From the Guidelines
Avoid vigorous exercise, such as cycling, and other strenuous activities for at least 2 days prior to PSA testing, as this may result in false positive elevation. When considering activities before a PSA test, it's essential to prioritize those that minimize the risk of false positives. According to the clinical practice guideline on prostate cancer screening with prostate-specific antigen (PSA) test 1, vigorous exercise and physical activities can lead to elevated PSA levels.
- Strenuous activities to avoid include:
- Cycling
- Horseback riding
- Motorcycle riding
- Sexual activity, especially ejaculation
- High-intensity workouts
- It's also crucial to avoid prostate manipulation procedures, such as digital rectal exams, prostate massage, prostate biopsy, or cystoscopy, for at least a week before the test, as these can temporarily elevate PSA levels in the bloodstream 1.
- Normal daily activities like walking, light housework, or gentle stretching are generally fine and won't affect your PSA results.
- Always follow any specific pre-test instructions provided by your healthcare provider, as they may have additional recommendations based on your individual health situation, as outlined in the guideline on prostate cancer screening with PSA test 1.
From the Research
Strenuous Activities Before a PSA Test
There are no specific studies provided that directly address what is considered a strenuous activity before a PSA test. However, some studies discuss factors that can affect PSA levels:
- Inflammation and benign prostatic hyperplasia can cause elevated serum PSA levels 2.
- Prostatic subclinical inflammation is not associated with high urinary PSA, but aggressiveness of inflammation is correlated with serum PSA 3.
- Sexual dysfunction in elderly men with benign prostatic hyperplasia can lead to prostatic inflammation, which affects the positive predictive value of PSA 4.
- Repeating a PSA test in patients with an elevated PSA level is associated with decreased risk of prostate biopsy and prostate cancer diagnosis 5.
Factors Affecting PSA Levels
Some factors that can affect PSA levels include:
- Prostate volume: larger prostates can contribute to elevated PSA levels 2.
- Inflammation: acute and chronic inflammation can contribute to elevated PSA levels 2.
- Prostatic calculi: can contribute to elevated PSA levels, but to a lesser extent 2.
- Nonisoechoic ultrasound lesions: can contribute to elevated PSA levels, but to a lesser extent 2.