Prostate-Specific Antigen (PSA) is a protein produced by the cells of the prostate gland; a blood test measures its concentration in the bloodstream. While the PSA test is a primary screening tool for prostate cancer, an elevated reading alone does not diagnose cancer. A small amount of PSA in the blood is normal, but higher levels indicate an underlying prostate issue requiring investigation. Consult a physician immediately upon receiving an elevated result, as they interpret the number based on your age, medical history, and other diagnostic factors.
Understanding What Causes Elevated PSA Readings
Sustained PSA elevation is most commonly linked to non-cancerous conditions causing chronic irritation or enlargement of the prostate tissue. Benign Prostatic Hyperplasia (BPH) is an age-related enlargement of the prostate that frequently causes higher PSA levels. As the gland grows, it produces more PSA, which leaks into the blood circulation.
Prostatitis, the inflammation or infection of the prostate, also leads to elevated PSA levels. This inflammation can be acute (caused by a bacterial infection) or chronic (related to long-term pelvic pain). Prostate cancer is the most serious, though not the most common, cause of a persistently increasing PSA level and is the primary reason for follow-up testing.
Immediate Steps to Temporarily Reduce PSA Before Re-Testing
Quick reduction of PSA focuses on eliminating temporary factors that artificially spike the reading before a blood draw. Physical stimulation or trauma to the prostate causes a transient rise in PSA levels. Therefore, men should avoid ejaculation for at least 48 hours before the test, as this activity temporarily increases the PSA measurement.
Vigorous exercise and activities that put pressure on the perineum also cause short-term elevation. Cycling, horseback riding, or intense workouts should be avoided for 48 to 72 hours prior to the blood test. This physical pressure forces more PSA from the prostate tissue into the bloodstream, leading to an inaccurate baseline reading.
If a urinary tract infection (UTI) or acute prostatitis is present, the associated inflammation raises PSA levels significantly. The most effective immediate step is ensuring any active infection is completely treated, often with antibiotics, before re-testing. Re-testing is usually recommended four to six weeks after the infection resolves to allow inflammation-related PSA to clear from the system.
Dietary and Lifestyle Changes for Long-Term PSA Management
Long-term PSA management focuses on reducing chronic inflammation, which contributes to prostate enlargement and irritation. Incorporating a diet rich in fruits and vegetables provides antioxidants and helps mitigate inflammatory processes. Tomatoes are particularly beneficial because they contain lycopene, an antioxidant linked to prostate health that helps lower PSA levels.
Increasing omega-3 fatty acids, found in foods like salmon, walnuts, and flaxseeds, is beneficial due to their anti-inflammatory properties. Limiting red meat and high-fat dairy products is also advised, as high intake of animal proteins is associated with increased risk factors for prostate issues. Drinking green tea, a source of potent antioxidant catechins, can also reduce inflammation.
Maintaining a healthy body weight through consistent, moderate physical activity is important for prostate health. Excess body fat increases chronic inflammation and alters hormone levels, indirectly influencing PSA production. Regular exercise, such as 150 minutes of moderate-intensity aerobic activity per week, supports overall metabolic health and long-term PSA management.
Medical Management Options
For men whose elevated PSA is caused by BPH, certain prescription medications manage symptoms and lower the PSA value. The class of drugs known as 5-alpha reductase inhibitors (including finasteride and dutasteride) shrinks the prostate gland. These medications block the conversion of testosterone into dihydrotestosterone (DHT), the hormone responsible for prostate growth, reducing the gland’s volume and the amount of PSA produced.
These inhibitors can significantly affect PSA levels, often reducing the measurement by as much as 50% after six months of use. Alpha-blockers, such as tamsulosin, are another common medication class that relaxes muscles in the prostate and bladder neck to ease urinary symptoms. While alpha-blockers improve urine flow, they do not typically shrink the prostate or directly cause a large reduction in PSA levels.