Table of ContentsView AllTable of ContentsWhat Is a PSA Test?Medications That Increase PSA LevelsMedications That Lower PSA LevelsOther Causes for High PSA Levels
Table of ContentsView All
View All
Table of Contents
What Is a PSA Test?
Medications That Increase PSA Levels
Medications That Lower PSA Levels
Other Causes for High PSA Levels
Prostate-specific antigen (PSA)is a protein the prostate produces from both normal and abnormal cells. The prostate is amale reproductive organthat produces and transports reproductive fluid.
ThePSA test, a lab test, is used to measure how much PSA is in the blood.
Higher PSA levels may indicate that there is a problem with the prostate, such as:
PSA tests are most notably a screening tool to help determine if an individual may have prostate cancer.However, taking certain medications can increase these PSA levels, which can cause misleading results.
This article discusses factors that affect PSA levels, including medications that can alter these test results.
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The PSA test is not a routine lab test for most people. PSA testing typically begins around age 55. In higher-risk individuals, PSA screening may begin as early as 40.
Because the PSA test is a screening test, it is not for diagnostic purposes.Prostate cancer is often diagnosed after an elevated PSA is detected and additional testing and imaging, such as aprostate biopsy, are completed.
Anabnormal PSA leveldoes not always mean something is wrong. Age, race, and taking certain medications can impact PSA levels.
It is important to be aware of which medications have the potential to increase PSA levels. Inform your healthcare provider if you are taking any of these medications before having PSA levels tested to help ensure results are interpreted accurately.
It is important to be aware of medications that can increase PSA levels. This way, you can make informed decisions regarding your health, avoid unnecessary concerns, and ensure appropriate follow-up monitoring is complete.
Betamethasone
Betamethasone is acorticosteroid medication.It is available in oral, topical, transdermal, and injectable formulations. It treats symptoms associated with several skin conditions.
Androgens are a class ofsex hormones, withtestosteronebeing the most prominent androgen. Androgen receptors play a significant role in the development and progression of prostate cancer, hence the potential impact of increased PSA in those using topical betamethasone.
Additional research is necessary to determine the actual impact of betamethasone on PSA levels in the blood of people living with prostate cancer as well as those undergoing screening for prostate cancer.
Testosterone Replacement Therapy
Testosterone is involved in several processes throughout the body. Clinically, testosterone deficiency is defined as having low testosterone levels, considered 300 nanograms (ng) per deciliter (dL). Symptoms of testosterone deficiency include:
Testosterone replacement therapy refers to any type of treatment for increasing serum testosterone levels, including:
The goal of testosterone replacement therapy is to raise testosterone levels to normal and achieve resolution of symptoms.
Testosterone replacement therapy, particularly when given as an injection into the muscle, has been associated with a rise in PSA levels that is dependent on testosterone levels at baseline. People with lower initial testosterone levels are more likely to experience increases in PSA.
The U.S. Food and Drug Administration (FDA) has issued a warning regarding the risk of prostate cancer in those on testosterone therapy. However, clinical trials and research have failed to provide a definitive link between the cancer and the therapy.
What Is Considered a High PSA Level?Your provider will be able to interpret your PSA results. In general, a PSA level is considered normal if it is less than 4 ng/mL. A PSA level between 4 and 10 ng/mL is considered borderline, and greater than 10 ng/mL is considered high.It is important to note that even PSA levels considered to be high are not diagnostic. It is possible to have what is considered a normal PSA and still have prostate problems. Conversely, high PSA levels do not necessarily mean there is something wrong with the prostate.
What Is Considered a High PSA Level?
Your provider will be able to interpret your PSA results. In general, a PSA level is considered normal if it is less than 4 ng/mL. A PSA level between 4 and 10 ng/mL is considered borderline, and greater than 10 ng/mL is considered high.It is important to note that even PSA levels considered to be high are not diagnostic. It is possible to have what is considered a normal PSA and still have prostate problems. Conversely, high PSA levels do not necessarily mean there is something wrong with the prostate.
Your provider will be able to interpret your PSA results. In general, a PSA level is considered normal if it is less than 4 ng/mL. A PSA level between 4 and 10 ng/mL is considered borderline, and greater than 10 ng/mL is considered high.
It is important to note that even PSA levels considered to be high are not diagnostic. It is possible to have what is considered a normal PSA and still have prostate problems. Conversely, high PSA levels do not necessarily mean there is something wrong with the prostate.
Medications can lower PSA levels through a variety of different processes depending on the medication. The following medications can lower PSA levels:
5-ARIs
5-ARIs are commonly taken over long periods to treat BPH. Drugs in this class have been shown to suppress PSA, resulting in a nearly 50% decrease in levels.
Statins
Statins help lower cholesterol and reduce heart disease risk in high-risk people. They have been associated with up to a 13% decrease in PSA levels when used long-term.
Thiazide Diuretics
NSAIDs
Though these medications may lower PSA levels when taken long-term, additional studies are necessary to determine if they may also reduce the risk of prostate cancer.
Besides medications, other factors can contribute to high PSA levels, such as:
Understanding which factors can influence PSA results allows you to provide valuable insights that your healthcare provider may have otherwise not known. This can aid in their assessment of your prostate health.
Summary
PSA testing usually begins around age 55 but may begin sooner for high-risk individuals. The PSA test is a screening tool and should not be used for diagnosis. If your PSA is elevated, the lab may be repeated, or additional imaging may be required. A PSA level of less than 4 ng/mL is typically considered normal.
However, having an elevated PSA does not necessarily mean something is wrong. In some cases, taking certain medications can affect how high or low your levels are. Betamethasone and testosterone replacement therapy, for example, have been shown to increase PSA levels. This means you should tell your healthcare provider if you take these medications before PSA testing.
Talk to your provider if you are taking or considering taking a medication that has the potential to impact your PSA levels to help ensure your prostate health is accurately assessed.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Cancer Institute.Anatomy of the prostate.National Cancer Institute.Prostate-specific antigen (PSA) test.MedlinePlus.Prostate-specific antigen (PSA) test.American Cancer Society.Screening tests for prostate cancer.Chang SL, Harshman LC, Presti JC Jr.Impact of common medications on serum total prostate-specific antigen levels: analysis of the National Health and Nutrition Examination Survey.J Clin Oncol. 2010;28(25):3951-3957. doi:10.1200/JCO.2009.27.9406DailyMed.Label: Betamethasone dipropionate cream, betamethasone dipropionate cream ointment, betamethasone dipropionate lotion.Iguchi K, Hashimoto M, Kubota M, et al.Effects of 14 frequently used drugs on prostate-specific antigen expression in prostate cancer LNCaP cells.Oncol Lett.2014;7(5):1665–1668. doi:10.3892/ol.2014.1936Aurilio G, Cimadamore A, Mazzucchelli R, et al.Androgen receptor signaling pathway in prostate cancer: from genetics to clinical application.Cells.2020;9(12):2653. doi:10.3390/cells9122653Mulhall JP, Trost LW, Brannigan RE, et al.Evaluation and management of testosterone deficiency: AUA guideline.J Urol. 2018;200(2):423-432. doi:10.1016/j.juro.2018.03.115Thirumalai A, Berkseth KE, Amory JK.Treatment of hypogonadism: current and future therapies.F1000Research.2017;6,68. doi.org/10.12688/f1000research.10102.1Cunningham GR, Ellenberg SS, Bhasin S, et al.Prostate-specific antigen levels during testosterone treatment of hypogonadal older men: data from a controlled trial.J Clin Endocrinol Metab. 2019;104(12):6238-6246. doi:10.1210/jc.2019-00806Kim DK, Noh JW, Chang Y, et al.Association between prostate-specific antigen and serum testosterone: a systematic review and meta-analysis.Andrology. 2020;8(5):1194-1213. doi:10.1111/andr.12806Busato WFS Júnior.Use of 5α-reductase inhibitor and delay in prostate cancer diagnosis and treatment.Int Braz J Urol. 2020;46(3):456-458. doi:10.1590/S1677-5538.IBJU.2020.03.02Fowke JH, Motley SS, Barocas DA, et al.The associations between statin use and prostate cancer screening, prostate size, high-grade prostatic intraepithelial neoplasia (PIN), and prostate cancer.Cancer Causes Control. 2011;22(3):417-26. doi:10.1007/s10552-010-9713-4Singer EA, Palapattu GS, van Wijngaarden E.Prostate‐specific antigen levels in relation to consumption of nonsteroidal anti‐inflammatory drugs and acetaminophen: Results from the 2001–2002 National Health and Nutrition Examination Survey.Cancer.2008;113(8), 2053-2057. doi.org/10.1002/cncr.23806Centers for Disease Control and Prevention.What is screening for prostate cancer?
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Cancer Institute.Anatomy of the prostate.National Cancer Institute.Prostate-specific antigen (PSA) test.MedlinePlus.Prostate-specific antigen (PSA) test.American Cancer Society.Screening tests for prostate cancer.Chang SL, Harshman LC, Presti JC Jr.Impact of common medications on serum total prostate-specific antigen levels: analysis of the National Health and Nutrition Examination Survey.J Clin Oncol. 2010;28(25):3951-3957. doi:10.1200/JCO.2009.27.9406DailyMed.Label: Betamethasone dipropionate cream, betamethasone dipropionate cream ointment, betamethasone dipropionate lotion.Iguchi K, Hashimoto M, Kubota M, et al.Effects of 14 frequently used drugs on prostate-specific antigen expression in prostate cancer LNCaP cells.Oncol Lett.2014;7(5):1665–1668. doi:10.3892/ol.2014.1936Aurilio G, Cimadamore A, Mazzucchelli R, et al.Androgen receptor signaling pathway in prostate cancer: from genetics to clinical application.Cells.2020;9(12):2653. doi:10.3390/cells9122653Mulhall JP, Trost LW, Brannigan RE, et al.Evaluation and management of testosterone deficiency: AUA guideline.J Urol. 2018;200(2):423-432. doi:10.1016/j.juro.2018.03.115Thirumalai A, Berkseth KE, Amory JK.Treatment of hypogonadism: current and future therapies.F1000Research.2017;6,68. doi.org/10.12688/f1000research.10102.1Cunningham GR, Ellenberg SS, Bhasin S, et al.Prostate-specific antigen levels during testosterone treatment of hypogonadal older men: data from a controlled trial.J Clin Endocrinol Metab. 2019;104(12):6238-6246. doi:10.1210/jc.2019-00806Kim DK, Noh JW, Chang Y, et al.Association between prostate-specific antigen and serum testosterone: a systematic review and meta-analysis.Andrology. 2020;8(5):1194-1213. doi:10.1111/andr.12806Busato WFS Júnior.Use of 5α-reductase inhibitor and delay in prostate cancer diagnosis and treatment.Int Braz J Urol. 2020;46(3):456-458. doi:10.1590/S1677-5538.IBJU.2020.03.02Fowke JH, Motley SS, Barocas DA, et al.The associations between statin use and prostate cancer screening, prostate size, high-grade prostatic intraepithelial neoplasia (PIN), and prostate cancer.Cancer Causes Control. 2011;22(3):417-26. doi:10.1007/s10552-010-9713-4Singer EA, Palapattu GS, van Wijngaarden E.Prostate‐specific antigen levels in relation to consumption of nonsteroidal anti‐inflammatory drugs and acetaminophen: Results from the 2001–2002 National Health and Nutrition Examination Survey.Cancer.2008;113(8), 2053-2057. doi.org/10.1002/cncr.23806Centers for Disease Control and Prevention.What is screening for prostate cancer?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Cancer Institute.Anatomy of the prostate.National Cancer Institute.Prostate-specific antigen (PSA) test.MedlinePlus.Prostate-specific antigen (PSA) test.American Cancer Society.Screening tests for prostate cancer.Chang SL, Harshman LC, Presti JC Jr.Impact of common medications on serum total prostate-specific antigen levels: analysis of the National Health and Nutrition Examination Survey.J Clin Oncol. 2010;28(25):3951-3957. doi:10.1200/JCO.2009.27.9406DailyMed.Label: Betamethasone dipropionate cream, betamethasone dipropionate cream ointment, betamethasone dipropionate lotion.Iguchi K, Hashimoto M, Kubota M, et al.Effects of 14 frequently used drugs on prostate-specific antigen expression in prostate cancer LNCaP cells.Oncol Lett.2014;7(5):1665–1668. doi:10.3892/ol.2014.1936Aurilio G, Cimadamore A, Mazzucchelli R, et al.Androgen receptor signaling pathway in prostate cancer: from genetics to clinical application.Cells.2020;9(12):2653. doi:10.3390/cells9122653Mulhall JP, Trost LW, Brannigan RE, et al.Evaluation and management of testosterone deficiency: AUA guideline.J Urol. 2018;200(2):423-432. doi:10.1016/j.juro.2018.03.115Thirumalai A, Berkseth KE, Amory JK.Treatment of hypogonadism: current and future therapies.F1000Research.2017;6,68. doi.org/10.12688/f1000research.10102.1Cunningham GR, Ellenberg SS, Bhasin S, et al.Prostate-specific antigen levels during testosterone treatment of hypogonadal older men: data from a controlled trial.J Clin Endocrinol Metab. 2019;104(12):6238-6246. doi:10.1210/jc.2019-00806Kim DK, Noh JW, Chang Y, et al.Association between prostate-specific antigen and serum testosterone: a systematic review and meta-analysis.Andrology. 2020;8(5):1194-1213. doi:10.1111/andr.12806Busato WFS Júnior.Use of 5α-reductase inhibitor and delay in prostate cancer diagnosis and treatment.Int Braz J Urol. 2020;46(3):456-458. doi:10.1590/S1677-5538.IBJU.2020.03.02Fowke JH, Motley SS, Barocas DA, et al.The associations between statin use and prostate cancer screening, prostate size, high-grade prostatic intraepithelial neoplasia (PIN), and prostate cancer.Cancer Causes Control. 2011;22(3):417-26. doi:10.1007/s10552-010-9713-4Singer EA, Palapattu GS, van Wijngaarden E.Prostate‐specific antigen levels in relation to consumption of nonsteroidal anti‐inflammatory drugs and acetaminophen: Results from the 2001–2002 National Health and Nutrition Examination Survey.Cancer.2008;113(8), 2053-2057. doi.org/10.1002/cncr.23806Centers for Disease Control and Prevention.What is screening for prostate cancer?
National Cancer Institute.Anatomy of the prostate.
National Cancer Institute.Prostate-specific antigen (PSA) test.
MedlinePlus.Prostate-specific antigen (PSA) test.
American Cancer Society.Screening tests for prostate cancer.
Chang SL, Harshman LC, Presti JC Jr.Impact of common medications on serum total prostate-specific antigen levels: analysis of the National Health and Nutrition Examination Survey.J Clin Oncol. 2010;28(25):3951-3957. doi:10.1200/JCO.2009.27.9406
DailyMed.Label: Betamethasone dipropionate cream, betamethasone dipropionate cream ointment, betamethasone dipropionate lotion.
Iguchi K, Hashimoto M, Kubota M, et al.Effects of 14 frequently used drugs on prostate-specific antigen expression in prostate cancer LNCaP cells.Oncol Lett.2014;7(5):1665–1668. doi:10.3892/ol.2014.1936
Aurilio G, Cimadamore A, Mazzucchelli R, et al.Androgen receptor signaling pathway in prostate cancer: from genetics to clinical application.Cells.2020;9(12):2653. doi:10.3390/cells9122653
Mulhall JP, Trost LW, Brannigan RE, et al.Evaluation and management of testosterone deficiency: AUA guideline.J Urol. 2018;200(2):423-432. doi:10.1016/j.juro.2018.03.115
Thirumalai A, Berkseth KE, Amory JK.Treatment of hypogonadism: current and future therapies.F1000Research.2017;6,68. doi.org/10.12688/f1000research.10102.1
Cunningham GR, Ellenberg SS, Bhasin S, et al.Prostate-specific antigen levels during testosterone treatment of hypogonadal older men: data from a controlled trial.J Clin Endocrinol Metab. 2019;104(12):6238-6246. doi:10.1210/jc.2019-00806
Kim DK, Noh JW, Chang Y, et al.Association between prostate-specific antigen and serum testosterone: a systematic review and meta-analysis.Andrology. 2020;8(5):1194-1213. doi:10.1111/andr.12806
Busato WFS Júnior.Use of 5α-reductase inhibitor and delay in prostate cancer diagnosis and treatment.Int Braz J Urol. 2020;46(3):456-458. doi:10.1590/S1677-5538.IBJU.2020.03.02
Fowke JH, Motley SS, Barocas DA, et al.The associations between statin use and prostate cancer screening, prostate size, high-grade prostatic intraepithelial neoplasia (PIN), and prostate cancer.Cancer Causes Control. 2011;22(3):417-26. doi:10.1007/s10552-010-9713-4
Singer EA, Palapattu GS, van Wijngaarden E.Prostate‐specific antigen levels in relation to consumption of nonsteroidal anti‐inflammatory drugs and acetaminophen: Results from the 2001–2002 National Health and Nutrition Examination Survey.Cancer.2008;113(8), 2053-2057. doi.org/10.1002/cncr.23806
Centers for Disease Control and Prevention.What is screening for prostate cancer?
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