Medically reviewed by Mr Maneesh Ghei, Consultant Urological Surgeon (GMC: 5208045)

A PSA blood test measures the level of prostate-specific antigen in your blood and is one of the primary tools for detecting prostate problems early. For your results to be meaningful, it is important to prepare correctly. Several common activities — including ejaculation, vigorous exercise and certain medications — can temporarily raise or lower PSA levels and lead to inaccurate results.

Understanding PSA levels

PSA is a protein produced by the prostate gland. While it’s normal for small amounts of PSA to circulate in the blood, elevated levels can signal potential prostate conditions. However, PSA levels can fluctuate due to factors unrelated to health issues. Being mindful of these factors can help ensure your test results are as accurate as possible.

What to avoid doing before your PSA blood test

1. Avoid ejaculation

“Ejaculation can temporarily raise PSA levels, leading to misleading results.” Experts recommend abstaining from sexual activity, including masturbation, for at least 48 hours before your test. This precaution is particularly relevant as it helps avoid unnecessary follow-up tests or concerns caused by artificially elevated PSA levels.

2. Skip vigorous exercise

Certain types of physical activity, especially cycling, can impact PSA levels. The pressure exerted on the prostate during cycling can lead to a temporary increase in PSA.

To be safe, it’s best to avoid cycling, running, or any strenuous exercise for at least 48 hours prior to your appointment. Walking or light stretching, however, is generally fine.

3. Don’t have a Digital Rectal Exam (DRE) beforehand

A digital rectal exam, often conducted as part of a routine prostate health check, can also temporarily raise PSA levels. If both a DRE and a PSA test are planned, ensure the PSA blood draw is done first to avoid skewing the results.

4. Refrain from recent medical procedures

Medical procedures involving the prostate, such as a prostate biopsy or catheterisation, can cause PSA levels to spike. Inform your healthcare provider if you’ve undergone any recent procedures, as they may recommend delaying your test. Waiting a few weeks after such interventions ensures a more accurate reading.

5. Avoid certain medications

Some medications can interfere with PSA levels, either elevating or lowering them. For instance:

• 5-alpha reductase inhibitors (e.g., finasteride or dutasteride): These are often prescribed for conditions like benign prostatic hyperplasia (BPH) and can lower PSA levels, potentially masking signs of prostate issues.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Some studies suggest these may also influence PSA readings.
• Herbal supplements: Products marketed for “prostate health” can sometimes affect PSA levels.

Always inform your GP about any medications or supplements you’re taking before your test.

6. Don’t consume alcohol excessively

While moderate alcohol consumption is unlikely to affect PSA levels, excessive drinking might influence overall health markers, including PSA. To be cautious, it’s advisable to limit alcohol intake for at least 24-48 hours before the test.

7. Steer clear of spicy and processed foods

Although there’s limited direct evidence linking diet to immediate PSA levels, consuming a balanced diet in the days leading up to your test is a good idea. Avoiding overly spicy or processed foods may help maintain overall prostate health, which could indirectly support accurate results.

8. Don’t ignore hydration

Proper hydration is crucial for any blood test. Dehydration can make it challenging for healthcare providers to draw blood, potentially delaying the process. Drink plenty of water on the day of your test to ensure smooth sample collection.

9. Avoid stress

Stress can impact various aspects of your health, including PSA levels. While it’s natural to feel anxious about medical tests, engaging in relaxation techniques such as deep breathing or mindfulness exercises can help you stay calm.

10. Don’t schedule your test during an illness

If you’re dealing with a urinary tract infection (UTI) or other illnesses, it’s wise to postpone your test. Infections can significantly elevate PSA levels, leading to misleading results. Once you’ve recovered, discuss with your GP the best time to proceed with the test.

What happens if PSA levels are elevated?

If your PSA levels come back higher than expected, your GP may recommend additional tests, such as a repeat PSA test, MRI, or biopsy, to rule out any serious conditions. A private prostate specialist can review your result in full clinical context and advise clearly on whether further investigation is needed.

Elevated PSA levels don’t always mean cancer; they can also indicate conditions like prostatitis or BPH. However, accurate initial results are critical in determining the next steps.

Final notes

Preparing for a PSA blood test is simple but essential for obtaining reliable results. By avoiding activities like ejaculation, vigorous exercise, and certain medications, and by staying hydrated and stress-free, you can help ensure your PSA levels reflect your true prostate health.

Regular communication with your GP about your lifestyle and medical history also plays a vital role in achieving accurate outcomes. Taking the time to prepare properly gives you the peace of mind that comes with knowing you’ve done everything possible to support your health and well-being.

If you are based in London and concerned about your prostate health, Mr Maneesh Ghei consults privately at The Wellington Hospital, St John’s Wood. No GP referral is needed and same-week appointments are usually available.

Frequently Asked Questions

How long before a PSA test should you avoid ejaculation?

Most guidelines recommend avoiding ejaculation for at least 48 hours before a PSA blood test. Ejaculation can temporarily raise PSA levels, which may produce a falsely elevated result and lead to unnecessary further investigation.

Can exercise affect PSA results?

Yes. Vigorous exercise, particularly cycling or activities that put pressure on the perineum, can temporarily raise PSA levels. Avoid strenuous exercise for 48 hours before your test. Gentle walking is generally considered safe.

What medications should you avoid before a PSA test?

5-alpha-reductase inhibitors such as finasteride and dutasteride lower PSA levels artificially, so your doctor should be aware if you take them. Testosterone therapy can also affect PSA. Always inform your doctor of any current medication before the test. Do not stop prescribed medication without medical advice.

What should you eat before a PSA blood test?

There is no strict dietary restriction for a PSA test. Some evidence suggests spicy foods and a high-fat meal shortly before the test may influence results. Staying well hydrated and eating normally is the safest approach.

Can stress affect PSA levels?

Psychological stress does not directly raise PSA levels, but physical stress caused by illness, recent surgery or urinary tract infection can. If you are currently unwell or have recently had a urinary procedure, discuss the timing of your test with your doctor.

What is a normal PSA level for my age?

PSA levels naturally increase with age. As a general guide: under 3 ng/mL is considered normal for men under 60; under 4 ng/mL for men aged 60 to 69; under 5 ng/mL for men aged 70 and over. A specialist will always consider your age, ethnicity, family history and symptoms alongside the result.

Where can I see a private prostate specialist in London?

Mr Maneesh Ghei is a consultant urological surgeon with a specialist interest in prostate conditions. He sees patients privately at The Wellington Hospital, Platinum Medical Centre, St John’s Wood, London NW8 7JA. No GP referral is required and same-week appointments are available.

About the Author

Mr Maneesh Ghei, Consultant Urological Surgeon (GMC: 5208045)

Mr Maneesh Ghei is a consultant urological surgeon with NHS and private practice across four London hospitals. He specialises in the diagnosis and management of prostate conditions including BPH, prostatitis and prostate cancer, as well as urinary symptoms, kidney stones and male sexual health. Mr Ghei sees new patients privately with same-week availability. No GP referral is required. Book a prostate screening consultation.