What is Prostate-Specific Antigen?
Prostate-specific antigen (PSA) is a protein made by the prostate gland that helps sperm move more easily by keeping semen in a liquid state. Small amounts of PSA normally enter the bloodstream. But when prostate tissue becomes irritated, inflamed, infected, enlarged, or begins growing abnormally, more PSA can leak into the blood.
As men age, PSA levels often gradually increase due to conditions such as benign prostate enlargement (a common, noncancerous increase in prostate size).
Why Does PSA Matter?
- Supports sperm motility and fertility by liquefying semen so it can move freely into a woman’s cervix
- Provides insight into prostate health by indicating possible prostate enlargement, inflammation, or malignancy
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How to Interpret PSA?
(Ranges may vary slightly by lab)
Standard reference ranges represent the middle 95% of healthy individuals but don’t necessarily reflect levels associated with longevity. Optimal ranges are derived from clinical guidelines, peer-reviewed research, and real-world outcomes data, with an emphasis on levels associated with peak functioning and reduced disease risk.
Benefits of Having PSA in a Healthy Range
- Optimal prostate function
- Preserved urinary function
- Lower chronic inflammation
- Lower risk of prostate cancer
- Lower risk of progressive benign prostatic hyperplasia
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Low PSA Levels
Low PSA levels (typically below 3-4 ng/mL) are considered normal and may suggest a lower risk of prostate cancer.
High PSA Levels
PSA levels above 4 ng/mL may signal that something is affecting the prostate. It does not automatically mean cancer.
Recent ejaculation can temporarily cause PSA to spike. For accurate evaulation avoid ejaculating 24-48 hours before your test.
Symptoms:
- Frequent or urgent urination
- Difficulty starting urination
- Urinary leakage
- Weak urinary flow
- Waking at night to urinate
- Blood in urine or semen
- Pelvic pain
- Erectile dysfunction
- Unexplained weight loss
Causes:
- Enlarged prostate
- Prostatitis/infection
- Age
- Prostate cancer
Healthspan Impacts:
How Hone Treats Out of Range PSA
Because high PSA levels reflect prostate activity, not a disease itself, treatment focuses on identifying and addressing the underlying cause of elevation, whether that’s inflammation, enlargement, or something that requires further urologic evaluation. Based on the cause, your Hone physician will create a treatment plan that may include medications, supplements, and lifestyle changes.
- 5-alpha reductase inhibitors (e.g., finasteride or dutasteride) — to reduce DHT activity and slow prostate enlargement in men with severe BPH
- Antibiotics* – to treat bacterial prostatitis
*Your Hone Physician does not prescribe these treatments but will recommend further evaluation and help coordinate care with your primary care provider when medical treatment is indicated.
- Saw palmetto
- Beta-sitosterol3
- Limit alcohol consumption
- Avoid delaying urination when you feel the urge
- Engage in regular physical activity
- Incorporate more lycopene-rich (tomatoes; guava) foods into your diet4
Maeda-Minami, A., et al. (2023). Association of PSA variability with prostate cancer development using large-scale medical information data: A retrospective cohort study. Genes and Environment.
↑Jehle, D. V. K., et al. (2024). PSA Levels and Mortality in Prostate Cancer Patients. Clinical Genitourinary Cancer.
↑Macoska, J. A. (2023). The use of beta-sitosterol for the treatment of prostate cancer and benign prostatic hyperplasia. American Journal of Clinical and Experimental Urology.
↑Kapała, A., Szlendak, M., & Motacka, E. (2022). The Anti-Cancer Activity of Lycopene: A Systematic Review of Human and Animal Studies. Nutrients.
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Reviewed for Accuracy by Our Medical Review Board
This biomarker information has been reviewed by a member of Hone’s medical review board. As part of the medical review team, physicians fact-check this content against the latest research and their own experience treating their patients.
Ashley Winter, M.D., is a board-certified urogynecologist trained at Weill Cornell and Cleveland Clinic. She specializes in female and male sexual dysfunction, urinary issues, genital pain, and hormone therapy.
James Staheli, D.O., is the Medical Director for Broad Health, Hone Health’s affiliated medical practice and a family medicine doctor in Atlanta, Georgia.
