Association Between Prostate-Specific Antigen and Serum Testosterone: A Systematic Review and Meta-Analysis

April 2020 in “ Andrology ”

Do Kyung Kim, Jin‐Won Noh, Yoosoo Chang, Hyun Young Lee, Jae Joon Park, Seungho Ryu, Jae Heon Kim

prostate-specific antigen serum testosterone testosterone replacement therapy intramuscular testosterone replacement therapy oral testosterone replacement therapy topical testosterone replacement therapy benign prostate hyperplasia PSA TRT IM TRT non-BPH

TLDR Testosterone replacement therapy, especially intramuscular, raises PSA levels, but no overall link between PSA and testosterone was found except in non-BPH patients.

This systematic review and meta-analysis assessed the association between prostate-specific antigen (PSA) and testosterone, as well as the effects of various types of testosterone replacement therapy (TRT) on PSA levels. The study included 22 articles for the analysis of TRT effects and 18 studies for the association between PSA and testosterone. Results indicated that TRT, particularly intramuscular (IM) TRT, significantly increased PSA levels compared to placebo. However, oral and topical TRT did not show significant changes. No overall correlation was found between PSA and testosterone, but a significant correlation was observed in patients without benign prostate hyperplasia (non-BPH). These findings suggested the potential of PSA as a surrogate marker for testosterone.