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What causes PSA to rise?

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Before you have your prostate-specific antigen (PSA) level checked, it’s a good idea to know what causes PSA to rise. Why?

One, you should know there are many situations or reasons directly unrelated to the prostate that can cause PSA to rise. Therefore, if you know about these factors before you go for your PSA test you and your healthcare provider can take them into account when assessing your test results. That way you can be assured of a more accurate reading from your blood test and avoid any unnecessary follow up tests, like a biopsy.

Two, an elevated PSA does not necessarily mean you have prostate cancer. In fact, there are other prostate-related situations associated with a rise in PSA, so don’t let the fear of prostate cancer prevent you from getting your PSA level checked.

PSA levels can rise for reasons related to the prostate, but there are actually more situations that are not directly related to prostate health that can cause PSA to rise. The factors in the latter category typically are temporary causes. Here are eight reasons why you may experience a rise in your PSA levels:

Enlarged prostate. The presence of an enlarged prostate (aka, benign prostatic hyperplasia, BPH) is associated with a rise in PSA. An enlarged prostate is a benign and treatable condition and should be diagnosed by a physician.

Prostatitis. Inflammation of the prostate is another benign condition that is characterized by a rise in PSA. Again, it is a treatable condition and should be diagnosed by a doctor, since there are several forms of the disease and an accurate diagnosis is necessary to ensure effective treatment.

Prostate cancer. An elevated (generally, 4.0 ng/mL or higher) PSA is not an accurate indicator of prostate cancer. In fact, men with a low PSA can be diagnosed with prostate cancer while those with a high level can be completely cancer free.

Recent sexual activity. Engaging in sexual activity within 48 to 72 hours of having your PSA checked may result in an artificially elevated reading.

Riding a bike. Some research has indicated that strenuous bicycling riding can cause a slight rise in PSA level. Although the study findings are mixed, it’s best to avoid riding a bike for about 48 hours before a PSA test. The same effect on PSA levels may occur if you spend a significant amount of time riding a motorcycle, riding lawnmower, all-terrain vehicle, or horse.

Digital rectal exam. Having a DRE within 24 to 48 hours of a PSA test may result in a mild rise in PSA. If you are having both a PSA test and a DRE, have your blood drawn first.

Medical procedures. One of the most common medical procedures associated with a rise in PSA is placement of a urinary catheter. A prostate biopsy or a bladder or prostate examination that involves passing a scope into the urethra also can cause an increase in PSA levels. Wait for about two to three weeks before having a PSA test if you have had these procedures. Research also has indicated that a colonoscopy can result in an elevated PSA for seven days or more post procedure in some men.Urinary tract infection. A urinary tract infection can cause inflammation of the prostate and result in a rise in PSA. If you know you have a urinary tract infect, wait until the infection has completely cleared before having a PSA test. Most urinary tract infections respond well to a course of antibiotics.

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