From the Research
After ejaculation, PSA levels typically return to baseline within 24-48 hours, and it is generally recommended to abstain from ejaculation for 48 hours before a PSA blood test to ensure accurate results. For most men, PSA levels rise temporarily following ejaculation as the prostate releases this protein into seminal fluid, and some enters the bloodstream during sexual activity. This temporary elevation is usually modest, increasing by about 0.4-0.5 ng/mL on average, though individual responses vary 1. The temporary rise occurs because ejaculation causes contraction of the prostate gland, which can release additional PSA into the bloodstream. If you're scheduled for a PSA test, following this 48-hour abstinence guideline helps avoid false elevations that might lead to unnecessary concern or additional testing.
Some key points to consider:
- PSA levels can be affected by ejaculation, with a significant increase in the serum PSA concentration in men between 49 and 79 years of age that may persist for up to 48 hours 2.
- The effect of ejaculation on serum PSA levels may be clinically important when the PSA value is borderline with respect to biopsy decisions, and in these patients, ejaculation must be questioned, and repeated PSA levels should be evaluated 24 hours after ejaculation 1.
- The number of PSA determinations in the general population is estimated to be 45/1,000 person-years at ages 55 to 69 years, and PSA testing was moderate in the control arm but if different men undergo this test each year, the contamination rate may become rather high 3.
It's essential to note that individual responses to ejaculation may vary, and the impact of ejaculation on PSA levels can be influenced by factors such as age and baseline PSA level 2, 1. However, based on the most recent and highest quality study, abstaining from ejaculation for 48 hours before a PSA blood test is the recommended guideline to ensure accurate results 1.