FrankTalk.org

Gents:

I had a visit on Friday at the VA hospital with my Endocrinologist who writes for my "T". Yes, any of the MD's could write but I like giving this guy the hard way to go and I am educating him along the way. He is the type doctor who tries to cover his ass so nothing will come back to bite it - WRONG. He is always after doing a PSA on me like all the time. I believe it makes him feel better because of my taking "T". My numbers have generally always been low but a few times they did elevate to say 3. something or even 4. something once. Well there are a number of reasons other than cancer that these numbers will elevate. I hadn't thought about them because my old primary care doctor knew that I had a rather healthy sex life and that I was big into prostate massage and since I was gay, there may well be some other activity taking place thru my backdoor.

Well, on Friday, my PSA came back at a whole 3.9 and this doctor almost blew a cork. I told him get a grip. I said this is most likely like the last "T" test when you said I had a "T" level over 1500mgs. On a recheck it was in fact right at 525mgs. Our lab isn't always fully reliable. He said you will be here on Thursday we will check it again. I said fine. I had to see the urologist also to have my implant checked which if you go to humor you will find a funny story.

It is about a 2 1/2 hour drive at best and it was pouring cats and dogs which meant I couldn't drive as fast. I took it easy but whole way back there was something in the back of my mind telling me those numbers weren't correct. Well Saturday and Sunday I didn't do much but sleep. I had a long week last and I slept most of Saturday and Sunday.

As I worked on personal things for myself today, my mind drifted back to Friday's visit. I decided on a whim to look up PSA and go over the many reasons why your PSA might be elevated. As I read, I had to laugh because my old primary care doctor was a much wiser man and called me once when my labs returned and my PSA was somewhat elevated that time. I remember he was looking for the right words and I said oh just spit it out you know I am not shy. He said it's rather personal and my answer was "SO". He asked about my sexual activity especially the day before, I said well yes to the day before and the morning before that test in the afternoon. He had mentioned it concerned the PSA and I thought - I said you might need to know one more small piece of information. I am gay and my backdoor does get used as well. He said I understand and he said that would explain the numbers I saw. He said I will put in for another test in about 6 weeks. He said if you did have say 2 days without any activity, it would give me a better feel on the number. I did make his request possible.

THE POINT IS: If your PSA is somewhat elevated you and your doctor need to talk. This new doctor I have either is way to shy to ask the questions needed or he isn't as smart as he should be. In your medical care the BEST ADVOCATE IS YOU. You need to educated yourself so that you are knowledgeable making sure that what your doctor is telling you is correct. I just sent this doctor a message telling him he didn't ask me the right questions. I will keep you up on this.

WES

I've been taking T shots for maybe 7 years now.
I get PSA tested every 6 months. My levels have all been around 3.8 and 3.9.
My doc seems to believe 4 is the magic number.
I'd worry more if it suddenly jumped up.
I asked if T causes prostate cancer. He said "no, it feeds it though".

You are so correct but there are several things which change the PSA and he didn't ask the right things. I'm exactly a doctor but on the other hand I am more knowledgeable than the average patient. Sexual activity within 24 hours of taking a PSA test will make it higher. Prostate massage will make it higher. Should you combine the two together, your PSA could be better than a 4. As you age your PSA numbers go up, although I am getting close to 70, my PSA numbers have been much lower than for someone 60 to 69 which is considered to be in the 2.5 range. A 1.3 is the highest I have seen mine as I have taken "T" since I was 27 years old. This one coming back at 3. whatever was no reason not to write my "T" for me. At the time I didn't think fast enough on my feet. Somewhere in my 50's this happen and my Primary Care doctor called me and he was having trouble finding the right words. I knew him very well and so I said ask. I had a sudden PSA of 4.7. On the phone he did ask the right questions and so I generally try if i know I will have a PSA test try to not do any extra activities for at least 2 days. The problem wasn't the "T" the problem was I had lots of fun that is the long and the short.

handfulWES

Guys: This is important information: If your PSA level is checked and you are 60 or over you need to be able to tell your doctor that 1) you had sexual activity within the last 24 hours and if you do backdoor play with your prostate, you need to tell him this as well. I have a stupid doctor who doesn't think a patient knows anything about anything. On my recheck 2 1/2 weeks later my PSA was back to 0.23 from the 3.7 from before. I didn't think fast on my feet or I would have told him this bit of information. At the VA now if the VA you attend is what is termed "A Full Service VA" then for each item you are to see a specialist, in this case an Endocrinologist and I drew the stupid one.

WES

As a diabetic, my Endocrinologist tests my blood every four months. For the past 25 years, my PSA has ranged from 1.1 to 1.2. The only exception was several years ago when I was using androgel for six months and my PSA increased to 1.6. My endo then recommended I phase out of TRT.

dtwarren1942 wrote:As a diabetic, my Endocrinologist tests my blood every four months. For the past 25 years, my PSA has ranged from 1.1 to 1.2. The only exception was several years ago when I was using androgel for six months and my PSA increased to 1.6. My endo then recommended I phase out of TRT.

I feel your doctor isn't following the true guidelines. As we age, our PSA levels generally do rise some. A guy in his 70's the considered NORMAL is 3.5 to 4.0. I also need to ask a personal question. Had you had sex within 48 hours of the test even if it was a private JO session? See any type of sexual activity will up the PSA level.

I am very, very activity sexually and I also do prostate massage. The massage is to keep my prostate healthy and it also boost the rest of sexual performance, even though I have an implant. If you want to read up on PSA levels go to Web MD or any of the articles on PSA levels. The day he decided to check mine again this time it came back at a 3.7. My urologist told me he doesn't get upset till it reaches about 5.5 and knows I am very sexually activity.

If he would have (1) performed a prostate exam and (2) asked about the sexual activity this would have given him some answers. After talking with an old friend who is a urologist he told me that unless there is something bad wrong the Endocrinologist isn't necessary the best doc for this job. I read on FT about all the prostates which have been removed or had radiation when they could have been saved had guys taken care of them. Yes, there are things which affect the prostate and diabetic I'm sure doesn't help. I offer this based on what facts you gave me.

It was several years ago so I have no idea what I was doing prior to the blood test. However, today I started off with about 20 minutes of penetration but without orgasm. Then had my blood tested at about 12:00 pm. The doc just called to say everything was good (my A1c dropped from 7.8 down to 7.2) and my PSA came in at 1.4.

No big deal about dropping out of TRT several years ago. Though the Androgel increased my total T from 290 to over 800 and significantly improved my libido, I was still unable to generate an erection. I had high libido, but only a limp noodle to try and satisfy it.