8 Non-Cancerous Causes of High PSA Levels

Prostate-specific antigen (PSA) is a protein made by the prostate gland. When measured through a blood test, PSA levels are reported in nanograms per milliliter (ng/mL). In many clinical settings, a PSA level of 10 ng/mL is already considered elevated. So if you’re asking, “My PSA is 56 should I worry?” it’s understandable to feel concerned. However, while a significantly elevated PSA can be linked to prostate cancer, there are several other possible explanations.

PSA values alone do not provide a complete picture of prostate health. Healthcare professionals evaluate PSA results alongside other important factors, such as your age, findings from a digital rectal exam, overall medical history, and family history of prostate cancer. Understanding the broader context is essential before jumping to conclusions about risk.

If you’re unsure how your number compares to standard thresholds, you may also want to review What is a dangerous PSA level for additional perspective. Keep reading to explore the common reasons PSA levels may rise and what steps typically follow.

1. Age

PSA levels may increase naturally as men grow older. This gradual rise is often due to age-related enlargement of benign prostatic tissue rather than cancer.

As the prostate increases in size over time, it can release more PSA into the bloodstream. For this reason, what is considered a “normal” PSA may vary depending on age. Your healthcare professional will interpret your result within the context of age-specific reference ranges.

2. Benign prostatic hyperplasia (BPH)

Benign prostatic hyperplasia (BPH), commonly referred to as an enlarged prostate, frequently affects older adults. BPH can raise PSA levels and may interfere with normal bladder and urinary function.

Symptoms may include:

• difficulty initiating urination
• weak urine stream, dribbling, straining, or interrupted flow
• frequent urination
• sudden, urgent need to urinate
• inability to completely empty the bladder

Treatment for BPH is typically only necessary if symptoms significantly impact quality of life or overall health. Medical management often includes medications such as alpha-blockers or 5-alpha reductase inhibitors, which can help improve urine flow and reduce prostate size.

If symptoms are severe or fail to improve with medication, minimally invasive surgical procedures or laser therapy may be recommended. Addressing BPH can sometimes help stabilize PSA levels over time.

3. Urinary tract infection (UTI)

A urinary tract infection (UTI) can temporarily elevate PSA levels.

Symptoms may include:

• burning or painful urination
• cloudy, foul-smelling, or bloody urine
• frequent urination
• inability to fully empty the bladder
• urgent need to urinate

UTIs become more common with advancing age. Additional risk factors include:

• diabetes
• kidney stones
• enlarged prostate

If you suspect a UTI, consult a healthcare professional promptly. Diagnosis is typically made with a urine test, and treatment generally involves antibiotics. Importantly, if your PSA level is elevated and you have a confirmed UTI, you should wait until the infection has resolved before repeating the PSA test. Infection-related inflammation can falsely raise PSA results.

4. Prostatitis

Prostatitis refers to inflammation of the prostate gland, often caused by a bacterial infection. This condition leads to swelling and irritation, which can increase PSA levels.

Symptoms may include:

• difficult or painful urination
• rectal pressure or discomfort
• difficulty ejaculating

If a bacterial infection is responsible, flu-like symptoms such as fever and chills may also occur, and antibiotics are typically prescribed. In some cases, prostatitis may result from nerve damage in the urinary tract due to injury or as a complication of surgery. When no infection is detected, anti-inflammatory medications or alpha-blockers may be used to relieve symptoms.

Because inflammation can significantly affect PSA readings, treating prostatitis often leads to a decline in PSA levels after recovery.

5. Recent ejaculation

One 2016 study reported that PSA levels can temporarily increase after ejaculation in some individuals. In certain cases, PSA may remain elevated above baseline for up to 24 hours.

Although additional research is needed to fully clarify this effect, it is commonly recommended that individuals avoid sexual activity that leads to ejaculation for 24 hours prior to a scheduled PSA test. This precaution may help prevent misleading results.

6. Serum parathyroid hormone (PTH)

Serum parathyroid hormone (PTH) is a naturally occurring hormone that helps regulate calcium levels in the bloodstream.

Research suggests it may also promote prostate cancer cell growth, even in individuals without a prostate cancer diagnosis. Elevated levels of parathyroid hormone have been associated with increased PSA levels, although this relationship is still being studied.

7. Recent injury

An injury involving the groin area can cause a temporary spike in PSA levels. Trauma from a fall, sports injury, or direct impact may irritate the prostate.

If you believe a recent injury could have influenced your test results, inform your healthcare professional. Timing of the test in relation to the injury may explain a temporary elevation.

8. Recent surgery

Any medical procedure that causes temporary trauma or irritation to the groin region may affect PSA readings.

This includes insertion of medical instruments, such as a catheter or surgical scope, into the bladder. Even minor procedures can lead to short-term increases in PSA due to localized inflammation.

Understanding the relationship between PSA levels and cancer

Prostate cancer can lead to elevated PSA levels. If your PSA result is high — especially if you’re wondering, “My PSA is 56 should I worry?” — your healthcare professional may suggest additional testing. A PSA blood test is often performed in conjunction with a digital rectal exam and possibly imaging studies to better evaluate your level of risk.

PSA testing is commonly recommended beginning at age 50. However, earlier screening may be advised if you have specific risk factors, such as a strong family history of prostate cancer or certain genetic predispositions.

If PSA levels are elevated and other assessments suggest increased cancer risk, a biopsy may be recommended to confirm or rule out a prostate cancer diagnosis. A biopsy involves collecting small samples of prostate tissue for laboratory analysis.

It’s important to note that prostate cancer is often slow-growing. In some cases, individuals may choose active surveillance, also known as watchful waiting, instead of immediate biopsy or treatment. Your clinician will review the advantages and risks of each option to help guide informed decision-making.

Seeking a second medical opinion can also provide reassurance or present alternative approaches, empowering you to choose the most appropriate course of action for your situation.

If additional PSA testing, imaging, or biopsy is advised, discuss the potential benefits and possible risks of each procedure with your healthcare professional. Shared decision-making is key in managing prostate health concerns.

The bottom line

An elevated PSA level can have multiple causes, ranging from benign conditions like BPH or infection to prostate cancer. If you’re thinking, “My PSA is 56 should I worry?” the most important step is to work closely with your healthcare professional to determine the underlying reason.

When prostate cancer is detected early, it is often highly treatable. Likewise, many noncancerous causes of elevated PSA — including infections and inflammation — can be effectively managed. Careful evaluation, appropriate follow-up testing, and open communication with your clinician will help ensure the best possible outcome for your prostate health.