PSA #’s elevated from sex (After ADT and RT)

[Jimhoy]

Hello again my friends!  I think my question is a simple one but I can’t seem to find an answer anywhere, so I turn to the experts here!  A favorable answer would eliminate 6 more months of anxiety for me while waiting for the other shoe to drop!

I’ve been on Active Surveillance since completing my ADT and RT both in 2017 &18 finally coming out of castration in 2019 / early 2020 with a basement T level, so I began Penile Rehab.  Well over a year after that, I was able to resume (what I now refer to as) sexual relations with my wife!  

It seem more than a coincidence that since we resumed love making (on a very regular basis), that my PSA ticked up a bit, or its the beginning of bad news.  It went from 0.3 & 0.4 then after resuming sex, 0.5 & 0.6 to 0.8 now.  I was reading that sex, exercise, strenuous work, etc, can cause elevated PSA levels!  I exercise on a regular basis and returned to strenuous work as well!  I was just reading that one should refrain from / limit all those activities 48 to 72 hours prior your blood test!  I was 67 yo when I first heard this!  I turned 67 last week!!!

 FINALLY.... the question..... does this elevated PSA still apply after having had Radiation Treatment where in theory, the gland is cooked? 

 I would love to hear that it could be, so a PET will not be required after my next PSA test in 6 months (if it takes another tick upwards?), but I’ve (again) been waiting for the other shoe to drop since going on vacation, so kind of expecting that anytime now!  Comments?

Jc

[Tall_Allen]

Yes, it applies - orgasm increases PSA output. But PSA levels will always fluctuate for men, like us, that have prostates. IF your PSA reaches 2.0, further investigation may be required.

[Jimhoy in reply to Tall_Allen]

Thank you... good to hear! Going to ask for a mulligan, take the test again and refrain from those activities this time! My Urologist said that if I went “over” 1.0 he wanted to order a PET. I had heard it was @ 2.0 as well, but err on the side of caution is all right?? Note the ?? But I really trust this guy after firing 3 others!

Thanks again.... you’re the best!

Jc

[Tall_Allen in reply to Jimhoy]

That's prudent, unless you have a history of prostatitis. Will insurance cover a PSMA PET before PSA reaches 2.0?

[Jimhoy in reply to Tall_Allen]

Thats good question to pose to Dr! Got the Mulligan just now! Will be good to know the difference a couple weeks and restraint makes in the test results! Will let you know fyi! Thanks again!

[lokibear0803 in reply to Tall_Allen]

Can you tell me, what is the recommended time to wait after orgasm before PSA? and is this a function of the PSA half-life, or some other biological mechanism?

Explanation of question: it’s always confused me that the wisdom seems to be wait 48-72 hours, but I also understand the half-life of PSA is about 3 days…it would seem we’d want to wait a little longer than just the 72 hrs?

[Jimhoy in reply to lokibear0803]

I agree with your thinking! Just got an order sent in for another test, going to give it until Monday to draw blood. No gym and fun until then!

Jc

[Tall_Allen in reply to lokibear0803]

The increase from an orgasm is small. In trials, there was no measurable increase after 2 days.

[jackwfrench in reply to Tall_Allen]

Hi TA- any info on PSA increasing on orgasm without prostate, and on ADT?

[Tall_Allen in reply to jackwfrench]

An orgasm cannot increase PSA if you don't have a prostate because there are no contractions that squeeze out PSA-containg semen.

[Jimhoy in reply to jackwfrench]

My post fell off my radar until your question and TA's response showed up.... I apologize to anyone following!!! I was more so referring to the physical exertion during sex, work & exercise, not the climax! I did get retested shortly after my 0.8 result but without any of those activities above. I believe it lowered to (I believe ( by memory)) to 0.5 where it lived for a few years and still @ that! Was the 0.8 an indicator of a problem, I don't think so other than my Urologist wanting to take action at 1.0. At that, .5 is much better than .8!

[CarverD]

I'm in the camp that isn't going to stop going to the gym or give up sex for three days to lower my PSA results. Having undergone HDR-BT as long as my PSA remains under 2.0 ng/ml I'm happy. I've been known to leave the gym and go straight to my blood draw. Two year PSA was 0.78 ng/ml - the lowest it's been prior to or post treatment. Being consistent is what I'm after and since I work out every morning it made more sense to go this route than try to remember not to every 3 months. Now if only I was having sex every morning....

[Jimhoy in reply to CarverD]

how did you handle ADT.

[Jimhoy]

I was discharged from my RO last summer! He didnot see the .8 result! My Urologist is the best of the 4 I’ve had.... 3 were fired! What I omitted was that besides sex x 2, I had a strenuous 2 hour work out at the gym and worked, shoveling stone all day! All within 12 or so before blood drawn! Just now did the “Mulligan” (do over) blood test! I’ll share the results of that test which was after abstaining from all the above activities soon! And yes.... I wholehearted agree with addressing PSA <2.0. Don’t necessarily care if insurance doesn’t pay.... I have my reasons for being this picky but thats long long story! Praying its a moot point with new results!

Thanks

Jc

[Jimhoy]

So.... hoping / praying that this is a non issue!  The original question was “can sex before PSA test raise #’s”!  In fact, it was much much more!  Sex X 2 times, extreme exercise, and physical work.... just hours before my test!  In my heart of hearts.... I know it will be one day... but maybe not now!  Did my retest today and will (hopefully) have my answer soon!  Thank you everyone!Jc