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How to Control Prostaglandin Production: Do’s & Don’ts

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Prostaglandins - Dr. Axe

Almost all organs in the body are capable of making compounds called prostaglandins, which are similar to hormones but also have some key differences. What is the purpose of prostaglandins? One important one is triggering inflammation and blood clotting in response to illness or injury.

Something that makes prostaglandins unique is that they don’t travel through the bloodstream like other hormones, but instead are released at specific tissues sites in the body where and when they are needed. While prostaglandins have many functions and certain benefits, they can also contribute to ongoing pain and disease when produced in either excess, or when levels are not high enough.

Hormonal imbalances, nutritional deficiencies, environmental stress and genetic defects can all affect prostaglandin levels. How can you balance production of prostaglandins? Some helpful diet and lifestyle habits you’ll read more about below include: eating a high-fiber, anti-inflammatory diet; taking certain supplements to control inflammatory responses; exercising and managing stress; and treating hormone imbalances including estrogen dominance.

What Are Prostaglandins?

Prostaglandins are lipid compounds, called eicosanoids, that have hormone-like effects in humans and other mammals. What are some of the functions of prostaglandins? Two of the most important are regulating inflammation and contracting the uterus in females in order to allow for birth and menstruation.

Prostaglandins function:

Major functions of prostaglandins include: (1)

  • Promoting inflammation in tissue that has been damaged or infected, in order to encourage healing
  • Regulating functions of the female reproductive system, including ovulation, menstruation and the induction of labor
  • Promoting blood clotting
  • Repairing damaged blood vessels
  • Controlling blood flow — this includes causing muscles in blood vessel walls to contract and narrow to help prevent blood loss, and dilating blood vessels when needed by relaxing muscles
  • Removing blood clots that are no longer needed
  • Causing pain and fevers
  • Regulating contraction and relaxation of the muscles in the digestive system/gut and respiratory system/airways
  • Regulating body temperature

What triggers prostaglandin production? The body makes more prostaglandins in response to injury, infection, disease or other stressors. This ultimately causes symptoms associated with inflammation, including: redness, swelling, pain, fever, cramping and tenderness. (2)

Types of prostaglandins:

There are four bioactive prostaglandins produced in the body human body, including:

  • prostaglandin (PG) E2 (PGE2)
  • prostacyclin (PGI2)
  • prostaglandin D2 (PGD2)
  • prostaglandin F (PGF)

Prostaglandins are made from the fatty acid called arachidonic acid, which is converted into prostaglandin H2 (or PGH2) and is the precursor for all four of the primary prostaglandins. Different types of prostaglandins have different and sometimes opposite functions, such as stimulating the formation of a blood clot to help injured blood vessels, narrowing blood vessels to prevent excess bleeding, and removing unneeded clots.

Prostaglandins’ Role in Inflammation

What is the role of prostaglandins in the inflammatory response?  First, it’s important to understand that inflammation is both good and bad depending on the context. For example, chronic inflammation, the root of most diseases, is problematic because it contributes to health problems such as heart disease, diabetes, neurological diseases and many others. But acute (short-term) inflammation is life-saving and a necessary part of healing.

Each type of prostaglandin works differently to maintain homeostasis in the body. During an inflammatory response, both the level and the types of prostaglandin production change dramatically.  Prostaglandin production is normally low in tissues that are not inflamed, but levels increases during an acute inflammatory response. When prostaglandins increase, this helps with recruitment of leukocytes and the infiltration of immune cells.

Prostaglandins are similar to hormones because they act as signals to help the body carry out different processes as needed, one of which is repairing damaged tissue. However, they are different than hormones because they are not made by glands and are produced at the sites where the body requires them via a chemical reaction. They have various effects depending on the part of the body in which they are made. (3)

Prostaglandins are important for overcoming a number of health conditions because they help to control processes that release inflammatory compounds, help regulate blood flow and play a role in the formation of blood clots. They also increase pain and can cause a fever, which are normal reactions to injury, infection or illnesses.

Prostaglandins are produced via a chemical reaction that first takes place due to the effects of an enzyme called cyclooxygenase (cyclooxygenase-1 and cyclooxygenase-2). Normally prostaglandins are produced by cyclooxygenase-1, but when inflammation needs to be increased, cyclooxygenase-2 is activated in order to make extra prostaglandins. Prostaglandins have been found to act on at least eight different receptor sites in the body. Their effects are limited to the sites where they act on and they are short-lived, since the body breaks down prostaglandins quickly compared to other hormones.

Pros and Cons of Prostaglandins

Pros of prostaglandins:

  • Help with overcoming illnesses and infections.
  • Help to repair damaged tissue.
  • Can induce labor. It does this by causing relaxation of cervical smooth muscle which facilitates dilation. There are even synthetic/manufactured forms of prostaglandins, called prostaglandin E2 and F2, that are prescribed to help induce labor when at the end of pregnancy. Additionally, women need enough prostaglandins to help with stimulating ovulation and making sure the uterus contracts appropriately to allow for menstruation.
  • Can help to control postpartum hemorrhage (bleeding).
  • Used to help treat impotence in men and to improve sperm function.
  • Can help treat stomach ulcers by regulating acid secretion of the stomach and protecting the intestines from damage.
  • Regulate production of mucus.
  • Used to help treat glaucoma.
  • Help regulate gut bacteria by impacting release of inflammatory compounds. (4)
  • Can be used intravenously to treat Raynaud’s syndrome, especially in patients who have not responded well to other treatments like oral or topical vasodilators.
  • Can stimulate bowel movements.
  • Can help treat congenital heart disease in newborn babies.

Cons of prostaglandins:

  • Increase pain in response to injury or illness. NSAIDs (non-steroidal anti-inflammatory drugs) that are used as pain relievers and to reduce inflammation and fever symptoms work by blocking the effects of prostaglandins. For example, the drugs ibuprofen and aspirin work by stopping prostaglandins from being made by modifying the enzyme called cyclooxygenase. (5)
  • Can cause a fever, swelling, redness, etc.
  • Cause PMS symptoms/PMDD symptoms/strong menstrual cramps. Why do prostaglandins contribute to menstrual cramps? In a woman’s uterus, prostaglandins signal muscles to contract each month in order to shed the lining of the uterus (called the endometrium) that results in menstruation. The more prostaglandins someone makes,  the stronger these muscle contractions will be, which can worsen menstrual cramps. Severe menstrual cramps and pain is known as dysmenorrhea. (6)
  • May increase allergies and autoimmune reactions.
  • Can interfere with the normal healing process if levels are too high or too low. Chronic production of prostaglandins in high amounts can contribute to diseases tied to chronic inflammation.
  • Can contribute to problems with chronic pain, including arthritis.
  • Have been linked to cancer development when chronically produced in excess.
  • May cause diarrhea when released in high amounts.
  • Excess production may contribute to bone fragility and low bone mass.

How to Control Prostaglandin Production

Let’s go back to the topic of prostaglandin product that was mentioned earlier. What causes prostaglandins to increase, and what does this tell us about how we can control it?

Prostaglandin levels increase in response to injury and inflammation, which is why an anti-inflammatory diet and lifestyle is key for balancing production of these compounds. How do you naturally stop prostaglandins?

How to balance prostaglandins with a healthy diet:

  • Avoid pain-triggering foods, which include: foods with added sugar, potentially conventional dairy products, refined vegetables oils, processed grains, poor quality meats and processed meats (like cold cuts, hot dogs, cured meats, etc.), alcohol and caffeine.
  • Don’t over-consume omega-6 fatty acids, which are what prostaglandins are synthesized from. The best way to do this is to limit your use of processed vegetable oils.
  • Eliminate food allergies that make symptoms worse, which can include gluten, dairy, nuts, eggs, night shades, etc. (depending on the person).
  • Eat high-fiber foods to help balance hormones including estrogen. This includes: vegetables, fruits, legumes, beans, nuts, seeds and 100 percent whole grains.
  • Consume omega-3 foods which help to decrease inflammation, including wild-caught fish like salmon, sardines, mackerel, etc. Some studies have also found that consuming more fish oil may help decrease prostaglandin production. (7)
  • Increase intake of anti-inflammatory herbs and spices, especially ginger, turmeric, cinnamon, parsley, etc.
  • Focus on healthy fats, including: olive oil, flax seeds, chia seeds, all types of nuts, and coconut oil.
  • Increase intake of magnesium-rich foods and potassium-rich foods, including: leafy green veggies, cruciferous veggies, bananas, apricots and figs, sweet potatoes, avocado, beans/legumes, salmon, and organic dairy products if tolerated.
  • Eat more foods high in zinc including: pumpkin seeds, beef, lamb, organ meats, cashews, chickpeas, chicken, yogurt and spinach.
  • Consume black and green teas, which seem to regulate levels. (8)

What foods contain prostaglandins? Prostaglandins are not actually found in foods, but created by the body. You can control how much you produce by eating enough vitamins, minerals, antioxidants and fiber, and by not over-consuming fatty or inflammatory foods.

Other ways to control prostaglandin production:

  • Take a magnesium supplement. Magnesium can help to ease muscle cramps, including menstrual cramps, and chronic pain. However, you’ll want to avoid taking magnesium citrate if you have diarrhea/loose bowels. A standard recommendation is to take a dose of about 300–450 milligrams nightly before bed.
  • Consume zinc, both from food sources and supplements if needed. Zinc is a key structural component for a slew of hormone receptors and proteins that contribute to healthy, balanced mood and immune function. If you suffer from strong menstrual cramps, zinc may help due to its antioxidant and anti-inflammatory actions in the uterus. (9) Research has shown that taking 30 milligrams of zinc 1–3 times daily for one to four days prior to onset of menses can significantly reduce menstrual cramping.
  • Try ginger and turmeric supplements, which help to combat inflammation. Certain studies have found that taking 1,000–2,000 milligrams per day of ginger (or more) can help reduce pain and cramps. (10)
  • Take bromelain supplements, a compound derived from pineapple that has anti-inflammatory effects which may help dull pain. Resveratrol is another antioxidant compound found in foods like berries and red wine that decrease inflammation and support the immune system. (11)
  • Manage stress, such as by getting enough sleep, time to rest and doing relaxing activities.
  • Exercise appropriately, meaning not too much or too little. Try a combination of aerobic exercise and strength-building exercise, but be sure to take enough time to rest and stretch in order to manage pain/inflammation.
  • Try evening primrose oil. Evening primrose oil contains linoleic acid and gamma-linolenic acid, which seem to help regulate production of prostaglandins and their activities, including vascular activity. Research has shown that supplementing with primrose oil can help reduce PMS symptoms, Raynaud’s syndrome, IBs, skin ulcers, heart disease risk, inflammatory skin conditions like eczema, and more. (12)
  • Sex can increase prostaglandin production by stimulating the uterus, which is one reason it’s sometimes recommended to induce labor. Semen also contains prostaglandins.
  • Consider acupuncture, which according to Chinese medicine stimulates channels of qi (or energy) along meridians that helps organs and systems to function better. Study results have overall been mixed in regards to whether acupuncture and/or transcutaneous nerve stimulation (TENS) may stimulate the release of prostaglandins and oxytocin. (13)

Things to avoid to manage prostaglandins:

  • Quit smoking, which increases inflammation and often chronic pain.
  • Limit use of soy, corn, cottonseed and safflower oils.
  • Limit or avoid stimulants, including caffeinated drinks, nicotine and potentially cocoa/chocolate products.
  • Cut down on alcohol or eliminate it all together.
  • Treat estrogen dominance with a healthy diet, exercise, and avoidance of chemicals that mimic the effects of estrogen.
  • Try an elimination diet if you’re unsure about which foods increase pain and symptoms, such as allergens or sensitivities. Continuing to eat foods that you are sensitive to will cause your immune system to respond by increasing inflammation.
  • Avoid sleep deprivation.
  • Take steps to limit chronic stress.

Signs of Prostaglandin Issues

What are some conditions and symptoms that are tied to abnormally high or low prostaglandin levels? Some of the most common prostaglandin-related health issues include: (14)

  • Very painful periods
  • Diarrhea and changes in bowel movements, including during a woman’s period (a sign that prostaglandin levels are too high). Prostaglandins can contract not only uterine muscles but also the bowels.
  • Autoimmune disease
  • Diabetes
  • Poor pituitary function and low thyroid function
  • Chronic pain and ongoing tissue damage that won’t heal
  • Swelling, redness and tenderness, including edema in the limbs
  • Eczema
  • Migraines
  • Certain types of cancer
  • Neurodegenerative diseases. Recent research has shown that high prostaglandin production seems to play a role in diseases including multiple sclerosis, Parkinson’s disease, ALS and Huntington’s disease. (15)
  • Scarring and loss of organ function

Prostaglandin Medications and Usage

Prostaglandins are used medically for a variety of reasons, including to relax muscles and induce labor. Two “prostaglandin analogs” are currently used for the purpose of “cervical ripening” to help with labor, called dinoprostone gel (Prepidil) and dinoprostone inserts (Cervidil). They can help relax cervical smooth muscle and also increase contractions of uterine muscles. However, the use of these prostaglandins also comes with some risks, including the potential for side effects like nausea, vomiting, diarrhea and fever.

Certain drugs are also used to block cyclooxygenase-2 and, therefore, to reduce prostaglandin levels. This is why NSAIDs are given to manage pain and symptoms associated with inflammatory conditions — like arthritis, heavy menstrual bleeding/cramps, heart conditions tied to blood clots, and even certain types of cancer, including colon and breast cancer. Oral contraceptives (birth control pills) also lower the production of prostaglandins by inhibiting the growth of the endometrial cell layer in the uterus. (16)

Final Thoughts

  • Prostaglandins are lipid compounds that have hormone-like effects. Prostaglandin functions include: promoting inflammation in tissue that has been damaged or infected in order to encourage healing; regulating functions of the female reproductive system, including ovulation, menstruation and the induction of labor; promoting blood clotting; repairing damaged blood vessels; regulating blood clots, and more.
  • What releases prostaglandins? Stressors including tissue damage, infection and illness can all trigger more prostaglandins to be produced. They are also produced to help contract the uterus in order to bring on menstruation and labor.
  • There’s both a good and bad connection between prostaglandins and inflammation. They can help encourage healing by increasing inflammatory responses, but can also increase chronic pain, cramps, fever, swelling, etc.
  • To balance prostaglandin production, steps to take include: eating a high-fiber, anti-inflammatory diet; taking magnesium, zinc, omega-3s and bromelain; exercising and sleeping enough; treating estrogen dominance; treating food allergies; avoiding stimulants, alcohol and smoking.
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