Prostate-Specific Antigen (PSA) is a biomarker primarily used in screening for prostate cancer in men. However, PSA is also present in women, though typically at much lower levels. The detection of PSA in women has broadened scientific understanding of this protein, moving beyond its traditional association with the prostate gland. This presence opens avenues for research into its roles in women’s health.
What is PSA?
Prostate-Specific Antigen (PSA) is a protein predominantly produced by the prostate gland in men. Its main role is to liquefy semen after ejaculation, aiding sperm motility.
In men, PSA is a well-established biomarker for prostate cancer. Elevated levels often prompt further investigation for the disease or other prostate conditions like benign prostatic hyperplasia (BPH) or inflammation. While its presence in the bloodstream is usually minimal in healthy men, an increase can indicate prostatic issues. Despite its name, PSA is not solely produced by the prostate and has been detected in various female tissues.
Where PSA is Found in Women
In women, PSA is produced by several tissues. The Skene’s glands, also known as the female prostate or paraurethral glands, are a primary source. These glands are considered homologous to the male prostate and can secrete PSA, often detectable in urine.
Breast tissue is another significant site of PSA production in women, found in both normal and cancerous breast cells. PSA has been detected in various breast fluids, including milk, nipple aspirate fluid, and cyst fluid. Its production in breast tissue is influenced by steroid hormones. Other less common sources include salivary glands, sweat glands, and tears, contributing to its widespread, low-level presence.
When PSA Levels Are Elevated in Women
Elevated PSA levels in women can be associated with a range of conditions, though it is not used as a primary diagnostic marker like for prostate cancer in men. Breast cancer, particularly estrogen receptor-positive types, is one condition where PSA levels may be elevated.
Other conditions that can lead to increased PSA levels include ovarian cancer and benign breast diseases, such as fibrocystic changes and breast cysts. Polycystic Ovary Syndrome (PCOS), characterized by hormonal imbalances and often an excess of male hormones, is another condition linked to higher PSA levels. Renal disease and certain medications can also influence PSA levels. Additionally, temporary elevations might occur due to factors like urinary tract infections or sexual activity.
Diagnosing and Interpreting PSA Results in Women
PSA levels in women are measured through a blood test. The typical reference ranges for PSA in women are considerably lower than in men, usually at or below 0.01 ng/mL. The interpretation of elevated PSA results in women is complex and generally does not lead to a standalone diagnosis.
Further clinical investigation is almost always required to understand the cause of any elevation. PSA testing is not a routine screening tool for women, unlike its established role in prostate cancer screening for men. Challenges in interpretation arise from the various non-cancerous causes of elevated PSA and the absence of standardized guidelines for female PSA testing, making careful clinical correlation necessary.