How can I lower my PSA? Is it a concern?

[Virginian]

My doctor is concerned that my PSA seems to be higher than it used to be. Before TRT, my PSA levels were generally between 1 and 2. Now on TRT they are running between 2.5 and 4.

What can I do to get PSA levels down? Just how significant is the elevated PSA level? What is the concern?

 

[Mprtz]

Do you have any prostate symptoms? Elevated PSA can be due to prostate enlargement. Prostate enlargement has traditionally been considered one of the side effects of androgens.
Have you had a DRE? I'm sure there's ultrasound, etc. that can measure prostatic volume.

The primary concern is that rising PSA is also a possible sign of prostate cancer. If this is suspected, a biopsy may be performed. I don't think a level of 2.5 to 4 warrants that level of concern. I'd keep an eye on it.

Make sure your E2 is under control, that caused me some prostate irritation early on. Now my prostate feels better than before I started TRT and my PSA has remained below or at 1.

 

[tmangh]

Are you aware of the several factors that can elevater your PSA levels prior to testing? Your doctor should have made you aware of them....

Between 4-10 your chances go up 25 percent. 10 and up is 50 percent.

 

[Megatron28]

Manage your estradiol so it doesn't go above the normal range. Ideally keep it in the 20-30pg/ml range.

 

[Dean407]

My Dad's PSA *always* ran very high. His very first PSA when he was in his late 40's came back in the TEENS. He's 65 now and has had 4 or 5 biopsies and many blood tests that showed his PSA going well into the 30's. No biopsy has come back positive.

At the age of 43 I decided to get my PSA checked as a curiosity. My digital exam was fine, but I was curious. I expected it to come back high.

Well, it did come back high. 4.1 and 3.9

My urologist wouldn't proceed with TRT without getting a biopsy. Mine came back just fine as well.

My urologist told me that my prostate was slightly enlarged for my age, but not by much.

My point is that a high PSA isn't an automatic cause to freak out.

It seems wise to get a baseline PSA and get it checked frequently.

If you do get a biopsy, just make sure they will utilize the numbing needle before taking the core samples. The anxiety of what it would feel like was FAR worse then the actual procedure!

Even the numbing needle wasn't bad. The needle goes in VERY slowly as it injects the numbing agent. I only felt a little pressure, to my relief.

To get the 12 core samples a needle "gun" is used. It makes a loud sound and quickly punctures you. I'd say of all 12 samples pulled only 1 hurt but not terribly so. A couple more had more pressure then the rest.

I was able to joke around and tell the Urologist he could have at least got me a nice dinner before violating me and if I saw him smoking after we were done I'd be upset.

For about 4-6 weeks afterwards there were remnants of blood in my semen and my ejaculations felt weak and the sexual sensations were dulled a bit. It slowly got better. My total out of pocket for the procedure was $121 after insurance.

Hope this helps...