Prostaglandins are primary mediators of pain and are involved in pathological conditions such as hypertension, cancer and inflammation but are also needed for normal function of the female reproductive system. This may hold true for other systems because long term use of selective COX-2 inhibitors such as VIOXX and BEXTRA was associated with heart failure, leading to their withdrawal. A thorough study of the contribution of prostaglandins in the regulation of normal body function is clearly needed. A major drawback of the current therapeutic strategies aiming at controlling PGs is that they aim at early steps of biosynthesis thus blocking all PGs, good and bad. However, PGs often work as opposing dyads such as PGI2-TXA2 in the vascular system and PGF2alpha-PGE2 in the female reproductive system. The paradigm thus appears as effecting selective synthesis, transport and action of individual PG isoforms. In this respect, the female reproductive system appears as an ideal study model. Data from human and animal genome projects allowed identifying the corresponding members of the biosynthetic and signal transduction components of the PG system in different animal species. Of particular interest was that PG terminal synthase shared similarities or identity with enzymes previously known for steroid or sugar metabolism and free radical detoxification. We present here an integrated view of PG action based on observations in the female reproductive system, but with potential strategic implications for cardiovascular and metabolic complications.