unequal weight on the organ, prompting it to turn, says Hoaglin. Women with polycystic ovary syndrome (PCOS)—a hormonal condition characterised by tiny cysts on the ovaries—are certainly at elevated risk, but anyone can develop a cyst. And while most cysts are benign, they do occasionally turn out to be cancer. Either way, you'll need treatment. (If it's just the twisted ovary, you'll need laparoscopic surgery to untwist it.) Bottom line: "If you have pain, don't blow it off," says Choi.
Those meds designed to help you get pregnant have a tendency to make your ovaries get bigger, and larger ovaries are more likely to twist, says Mira Aubuchon, M.D., an ob/gyn and fertility specialist with the Missouri Centre for Reproductive Medicine. To minimise the risk of torsion, "I usually counsel women to keep exercising but to avoid workouts that involve jumping or bouncing," says Aubuchon. So yoga, yes; capoeira, no.
Along with lowering your risk for some cancers and clearing up your skin, birth control pills and other forms of hormonal contraception can help prevent cysts on your ovaries, which in turn makes you less likely to experience the exquisite torture of getting them twisted.
You know how some people have freakishly short fingers? Or sky-high legs that stretch on for days? The same size variation can occur in the fallopian tubes, and Aubuchon says that "an extra-long fallopian tube may make [the ovary] more prone to twisting."
Ovarian torsion is more likely to occur on the right side—but if you show up in the ER complaining of pain in your lower right abdomen, the doc will probably do a CT to rule out appendicitis. "In the ER, we think of the things that'll kill you first," says Hoaglin.
While ovarian torsion does cut off the blood supply to the ovary, it doesn't necessarily mean that the ovary won't work anymore. For one thing, the supply may not be cut off completely. Choi says that in the old days, they used to automatically remove the ovary, but now, she says, "even if it's dusky and purple, we'll untwist it, leave it in place, and in many cases it'll recover." However, if the ovary doesn't spring back to life, you'll need surgery to remove it to prevent infection. But even then, as long as your other ovary is still working, infertility should not be an issue.
This article originally appeared on Womenshealthmag.com.