From the Guidelines
You should abstain from ejaculation for at least 48 hours before a PSA test to ensure more reliable results. This guideline is based on the recommendation from the National Comprehensive Cancer Network (NCCN) clinical practice guidelines in oncology: prostate cancer early detection 1. The NCCN suggests that PSA test results are more reliable if the patient has abstained from ejaculation for 48 hours. If this condition is not met and the original sample was marginally elevated, it is recommended to repeat the test after 48 hours of abstention.
- Key points to consider:
- Ejaculation can temporarily increase PSA levels in the bloodstream, potentially leading to falsely elevated results.
- Abstaining from ejaculation for 48 hours before the PSA test can help ensure more accurate results.
- Certain medications, such as finasteride and dutasteride, can affect PSA levels, and their use should be considered when interpreting test results 1.
- It is essential to follow the specific instructions provided by your healthcare provider, as they may have particular recommendations based on your individual health situation. Additionally, it's crucial to note that while abstaining from ejaculation for 48 hours is recommended, prolonged abstinence is not necessary and could potentially mask real elevations in PSA levels.
From the Research
Absence from Ejaculation Before PSA Testing
The duration of absence from ejaculation before a PSA test is a topic of discussion among medical professionals.
- According to a study published in 1996 2, it is recommended that men abstain from ejaculation for 48 hours prior to having a serum PSA determination, as ejaculation can cause a significant increase in serum PSA concentration that may persist for up to 48 hours.
- However, a study published in 1998 3 found that ejaculation has no clinically significant effect on PSA levels in a prostate cancer-screening population, and men should not be asked to abstain from sexual activities before a PSA-screening test.
- Another study published in 1995 4 found that ejaculation does not seem to affect the serum PSA concentration in normal men.
- A study published in 1992 5 examined the effects of prostatic manipulations, including digital rectal examination, prostate massage, transrectal ultrasonography, and transrectal needle biopsy, on serum PSA levels, but did not specifically address the issue of ejaculation.
Variability in Study Findings
The studies mentioned above have varying findings regarding the effect of ejaculation on PSA levels.
- The 1996 study 2 suggests a 48-hour abstinence period, while the 1998 study 3 finds no significant effect.
- The 1995 study 4 also finds no significant effect, but the 1992 study 5 does not address ejaculation specifically.
- A 2015 study 6 found that prostate massage, rigid cystoscopy, TRUS-guided prostate biopsy, and TURP caused statistically significant rises in total and free PSA levels, but did not address the issue of ejaculation directly.
Clinical Implications
The clinical implications of these findings are important for medical professionals to consider.
- The 1996 study 2 recommends a 48-hour abstinence period, which may be relevant for certain patients.
- However, the 1998 study 3 suggests that ejaculation may not have a clinically significant effect, which could impact patient instructions and test interpretation.
- Further research may be needed to fully understand the relationship between ejaculation and PSA levels, and to inform clinical practice guidelines.