Why Do Some Women Produce More Prostaglandins?

During menstruation, the uterus sheds the lining that developed during the cycle.
This process triggers the release of signaling molecules called prostaglandins, which stimulate uterine contractions (Dawood, 2006).

However, the amount of prostaglandins produced is not the same in every woman.

In some women, significantly higher levels can be measured in the uterine lining and menstrual fluid.

This difference is one of the main reasons why some women feel only mild discomfort while others experience strong cramps.

So the question becomes:

What influences prostaglandin production?

Several biological factors may contribute.

1. Thicker Uterine Lining

Prostaglandins are mainly released when the uterine lining breaks down at the beginning of menstruation.

If a thicker endometrium develops during the cycle:

• more tissue breaks down during menstruation

• more inflammatory mediators are released

• more prostaglandins may be produced

This can trigger stronger uterine contractions (Dawood, 2006).

2. Higher Inflammatory Activity

Prostaglandins are part of the body’s inflammatory signaling system.

If the body already has higher inflammatory activity, prostaglandin production may also increase during menstruation.

Factors that may contribute include:

• chronic stress

• lack of sleep

• certain dietary patterns

• hormonal imbalances

These influences can affect how strongly the uterus responds during the menstrual cycle (Iacovides et al., 2015).

3. Hormonal Balance (Estrogen and Progesterone)

The balance between estrogen and progesterone affects how the uterine lining develops during the cycle.

When estrogen activity is relatively higher:

• the endometrium may become thicker

• more tissue must be shed during menstruation

• prostaglandin production may increase

This can lead to stronger uterine contractions.

4. Greater Sensitivity of the Uterine Muscle

The amount of prostaglandin is not the only factor.

The sensitivity of the uterine muscle also matters.

In some women, the uterine muscle reacts more strongly to prostaglandins, leading to:

• more powerful contractions

• increased uterine pressure

• stronger cramping sensations (Dawood, 2006).

5. Reduced Pelvic Blood Circulation

During strong uterine contractions, blood vessels in the uterine muscle may become temporarily compressed.

This can reduce blood flow and lead to short-term oxygen shortage in the tissue, a process called ischemia (Iacovides et al., 2015).

If pelvic circulation is already less active, this oxygen shortage may occur more easily, increasing the sensation of pain.

Risk Factors for Strong Menstrual Pain

Research has identified several factors associated with a higher risk of dysmenorrhea (Ju et al., 2014):

• younger age

• early menarche (early first menstruation)

• heavy menstrual bleeding

• family history

• smoking

• high stress levels

• low levels of physical activity

In some cases, menstrual pain may also be caused by underlying conditions such as:

• Endometriosis

• Adenomyosis

• Uterine Fibroids

This is called secondary dysmenorrhea, and medical evaluation may be necessary.

Why Natural Approaches May Help

Understanding these biological mechanisms helps explain why certain natural approaches may reduce menstrual discomfort.

If pain is influenced by factors such as:

• increased muscle tension

• reduced pelvic circulation

• nervous system overactivation

then strategies that support the body’s natural regulation may provide relief.

Examples include:

• heat therapy, which improves blood flow

• gentle movement, which supports pelvic circulation

• breathing and relaxation, which calm the nervous system

• stress reduction, which may influence hormonal balance

These approaches do not block prostaglandins directly like medications do.
Instead, they work by improving the physiological environment in which the uterus functions.

Can movement reduce period pain?

If part of the pain mechanism involves strong muscle contractions and reduced circulation, then movement-based approaches may have an important role.

The Exercises of the Aviva Method?

• activate the hips and pelvis

• improve pelvic circulation

• support rhythmic movement in the pelvic region

may help reduce tension, improve circulation,  increase the heat in the lower abdomen, and support the body’s natural processes.

For some women, this is where targeted pelvic movement practices such as the Exercises of the Aviva Method become especially relevant. ((Kovács et al., 2024, 2025)

References

Dawood, M. Y. (2006). Primary dysmenorrhea: Advances in pathogenesis and management. Obstetrics & Gynecology, 108(2), 428–441.

Iacovides, S., Avidon, I., & Baker, F. C. (2015). What we know about primary dysmenorrhea today. Human Reproduction Update, 21(6), 762–778.

Ju, H., Jones, M., & Mishra, G. (2014). The prevalence and risk factors of dysmenorrhea. Epidemiologic Reviews, 36(1), 104–113.

Kovács, Z., Atombosiye, E., Hegyi, G., & Szőke, H. (2024).
The effect of Aviva exercise intervention on pain level and body awareness in women with primary dysmenorrhea. Medicina, 60(1), 184. Kovács, Z. (2025).
The effects of Aviva exercise on premenstrual syndrome symptoms, primary dysmenorrhea, body awareness and uterine artery circulation. PhD research program, University of Pécs.