Prostate-specific antigen, or PSA, is a protein that is produced in the prostate. Elevated levels of prostate-specific antigens can often, but not always, indicate prostate cancer, and can help be an early indicator. It is important for men to undergo regular prostate exams to screen for prostate cancer because if it is caught early, it is often treatable.
Elevated PSA can be diagnosed through a simple blood test that can be performed by a primary care physician to detect an increased level of PSA in the blood. If the physician determines the results are concerning, they will refer the patient to a urologist for further examination. The urologist will likely perform a prostate biopsy.
Here are 7 common things that can affect your PSA level.
Older men’s normal PSA levels run a little higher than those of younger men. Normal levels tend to vary a little between different ethnic groups, but in general…
40s - 0–2.5 ng/mL
50s - 0–4 ng/mL
60s - 0–4.5 ng/mL
70s - 0–6.5 ng/mL
What is a high PSA level and what is a normal PSA level vary by demographic factors. Your doctor will evaluate your test results, factor in your age, ethnicity, and any other relevant factors, and let you know whether your results suggest more testing.
2. Prostate size
Because PSA is naturally produced at a very low level by the healthy prostate, a man with a larger-than-usual prostate may have a higher-than-usual PSA level. Your doctor will be able to detect this with a DRE, and will take this into consideration when looking at your PSA test results.
Prostatitis is a painful condition in which the prostate is inflamed, swollen, and tender. It can be caused by a bacterial infection or just simply be inflamed. In some cases, an elevated PSA level may be another effect of this illness.
4. Benign prostatic hyperplasia (BPH)
Different from simply having a larger-than-usual prostate, BPH is an enlarged prostate. It’s somewhat common among men over 50, and it may make urination or ejaculation difficult, which could send you to the doctor to have it checked. Along with the swelling, a prostate with BPH may produce more PSA than usual. Your doctor may recommend additional tests to confirm BPH.
5. Urinary tract infection or irritation
An infection of the urinary tract, as well as irritation caused by medical procedures involving the urethra or bladder, may irritate the prostate and cause it to produce more PSA. If you have experienced any of these, be sure to let your doctor know. You’ll need to give the area some time to heal and calm down before running a PSA test.
6. Prostate stimulation
Any prostate stimulation can trigger the release of extra PSA. This can include some sexual activity, including ejaculation, but even having a DRE can raise PSA levels. For this reason, doctors usually draw blood before performing the DRE to avoid affecting the PSA test results.
Some medications can artificially lower the PSA, such as finasteride (Proscar or Propecia) or dutasteride (Avodart). Be sure to remind your doctor of any and all medications you may be taking, so they can factor them in when assessing your PSA test results.
PSA levels can fluctuate, and they can be influenced by a number of different factors. Your normal PSA levels might just be a little higher than most men in your demographic category. The important thing is to be able to freely talk over the possible factors so that your doctor can realistically assess your scores and you can monitor them over time.