Reasons for an elevated PSA

Prostate specific antigen (PSA) is a protein produced by cells of the prostate gland in men.  A man may have a PSA blood test measuring the level of PSA in a man’s blood with the results reported as nanograms of PSA per milliliter (ng/ml) of blood.  A normal PSA level is considered to be between 1.0 and 4.0 ng/ml.  If the number is above 4.0, the level is considered abnormal or elevated.

Typically when a man’s PSA blood level is elevated it is associated with prostate cancer.  But there can be additional reasons besides prostate cancer influencing a man’s PSA level to rise. 

Listed below are some of the more common reasons why a man’s PSA may be elevated that is not due to prostate cancer:

·         A man’s age

A man can have an elevated PSA level without having any prostate problems – often due to the PSA levels gradually increasing with a man’s age.  For instance, at age 40, a PSA of 2.5 is within the normal limit but by age 60, the limit can go up to 4.5 and by age 70, up to 6.5.  These higher levels of PSA can be normal for an older man but a doctor will most likely want to do some other testing just to be sure there is nothing more serious developing.

·         Benign prostatic hyperplasia (BPH)

BPH is an enlargement of the prostate gland but is not cancerous or considered to be prostate cancer.  More cells are producing PSA making the number increase.  Depending on whether a man is having symptoms such as frequent or difficulty urinating, BPH may not need to be treated.  For men after the age of 50, BPH is considered to be the most common prostate problem in men. 

·         Urinary tract infection

An infection such as a urinary tract infection can irritate and inflame prostate cells causing PSA to rise.  It is best to wait to have a PSA test until after an infection has cleared up to get a more accurate reading.

·         Sex

Ejaculation during sex can cause a slight elevation of a PSA level but usually the rise is not significant enough to make a difference unless the PSA level is borderline.  Normally the PSA should return to normal within two to three days.

·         Digital rectal exam

Having a digital rectal exam can increase PSA levels – a doctor will should always draw blood for a PSA test before doing a rectal exam.

·         Prostatitis

Prostatitis is an infection of the prostate causing inflammation of the prostate gland.  A man who has this condition should wait until after it is cleared up before having his PSA levels checked.

·         Bicycling

A few studies have linked prolonged bike rides to increasing PSA levels.  In order to make that happen, most doctors believe that a man would have to be training at the level of Lance Armstrong to be concerned with bicycling raising PSA.  Most doctors agree that any man who rides a bike for prolonged periods of time should refrain from this at least 24 to 48 hours and to refrain from ejaculation before having the PSA test done.