What are Some Other Causes of a High PSA?

So you’ve had your PSA test, and it came back high. Your doctor did a DRE and ran a few more tests, and assures you that prostate cancer is very unlikely. Still, you’re worried. What are some other causes of a high PSA?

First, what does PSA mean?

PSA: prostate specific antigen. A chemical released by prostate cells. A healthy prostate releases only small amounts of this chemical, but when some cancer has begun to develop, the affected cells pump out more. A simple blood test can detect PSA and serves as an effective screening test for prostate cancer.

DRE: digital rectal exam. A prostate in which cancer has begun to grow may change in size and shape. In this exam, a doctor inserts a lubricated, gloved finger about two inches into the rectum and assesses the prostate. It’s not a fun test, but together with PSA testing, they are your best defense against prostate cancer—which is highly treatable when caught at an early stage.

High PSA? Here are 7 common things that can affect your PSA level.

1. Age

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…

If you are in your … Your normal PSA range should be …
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.

3. Prostatitis

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.

7. Medications

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.