Photo: Greg Hernandez | Flickr
Do you know what ovarian torsion is?
“Cougar Town” actress Busy Philipps sure does.
Earlier this month, Philipps posted an Instagram detailing a recent hospital visit.
The actress shared that she had experienced ovarian torsion, or a twisting of the ovary that caused intense pain.
“I had a crazy excruciating pain in my lower right side and after a long time at Mass Gen, it was determined my ovary flipped over — it’s called torsion. Mine flipped back by itself and I’m OK, but sometimes if it doesn’t you have to get surgery or you can lose your ovary (which actually happened to a really good friend of mine).”
The ovaries are walnut-sized organs attached to the fallopian tubes and ovarian ligaments.
Ovarian torsion is when an ovary twists back and forth, causing intense pain in the pelvic area that comes and goes, explained Dr. Adeeti Gupta, a board-certified OB-GYN in New York.
‘It’s enough to stop you in your tracks’
As Philipps described, ovarian torsion makes itself known through sudden, intense pain.
“It’s enough to stop you in your tracks [and] cause you to bend over,” said Dr. Angela Jones, a board-certified OB-GYN in New Jersey.
Sudden onset nausea and vomiting are also common symptoms.
Sometimes ovarian torsion resolves itself on its own, as it did with Philipps. This is called intermittent torsion, meaning that the torsed ovary twists back into place and then ceases twisting.
However, experts say you shouldn’t wait to see if the ovary will twist back on its own. Waiting puts you at risk for cutting off the blood supply to the torsed ovary.
“You need to go in and be evaluated immediately,” especially if you have a known ovarian cyst, Jones told Healthline.
How ovarian torsion is treated
When a person comes in with a suspected ovarian torsion, medical professionals will check for a high pulse rate and examine the belly area for pain or tenderness.
The next step is to administer an ultrasound.
“One of the elements we look for is blood flood to the ovary, which is done by an exam called Doppler, and that’s done during the ultrasound,” Gupta told Healthline. “It should be done long enough so you can actually watch the blood flow come and go, and if you see an obstruction to the blood flow, then definitely that person should be taken up for surgery.”
Laparoscopic surgery to correct an ovarian torsion is minimally invasive.
In rare cases, a torsed ovary can be permanently damaged.
“Torsion... can essentially block the blood supply to the ovary, and it can lead to the death of the ovary, which is called necrosis,” said Gupta.
“It’s really sad if you get a necrotic, or dead ovary, in a 20-year-old or an 18-year-old because you have to remove the ovary,” she continued. “You don’t have another option.”
Ovarian torsion and cysts
Often, ovarian torsion occurs because of a cyst on the ovary.
The size of a cyst is the main factor in whether or not ovarian torsion may occur, Jones said.
Ovarian cysts are common in women and not necessarily a cause for alarm. In fact, most women will have at least one cyst on her ovary during her lifetime.
An OB-GYN will keep an eye on an ovarian cyst during routine gynecological exams to watch whether it grows in size.
“Anything that’s more significant than 5 centimeters in diameter increases your risk of having an ovarian torsion, which is sometimes why we’ll end up removing the cyst,” Jones explained.
Ovarian torsion can occur without the presence of a cyst, however.
“In cases where [torsion] happens without a cyst, it’s usually younger [girls],” explained Gupta. “They’re just attaining puberty and their body is growing, so the uterus, tubes, ovaries, everything’s growing, and... the ovary may tend to twist around.”
Teens who see a pediatrician for nausea, vomiting, and pain in the pelvic area run the risk of being misdiagnosed with appendicitis or gastroenteritis.
“I would just like all clinicians to be aware that [teenagers] could be having a torsion, which could be missed,” Gupta said.
There are other reasons women can feel pain in their pelvic area, such as menstrual cramps, endometriosis, or irritable bowel syndrome.
But sudden, intense pain in that area shouldn’t be ignored.
“Just listen to your body,” said Jones. “If something doesn’t feel right, you should go and be evaluated.”
Philipps echoed the same sentiment in her Instagram post about her hospital visit.
“I felt like an idiot for going to the hospital but ultimately, going was the right move,” she wrote. “It always is.”