EDUCATION CENTER

Does TRT Increase PSA?

PSA may rise modestly; prostate cancer screening is still individualized.

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Does TRT increase PSA?

It can. A modest PSA rise after starting testosterone is recognized. Large or rapid rises, abnormal digital exam when performed, or a history of prostate cancer change the plan.

TRT does not appear to create prostate cancer from nothing in the way older folklore suggested, but untreated prostate cancer is generally a contraindication to starting. Screening decisions follow age, ancestry, family history, and shared decision-making — not TRT marketing.

FAQs

What PSA increase is concerning?

Your clinician interprets the delta against baseline, time on therapy, and urology thresholds. Do not diagnose yourself from a 0.2 ng/mL bump.

References

  1. 1. Bhasin S, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744.

  2. 2. Mulhall JP, et al. Evaluation and Management of Testosterone Deficiency: AUA Guideline. J Urol. 2018;200(2):423-432.

  3. 3. Lincoff AM, et al. Cardiovascular Safety of Testosterone-Replacement Therapy (TRAVERSE). N Engl J Med. 2023;389:107-117.

  4. 4. U.S. Food and Drug Administration. Testosterone Information.

  5. 5. Bhasin S, et al. Testosterone Replacement in Aging Men: An Endocrine Society Scientific Statement. J Clin Endocrinol Metab.

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Men over 40 are commonly evaluated for hypogonadism. Safety depends on diagnosis, TRAVERSE-era cardiovascular data, prostate screening, hematocrit, and follow-up — not age alone.

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