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. These variations in PSA levels are not always associated with a prostate condition, other than an enlarged prostate. The PSA level may also vary depending on the man’s ethnicity or if they have a family history of prostate cancer.
Most common causes of elevated PSA:
· 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.
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.
· 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.
As men age, their prostate naturally gets bigger. This happens regardless of any medical condition affecting the prostate gland.
· 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.
· 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.
· 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.