Prostate-specific antigen (PSA) is a protein produced by the prostate gland. A test result of 10 nanograms of PSA per milliliter (ng/mL) of blood is generally considered high. Although an elevated PSA is often associated with cancer, this can happen for a variety of reasons.

PSA levels aren’t a good indicator of prostate health on their own. Instead, your healthcare professional will consider other risk factors, like age, digital rectal exam results, and family history.

Keep reading to learn more about why your PSA levels may be high.

PSA levels may increase as you get older.

This natural rise may be caused by the growth of benign prostatic tissue.

BPH, also known as enlarged prostate, is common in older adults. BPH can increase PSA levels and affect the bladder and urinary tract.

Symptoms may include:

  • difficulty initiating urination
  • weak urine output, including dribbling or straining or stops and starts during urination
  • frequent urination
  • urgent need to urinate
  • inability to fully relieve the bladder

BPH only requires treatment if symptoms affect your quality of life or overall health. Treatments include medications, such as alpha-blockers or 5-alpha reductase inhibitors.

If your symptoms are severe or do not respond to medication, your healthcare professional may recommend a minimally invasive surgical procedure or laser therapy.

UTIs may spike PSA levels.

Symptoms may include:

  • burning or painful urination
  • cloudy, foul-smelling, or bloody urine
  • frequent urination
  • inability to fully relieve the bladder
  • urgent need to urinate

UTIs become more common as you age. Other factors may also increase your risk, including:

Consult with a healthcare professional if you think you have a UTI. They’re usually diagnosed through a urine test and treated with antibiotics.

If you have high PSA levels and a known UTI, you must wait until you’ve recovered from your UTI before repeating the PSA test.

Prostatitis is often the result of a bacterial infection. It causes swelling, inflammation, and irritation of the prostate gland.

Symptoms may include:

  • difficult or painful urination
  • pressure in the rectum
  • difficulty ejaculating

If bacterial infection is causing your prostatitis, you may also experience flu-like symptoms and be treated with antibiotics.

Nerve damage in the urinary tract may also cause prostatitis. This can occur as a result of injury or as a surgical complication. If no infection is found, anti-inflammatory medication or alpha-blockers may be used to reduce discomfort.

One 2016 study found that PSA levels rise in some people after ejaculation. They may remain higher than their typical baseline level for up to 24 hours afterward.

More research is needed to understand the potential effects of ejaculation on PSA levels fully. However, if you have a PSA test scheduled, consider abstaining from sexual activities that may result in ejaculation for 24 hours before the test.

PTH is a naturally occurring hormone the body produces to regulate calcium levels in the blood.

It may also promote prostate cancer cell growth, even in people who do not have prostate cancer. For this reason, high levels of parathyroid hormone may escalate PSA levels.

An injury to the groin may temporarily spike PSA levels. If you suspect a fall, impact, or other injury may have affected your PSA levels, let your healthcare professional know.

Any procedure that causes temporary bruising or trauma to the groin can affect PSA levels.

This can include inserting any type of instrument, such as a catheter or surgical scope, into the bladder.

Prostate cancer can cause your PSA levels to increase, so your healthcare professional may recommend that you get a PSA blood test in conjunction with other tests, such as a digital rectal exam, to assess your potential risk.

Healthcare professionals often recommend PSA testing at age 50. Your doctor may recommend testing your levels at an earlier age if you have known risk factors for prostate cancer, like a family history of the disease.

If your PSA levels are high and other diagnostic tests also indicate an increased risk for prostate cancer, your healthcare professional will likely recommend a biopsy to confirm a prostate cancer diagnosis.

Prostate cancer is generally slow-growing, so some people may prefer to hold off on a biopsy in favor of watchful waiting. Your clinician will go over all of your options and explain the risks associated with each option.

Getting a second medical opinion can help put your mind at ease about your current care or give you a different perspective, which may help you to decide upon your best options for treatment.

If your healthcare professional recommends PSA testing or further testing or biopsy after a PSA test, make sure to discuss the benefits versus the risks of each procedure being recommended.

It’s important to remember that elevated PSA levels can mean many things. If a biopsy or other testing feels medically necessary, make sure to weigh the benefits versus the risks of each test.

Prostate cancer, especially when caught early, is treatable. Many other causes of elevated PSA are also treatable.