From the Guidelines
Before taking a Prostate-Specific Antigen (PSA) test, patients should avoid ejaculation and vigorous exercise, such as cycling, for at least 2 days prior to the test. This is because these activities can cause false positive elevation of PSA levels, as noted in the clinical practice guideline on prostate cancer screening with PSA testing 1.
Key Precautions
- Avoid vigorous exercise, especially cycling, for 2 days before the test, as this may result in false positive elevation of PSA levels 1.
- Avoid ejaculation in the 2 days prior to PSA testing, as this may also result in false positive elevation of PSA levels 1.
- Inform their doctor about any medications they're taking, particularly finasteride and dutasteride, as these can lower PSA levels and affect result interpretation 1.
Additional Considerations
- Patients should be aware that digital rectal examinations (DREs) and prostate biopsies can also affect PSA levels, but the primary concern before a PSA test is to avoid activities that can cause temporary elevations, such as vigorous exercise and ejaculation 1.
- It's also important for patients to follow their doctor's specific instructions regarding any medications, such as blood thinners, that may need to be stopped before a prostate biopsy procedure, although this is more relevant to the biopsy itself rather than the PSA test 1.
From the FDA Drug Label
To interpret an isolated PSA value in patients treated with finasteride tablets for six months or more, PSA values should be doubled for comparison with normal ranges in untreated men. Dutasteride capsules will reduce the amount of PSA measured in your blood Your healthcare provider is aware of this effect and can still use PSA to see if you might have prostate cancer. Increases in your PSA levels while on treatment with dutasteride capsules (even if the PSA levels are in the normal range) should be evaluated by your healthcare provider. The patient should avoid taking 5α-reductase inhibitors such as finasteride or dutasteride for at least 6 months before taking a Prostate-Specific Antigen (PSA) test, as these medications can decrease serum PSA concentration by approximately 50%. If the patient is already taking these medications, the PSA values should be doubled for comparison with normal ranges in untreated men 2, 3.
From the Research
Pre-PSA Test Precautions
Before taking a Prostate-Specific Antigen (PSA) test, there are certain things a patient should avoid to ensure accurate results.
- Medications: Patients should inform their doctor about any medications they are taking, especially finasteride or dutasteride, as these can affect PSA levels 4, 5, 6, 7, 8.
- Recent prostate procedures: Patients should avoid having a PSA test after recent prostate procedures, such as a prostate biopsy, as this can cause a temporary increase in PSA levels.
- Urinary tract infections: Patients should avoid having a PSA test if they have a urinary tract infection, as this can also cause a temporary increase in PSA levels.
- Prostate manipulation: Patients should avoid any activities that may cause prostate manipulation, such as a digital rectal exam or cystoscopy, for at least 48 hours before the test.
Additional Considerations
It is essential to note that the use of finasteride or dutasteride can decrease PSA levels, and patients taking these medications may need to have their PSA results adjusted accordingly 4, 5, 6, 7, 8.
- PSA velocity: The rate of change of PSA levels over time (PSA velocity) may be a more reliable indicator of prostate cancer risk in patients taking finasteride or dutasteride 5, 6.
- Biopsy thresholds: Patients taking dutasteride may require different biopsy thresholds to detect high-grade prostate cancer 5.
By avoiding certain activities and medications before the test and considering the effects of finasteride and dutasteride on PSA levels, patients can help ensure accurate results and reliable diagnosis.