People with prostate cancer usually have elevated levels of prostate-specific antigen (PSA). However, other causes for high PSA levels can include older age and a person’s sexual activity levels.

Health conditions, lifestyle factors, and testing inconsistencies can all contribute to high PSA test results. A doctor can further discuss the reasons for elevated PSA levels with a person.

They will also decide whether delaying testing or planning additional tests might help them determine the cause of high PSA test results.

The following possible causes of elevated PSA levels are in no particular order.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Learn more.

A number of noncancerous factors can cause elevated PSA.Share on Pinterest
Infographic by Sophia Smith

Cells in the prostate gland produce PSA, and levels typically remain below 4 nanograms per milliliter (ng/mL)Trusted Source. A person’s PSA levels tend to increase slowly with age.

People who are more than 50 years of ageTrusted Source should speak with their doctor about their risk of developing prostate cancer. They can also discuss the benefits and risks of PSA screening for them.

Urologists use age adjustment to put an elevated PSA in perspective for an older individual. For example, they consider a PSA of above 3 as elevated for an individual aged between 50 and 69 years.

Additionally, the Prevention Services Task Force does not recommend prostate cancer screening for people 70 years or older.

It is important for a person to discuss screening options with a doctor.

Prostatitis involves the inflammation of the prostate. It can be a chronic condition. The condition may sometimes occur due to a bacterial infection.

People with prostatitis may showTrusted Source elevated PSA numbers in test results.

Someone with prostatitis may experience the following symptoms alongside elevated PSA levels:

Benign prostatic hyperplasia (BPH) is an enlarged prostate that can raiseTrusted Source PSA levels. BPH is a common condition in males over the age of 50 years.

BPH does not increase the risk of cancer, but the symptoms can be similar to prostate cancer. A person with BPH will often experience irritation while urinating.

Medical procedures on the prostate can elevateTrusted Source PSA levels.

A recent prostate exam can cause false positives on a PSA test. Likewise, this can occur after inserting a urinary catheter or scope into the urethra.

For the most accurate results, a person should wait up to 6 weeks after a medical procedure before undergoing PSA testing. Alternatively, they can have the PSA test before the procedure.

A urinary tract infection (UTI) is an infection of the urethra or bladder that can cause PSA levels to rise.

Having a UTI can cause:

  • pain during urination
  • blood in the urine
  • an inability to urinate

In most cases, a urine test can accurately diagnose a UTI.

Ejaculation may causeTrusted Source PSA levels to rise for a short time.

People who have scheduled a PSA test should tell their doctors about any prostate symptoms they may be experiencing. Changes in ejaculation or urination often indicate a problem with the prostate.

The following symptoms could indicate a prostate issue:

A person’s PSA levels may rise if their prostate experiences stimulation during sex or if they receive anal sex.

A healthcare professional may recommend avoiding sexual activity for around 1 week before having a PSA test.

Cycling and doing other forms of vigorous exercise within 2 days before a PSA test may result in higher PSA levels.

More research into this is necessary. A person may consider asking a doctor about exercise recommendations before scheduling a PSA test.

The PSA test is a blood test. If a doctor finds elevated PSA levels during the test, they may orderTrusted Source a second PSA test to confirm the finding.

Depending on a person’s symptoms, they may recommend watchful waiting or further testing.

Watchful waiting involves monitoring the individual’s symptoms for any changes over time.

Additional tests the doctor may order include:

  • digital rectal exams, during which a doctor inserts a finger into the rectum to check the prostate for anomalies
  • prostate biopsy
  • MRI
  • high-resolution micro-ultrasound

A person’s doctor can advise on what tests they recommend based on the PSA test findings and any symptoms the individual is experiencing.

Elevated PSA levels will not cause any symptoms directly. A person may not know that they have elevated PSA levels until they receive routine screening for prostate cancer, at which point they might not haveTrusted Source any symptoms at all.

If raised PSA levels are due to prostate cancer, a person might not experience any symptoms until the cancer advances.

Other underlying conditions may cause symptoms. It is important to inform a doctor about any symptoms a person is experiencing, as this may help them reach an accurate diagnosis.

A 2017 studyTrusted Source noted that people who knew they had high PSA levels experienced feelings of uncertainty, anxiety, and depression. If a person is feeling uncertain about their health, they may feel negative emotions more frequently.

People who know that their PSA levels are high may find it helpful to seek further advice from a healthcare professional.

Prostate cancer can lead to elevated blood PSA levels.

However, a 2021 reviewTrusted Source stated that many factors besides prostate cancer can raise the level of PSA in a person’s blood. Among individuals with high levels of blood PSA, only 2% will have a form of prostate cancer requiring medical intervention.

If PSA levels are between 4 and 10 ng/mLTrusted Source, there is around a 1 in 4 chance that this is due to prostate cancer.

If PSA levels are above 10 ng/mL, the likelihood of this being due to prostate cancer is above 50%.

Prostate cancer may not cause any symptoms. However, symptoms may include:

These symptoms are similar to those of other prostate conditions, including prostatitis and BPH.

A person with symptoms of a prostate issue will typically need additional testing to help with diagnosis.

Several factors can cause a person to have elevated PSA levels. These include older age, prostatitis, benign prostatic hyperplasia, and urinary tract infections. Recent medical procedures, cycling, ejaculation, and prostate stimulation may also elevate PSA levels.

Individuals should speak with a doctor if they are experiencing symptoms of prostate cancer or if they wish to find out more about PSA testing.