Prostaglandins' Impact on Inflammation and Pain

Pain Signal Influencers

Prostaglandins are hormones that exert a lot of influence over key physiological processes in your body—including pain levels and inflammation. As part of the natural healing process, your body produces prostaglandins at the sites of infection or tissue damage.

Numerous drugs and dietary changes have been researched to counter the negative effects of prostaglandins.

Aspirin Tablets
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What Prostaglandins Are

Prostaglandins are a type of hormone. They act as signals to control processes in the parts of the body where they're made. The body contains about two dozen different types that perform different functions.

Prostaglandins don't last long—they carry out their function, and then the body breaks them down. That helps limit their activity, which is a good thing. When levels get too high, it can result in excess inflammation and pain.

What Prostaglandins Do

Prostaglandins play numerous roles in the human body, some negative and some positive.

Some of their functions include:

  • Vasodilation and vasoconstriction (the opening and closing of blood vessels)
  • Bronchoconstriction (the constriction of air passageways)
  • Blood clotting
  • Uterine contractions
  • Fever
  • Maintenance of tissues such as the stomach lining

Medications That Target Prostaglandins

Because of prostaglandins' important role in initiating and perpetuating inflammation, numerous drugs have been developed over the years to counter their actions. Healthcare providers consider these drugs effective and they're relatively inexpensive, as well. 

In ancient times, willow bark was used to relieve pain and reduce fever, and many holistic herbalists continue to recommend this plant to their feverish clients. In the 1820s, the active ingredient of willow bark was determined to be salicylic acid. However, when taken medicinally, it can cause intense stomach problems such as diarrhea and vomiting.

Eventually, acetylsalicylic acid was determined to be a safer option. In the 1890s, the Bayer company began marketing acetylsalicylic acid as aspirin.

COX Inhibitor Drugs

In the 1960s, a class of drugs called phenylolkanoic acids was found to reduce inflammation and pain by blocking the enzyme cyclooxygenase, or COX. COX enzymes tend to interrupt the production of prostaglandins at an early stage. 

Three COX enzymes have been discovered: 

  • COX 1, which protects your GI tract
  • COX 2, which plays a role in inflammation, fever, and pain
  • COX 3, which is found mainly in the brain

Well-known COX inhibitors on the market for pain and inflammation include aspirin and ibuprofen (Advil). Both drugs block COX 1 and COX 2 enzymes. Known side effects of these medications are decreased kidney function, ulcers, and bleeding in the lining of the stomach. Advil also comes with the risk for heart attack and stroke.

With the exception of aspirin, all non-steroidal anti-inflammatory drugs (NSAIDs) come with an FDA “black-box” warning that taking the medication raises the risk for cardiovascular disease.

Dangerous COX-2 Inhibitors

You may remember Vioxx and Bextra, the once-promising pain relievers that were pulled from the market in 2004. They only inhibited the COX 2 enzyme and were known as COX 2 inhibitors. They didn't cause stomach-related side effects, but they did increase the risk of serious and even fatal heart attacks and stroke.

In September of 2004, Merck voluntarily pulled Vioxx off the market. In April 2005, the FDA ordered drugmaker Pfizer to pull Bextra off the market but allowed Celebrex (celecoxib) to remain available.

Anti-Prostaglandin Diet

It is well known that inflammation is at the root of a number of modern-day diseases, including chronic pain. It's also well known that taking medication to address the ills associated with inflammation may come with side effects, some of which can be quite serious.

To that end, many health providers, patients, and natural medicine activists advocate or follow an anti-inflammatory diet. Numerous studies have shown foods can have an anti-inflammatory effect.

Knowing which ones may help form the basis for a diet that can help fight the effects of inflammation.

Some people also take anti-inflammatory herbs or supplements, such as willow bark.

A Word from Verywell

If you have inflammation and pain and would like to try reducing your prostaglandin levels, talk to your healthcare provider about it. While many of these medications are available over-the-counter, that doesn't mean they're without side effects. Long-term use carries certain risks, as well.

The good news is that you have a lot of options for controlling your inflammation and the pain it can cause.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Society for Endocrinology 2016. You and Your Hormones: Prostaglandins.

  2. UpToDate. Overview of COX-2 selective NSAIDS.

  3. Food and Drug Adminstration. Vioxx.

Additional Reading

By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.