An elevated PSA can mean a number of underlying conditions. Many people often associate an elevated PSA with prostate cancer, but that is not always the case. While prostate cancer is very common among older men, there are other conditions that may be affecting the prostate that could be the reason for developing an elevated PSA.

The PSA elevates in the blood as a result of the prostate cells or gland being disrupted in some way. A “normal” PSA level is generally between 1.0 and 4.0 ng/mL. Anything above 4.0ng/mL is considered “abnormal” or elevated. The PSA level may differ depending on a man’s age. As men age, the prostate gets larger. A larger prostate produces more PSA. Therefore, younger men generally have lower PSA levels while older men tend to have higher PSA levels. The following are the most common reasons why your PSA may be elevated:

Benign prostatic hyperplasia (BPH). BPH also means an enlarged prostate gland. This does not mean prostate cancer. BPH is the most common prostate condition men over 50 suffer from. It can often cause urination problems such as frequent urination or difficulty urinating.

Prostate cancer. An elevated PSA could indicate prostate cancer. If you have an elevated PSA, your doctor will also do a digital rectal exam to see if there are any suspicious lumps present on the prostate gland. If they suspect prostate cancer, a prostate biopsy will be recommended. It’s also important to monitor any changes in the PSA; if the PSA continues to rise, this may mean prostate cancer. If you continue to have an elevated PSA, but your biopsy is negative, your doctor will most likely recommend follow-up PSA tests and a follow-up biopsy within six months.

Urinary tract infection. A urinary tract infection can cause irritation and inflammation in the prostate gland, which can cause the PSA to go up. If you have a UTI, a doctor will prescribe antibiotics to treat it. The PSA should go back to normal after the infection has gone away so make sure to wait until then to have a PSA test. Men with an enlarged prostate have a higher risk for urinary tract infections.

Prostatitis. Prostatitis also means a prostate infection, which causes inflammation of the prostate gland. Prostatitis is the most common prostate condition in men younger than 50. It can usually be treated with antibiotics.

Age. As men age, their prostate naturally gets bigger. This happens regardless of any medical condition affecting the prostate gland.

After sex. After sex, or ejaculation, the PSA can go up. The PSA usually only goes up very slightly, so it may not even show a difference. The PSA should go back to normal within a few days.

Having certain medical procedures or exams. The prostate can sometimes be affected after certain procedures, such as a prostate biopsy or cystoscopy. It can also be affected after having a digital rectal exam. The PSA can elevate after having any of these done because they disturb the prostate gland. It can even rise after having a catheter in place. The PSA should go back to normal within a few days once the prostate has healed.