Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Increase In PSA Levels While On Exogenous Testosterone?
Question: My PSA has increases from 3.2 in December to 5.3 in January to 7.3 in February while on exogenous testosterone. If this is due to enlarged prostate, how fast does the prostrate grow in the presence of testosterone and how quickly will it shrink once I stop? No symptoms of LUTs yet but thinking ahead. Thanks
Brief Answer:
Strongly suggest prostate biopsy.
Detailed Answer:
Good Day and thank you for being with Healthcare Magic!
It's is really hard to say if that is because of prostate enlargement or not. Definitely there are reports that exogenous testosterone would increase the PSA of some but not all patients. What is your baseline prostate size before the testosterone treatment ?
My suggestion is to get a prostate biopsy to determine if you are are currently harboring prostate cancer. That's is the only way to find out. The rapid increase in your PSA increases your risk of having prostate cancer. Testosterone should not have cause the increase your PSA by that much.
Anything short of not having a prostate biopsy would be speculative. Another option would be to stop the testosterone and recheck the PSA after 2 weeks since the half life of PSA is 3-5 days. It will depend if you got the patch or the injections for your testosterone when will it be out of your system.
I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.HealthcareMagic.com/doctors/dr-manuel-c-see-iv/66014 I would gladly help you. Best wishes
Strongly suggest prostate biopsy.
Detailed Answer:
Good Day and thank you for being with Healthcare Magic!
It's is really hard to say if that is because of prostate enlargement or not. Definitely there are reports that exogenous testosterone would increase the PSA of some but not all patients. What is your baseline prostate size before the testosterone treatment ?
My suggestion is to get a prostate biopsy to determine if you are are currently harboring prostate cancer. That's is the only way to find out. The rapid increase in your PSA increases your risk of having prostate cancer. Testosterone should not have cause the increase your PSA by that much.
Anything short of not having a prostate biopsy would be speculative. Another option would be to stop the testosterone and recheck the PSA after 2 weeks since the half life of PSA is 3-5 days. It will depend if you got the patch or the injections for your testosterone when will it be out of your system.
I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.HealthcareMagic.com/doctors/dr-manuel-c-see-iv/66014 I would gladly help you. Best wishes
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I recognize there is a rosk of pc and will address that separately but my question specifocally related to prostate volume changes due to testosterone. M baseline was 27.7 with a 3.25 psa. So IF ithe psa increase was due to colume growth from testosterone, how quickly should psa decline (and volume size) after i stop? y
Brief Answer:
One month and you should see results.
Detailed Answer:
Good Day and thank you your follow up question.
Several studies have shown that there is only a small increase in prostate size and elevation in PSA in men with exogenous testosterone therapy. (~10%)
If ever your PSA elevation is due to the testosterone. you should see the drop 1 month after the last testosterone therapy.
Regards, Manuel C. See IV, M.D. DPBU FPUA
One month and you should see results.
Detailed Answer:
Good Day and thank you your follow up question.
Several studies have shown that there is only a small increase in prostate size and elevation in PSA in men with exogenous testosterone therapy. (~10%)
If ever your PSA elevation is due to the testosterone. you should see the drop 1 month after the last testosterone therapy.
Regards, Manuel C. See IV, M.D. DPBU FPUA
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So to clarify, if bph or prostatitis, my psa should drop back to 3.25 in a month after stopping. What would the psa do if ot is cancer? Would it drop by mot as much? Flatten? Thank tou for tour help.
Brief Answer:
Pls see detailed answer.
Detailed Answer:
yes if BPH or prostatitis it should return to your baseline PSA. Elevations in PSA would be because of infection or inflammation and prostate cancer. Like I said earlier testosterone doesn't really increase the size of the prostate. Your prostate size should remain almost the same as before or slightly increase in size.
Regards, Manuel C. See IV, M.D. DPBU FPUA
Pls see detailed answer.
Detailed Answer:
yes if BPH or prostatitis it should return to your baseline PSA. Elevations in PSA would be because of infection or inflammation and prostate cancer. Like I said earlier testosterone doesn't really increase the size of the prostate. Your prostate size should remain almost the same as before or slightly increase in size.
Regards, Manuel C. See IV, M.D. DPBU FPUA
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. A couple of clarifications/confirmations. You indicated persistent rise would be caused by inflamation/infection. What is the dofference between that and prostatitis? I thought it was the same? Also, do i understand you corrctly that if psa declines after i stop testosterone, It is probably something other than cancer? (Said differently, if it is cancer, the psa will remain at 7.3 or higher?). Does it make a difference that at 7.3 my free psa was 18% and at 5.3 free psa was 15%? If mu vilume is the same, obviously PSAD is above the comfort range but %free seems to indicate prostatitis. I have a uro appt tondiscuss biopsy scheduled but its not for a few weeks. Thanks .
Brief Answer:
pls see detailed answer.
Detailed Answer:
Good Day and thank you for your clarifications.
Infection can cause prostatitis but prostatitis/inflammation is not always due to infection. Orher causes may cause prostatitis, this is what we call Abacterial prostatitis.
Yes a decline in PSA is always a good sign because in prostate cancer, the psa rarely decreases without treatment and the trend would always to go up.
The free PSA of 18% is also another sign that you may have a benign cause of your elevation in PSA. The higher the free PSA the higher the chance that you don't have cancer.
Regards, Manuel C. See IV, M.D. DPBU FPUA
pls see detailed answer.
Detailed Answer:
Good Day and thank you for your clarifications.
Infection can cause prostatitis but prostatitis/inflammation is not always due to infection. Orher causes may cause prostatitis, this is what we call Abacterial prostatitis.
Yes a decline in PSA is always a good sign because in prostate cancer, the psa rarely decreases without treatment and the trend would always to go up.
The free PSA of 18% is also another sign that you may have a benign cause of your elevation in PSA. The higher the free PSA the higher the chance that you don't have cancer.
Regards, Manuel C. See IV, M.D. DPBU FPUA
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
