Prostaglandins

What are prostaglandins?

Prostaglandins are a group of lipids with hormone-like actions that your body makes primarily at sites of tissue damage or infection. There are several different types of prostaglandins, and they play several essential roles in regulating bodily processes, including:

• Blood clot formation at the site of an injury.
• Blood flow.
• Healing.
• Inflammation.
• Labor induction in pregnancy.
• Menstruation.
• Ovulation.

Prostaglandins have a role in the natural physiology of your body in addition to their role in defense and repair. For example, prostaglandins are responsible for uterine contractions during menstruation. These contractions help release the uterine lining (endometrium) from your uterus, thus producing a period.

Healthcare providers also use synthetic forms of certain prostaglandins to treat various conditions, including glaucoma and erectile dysfunction. They also use medications to block certain prostaglandin receptors to help treat certain conditions.

Are prostaglandins hormones?

Prostaglandins are lipids with hormone-like properties. Lipids are a class of organic compounds that are fatty acids or their derivatives. Your body produces prostaglandins from a fatty acid called arachidonic acid.

Prostaglandins are hormone-like because they coordinate different functions in your body and tell your body what to do and when to do it.

Prostaglandins are different from hormones because your endocrine system glands don’t release them into your bloodstream like they do hormones. Instead, your tissues make prostaglandins at the site of the action, damage or infection.

What is the function of prostaglandins?

There are several different types of prostaglandins and prostaglandin receptors that affect almost every part of your body. The effect of prostaglandins depends on multiple factors, including:

• The organ or tissue involved.
• The receptor to which they attach.
• The bodily function or physiological situation.

Prostaglandins can:

• Activate or inhibit (prevent) platelet buildup for blood clot formation.
• Cause vasodilation (widening of blood vessels) or vasoconstriction (narrowing of blood vessels).
• Cause bronchoconstriction (the narrowing of air passageways) or bronchodilation (widening of air passageways).
• Cause fever.
• Influence pain perception.
• Induce labor through uterine contractions.
• Cause your uterus to contract during menstruation to shed the uterine lining.
• Decrease pressure within your eye.
• Inhibit acid secretion in your stomach.
• Contract or relax smooth muscle in your gastrointestinal (GI) tract.
• Regulate several hormones.

Prostaglandins have a short half-life and have a short duration of action. Because of this, they can only affect cells that are close by. Several different tissues throughout your body can make prostaglandins.

As an example, if you cut your finger, prostaglandins would play a part in your body’s response in the following ways:

• The affected tissue in your finger would release prostaglandins that signal the platelets in your blood to stick together to form a blood clot at the site of the injury in order to stop the bleeding.
• The affected tissue would release prostaglandins to narrow affected blood vessels to try to lessen blood loss.
• The affected tissue would release prostaglandins that trigger the inflammatory response, causing blood vessels to leak fluid into the tissues (swelling). This helps isolate any foreign substances that entered through your broken skin from further contact with your body’s tissues. Prostaglandins involved with inflammation also attract white blood cells called phagocytes that "eat" germs and dead or damaged cells.
• Once your injury is healed, the affected tissue will release prostaglandins to break up the blood clot and remove it since it’s no longer needed.

Are prostaglandins good or bad?

Under normal circumstances, prostaglandins are necessary and natural. Prostaglandins have a lot of influence over key natural bodily processes, including pain levels and inflammation. The normal inflammatory process is your body’s way of protecting itself from further damage.

However, sometimes your body can have excessive amounts of prostaglandins, which can cause prolonged inflammation and intense pain. In these situations, high levels of prostaglandins can lead to chronic conditions and unpleasant symptoms.

While prostaglandins are necessary for menstruation, for example, excess prostaglandins can cause painful and heavy periods (menorrhagia).

How do prostaglandins affect pregnancy?

During pregnancy and labor, the uterine cells produce prostaglandins to help dilate your cervix (make it wider) and cause uterine contractions. These contractions help move the baby through the birth canal.

Healthcare providers also use synthetic prostaglandins to induce, or kick-start, labor if they recommend that you should give birth before labor naturally starts.

How are prostaglandins used in medicine?

Healthcare providers use several different kinds of synthetic prostaglandins as medication for a variety of conditions and situations, including:

• Travoprost can treat glaucoma and elevated eye pressure (ocular hypertension).
• Dinoprostone can help dilate the cervix in pregnant people who are at or near term. This will help induce labor.
• Alprostadil belongs to a group of medicines called vasodilators. These drugs increase blood flow by expanding blood vessels. They can help treat conditions such as cyanotic heart disease in infants and erectile dysfunction (ED).
• In some cases, healthcare providers use misoprostol rectally to treat postpartum hemorrhage.
• Iloprost can treat pulmonary hypertension and limited scleroderma (CREST syndrome).

Since excess prostaglandins can cause unnecessary pain and inflammation, healthcare providers also use medications to block (inhibit) the effects of prostaglandins. The most commonly used and well-known medications that block prostaglandins are nonsteroidal anti-inflammatory drugs (NSAIDs), also known as pain relievers. NSAIDs include aspirin compounds (Excedrin®), ibuprofen (Advil® and Motrin®) and naproxen sodium (Aleve®).

What kind of problems do prostaglandins cause?

Sometimes your body can make too many or not enough prostaglandins, which contributes to certain health conditions and symptoms.

Excess prostaglandins

Sometimes, your body produces too many prostaglandins, which leads to unwanted and unhelpful inflammation in your body. Excessive levels of prostaglandins can cause or contribute to a variety of health conditions, including:

• Chronic pain.
• Increased pain sensitivity.
• Painful menstruation or menstrual cramps (dysmenorrhea).
• Heavy menstrual bleeding.
• Certain types of cancer.

Lack of prostaglandins

Sometimes, your body doesn’t create enough prostaglandins to heal an injury or start labor if you’re at term with a pregnancy. While these situations aren’t connected to any kind of chronic health condition, artificial (synthetic) prostaglandins can help. Healthcare providers use synthetic prostaglandins to treat stomach ulcers and glaucoma. They can also use synthetic prostaglandins to kick-start labor.

When should I see my doctor about prostaglandin issues?

If you’re experiencing chronic pain and/or chronic inflammation, contact your healthcare provider. While several factors can contribute to these two conditions, your body’s use of prostaglandins could be the culprit.

Painful periods (dysmenorrhea), is one of the most common prostaglandin-related conditions that may cause you to see your provider. Talk to your doctor if you have painful periods that don’t get better when you take NSAIDs (pain relievers). Sometimes, painful periods are due to an underlying medical condition, such as endometriosis or uterine fibroids.

A note from Cleveland Clinic

Prostaglandins are natural and powerful substances that affect several aspects of your body. While prostaglandins are necessary for bodily processes such as healing, having excess prostaglandins can cause chronic pain and inflammation and lower your quality of life. If you’re experiencing ongoing pain or inflammation, talk to your healthcare provider. They can help determine the cause of your symptoms and suggest a treatment plan.