Is there any medicine to lower PSA? Understanding the Effects of Common Drugs

October 9, 2025 •

5 min read

PSA screening is a routine test for millions of men over 50, but many are unaware that certain medications can significantly alter their prostate-specific antigen (PSA) levels. Yes, there is medicine to lower PSA, and understanding these effects is crucial for accurate prostate health monitoring.

Quick Summary

This article explores various prescription and over-the-counter drugs that can reduce PSA levels, including 5-alpha reductase inhibitors, statins, and NSAIDs. It discusses the mechanisms behind these effects and the serious implications they have for prostate cancer detection and diagnosis.

Key Points

PSA-Lowering Medications Exist: Prescription drugs like finasteride (Proscar) and dutasteride (Avodart) are the most significant PSA-lowering medications, used primarily for benign prostatic hyperplasia (BPH).
Common Drugs Have Secondary Effects: Widely-used medications such as statins (for cholesterol), NSAIDs (e.g., ibuprofen), and thiazide diuretics (for blood pressure) can also cause a smaller, but still relevant, decrease in PSA.
Medication Masks Cancer Signal: The primary risk of medication-induced PSA suppression is that it can mask a rise in PSA caused by prostate cancer, leading to delayed or missed diagnoses.
Informed Medical Interpretation is Key: Doctors typically adjust PSA readings for patients on medications like 5-ARIs, often doubling the result for accurate prostate health assessment. Always inform your doctor of all medications you are taking before a PSA test.
Herbal Supplements are Ineffective: Despite common belief, clinical studies show that herbal supplements like saw palmetto do not significantly lower PSA levels compared to a placebo.
Long-term Use Increases Effect: The PSA-lowering effect of many medications, including statins and thiazide diuretics, becomes more pronounced with prolonged use, further complicating PSA interpretation over time.
Communication Prevents Diagnostic Errors: To avoid diagnostic pitfalls, open communication with a healthcare provider about all medications is essential for proper interpretation of PSA trends and overall prostate health management.

The Dual-Edged Sword of PSA-Lowering Medications

Prostate-specific antigen (PSA) is a protein produced by cells in the prostate gland. Elevated PSA levels can be a sign of prostate cancer but can also indicate other non-cancerous conditions, such as benign prostatic hyperplasia (BPH) or prostatitis. A PSA test is a key part of prostate health screening, but the results can be influenced by a variety of factors, including certain medications. While some drugs intentionally target the prostate to lower PSA, others do so as an unintended side effect. For men on these medications, it is critical to inform their doctor so PSA test results can be properly interpreted and a delayed or missed cancer diagnosis is avoided.

5-Alpha Reductase Inhibitors (5-ARIs): The Most Significant Impact

Among all drug classes, 5-alpha reductase inhibitors (5-ARIs) have the most pronounced and predictable effect on lowering PSA. These drugs are primarily prescribed to treat benign prostatic hyperplasia (BPH), or enlarged prostate, and are also used to treat male pattern baldness.

How they work: 5-ARIs block the enzyme 5-alpha reductase, which is responsible for converting testosterone into the more potent androgen dihydrotestosterone (DHT). By reducing DHT, these medications cause the prostate gland to shrink, which in turn reduces the amount of PSA produced by the prostate cells.
Common medications: Finasteride (Proscar, Propecia) and dutasteride (Avodart) are the two primary 5-ARIs. Dutasteride inhibits both type 1 and type 2 5-alpha reductase, while finasteride only inhibits type 2, which is more prevalent in the prostate. Some studies show that dutasteride is more effective at reducing PSA and prostate volume than finasteride.
Effect on PSA: These medications can suppress PSA levels by approximately 50% after 6 to 12 months of use. Doctors typically adjust PSA results by doubling the value for patients on these drugs to get a more accurate picture.

Common Medications with Secondary Effects on PSA

Several other classes of medications, widely used for unrelated conditions, have been found to have a secondary, often less significant, impact on PSA levels.

Statins

Used to lower cholesterol, statins have been linked to reduced PSA levels. A 2008 study of veterans found that after starting a statin, the median PSA level declined by 4.1%, with a greater reduction in those with the largest drop in LDL cholesterol. Proposed mechanisms for this effect include reducing intraprostatic inflammation or inhibiting androgen signaling.

NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)

Regular use of NSAIDs, such as aspirin and ibuprofen, has been associated with lower serum PSA levels. In a large cross-sectional study, regular NSAID users had PSA levels approximately 10% lower than non-users. This may be due to the anti-inflammatory properties of these drugs, as inflammation can cause PSA to rise.

Thiazide Diuretics

Prescribed for high blood pressure, thiazide diuretics have also been inversely associated with PSA levels. One study showed that after 5 years, men using thiazide diuretics had PSA levels 26% lower than non-users, and the combination of statins and thiazide diuretics resulted in an even greater reduction of 36%.

Understanding the Implications for PSA Testing

The most significant risk associated with medication-induced PSA suppression is the potential for delaying or missing a prostate cancer diagnosis. Artificially lowered PSA levels can provide a false sense of security, leading to a missed opportunity for further diagnostic tests, such as a biopsy.

Potential Diagnostic Complications:

Masking a Cancer Signal: A PSA level that is within the normal range for a patient on medication could actually be elevated for their corrected reading, indicating a potential problem. This masking effect can delay the diagnosis of cancer until it is at a more advanced stage.
Altered Biopsy Recommendations: For men with borderline PSA values, their doctor might recommend a biopsy. However, if the patient is on a PSA-lowering medication, the artificially low result could lead the doctor to decide against a biopsy, even though their corrected PSA is concerning.
Delayed Diagnosis: A 2019 Harvard Health blog highlighted a study of over 80,000 prostate cancer patients, finding that those who developed prostate cancer while taking 5-ARI inhibitors had significantly delayed diagnoses and worse outcomes compared to nonusers.

Herbal Supplements: Limited or No Effect on PSA

While some men turn to herbal supplements, particularly saw palmetto, for prostate health, scientific studies have shown no significant effect on PSA levels.

Saw Palmetto: This herbal extract is often marketed for BPH symptom relief, but a large randomized, double-blind study found no difference in PSA levels between participants taking saw palmetto and those on a placebo, even at high doses. As such, clinicians are advised not to adjust PSA readings for men taking saw palmetto.

A Clinical Comparison of PSA-Lowering Effects


Medication Type	Common Examples	Primary Use	Mechanism of PSA Reduction	Approximate PSA Reduction	Clinical Considerations
5-Alpha Reductase Inhibitors	Finasteride, Dutasteride	BPH, male pattern baldness	Reduces DHT, shrinks prostate	~50% (after 6-12 months)	Requires PSA adjustment (doubling); risk of delayed cancer diagnosis
Statins	Atorvastatin, Simvastatin	Lower cholesterol	Reduces intraprostatic inflammation	~4.1% to 13% over time	Can mask PSA elevations, potentially affecting prostate cancer detection
NSAIDs	Aspirin, Ibuprofen, Naproxen	Pain relief, anti-inflammatory	Reduces intraprostatic inflammation	~10% with regular use	Impact on cancer detection is unclear and warrants further investigation
Thiazide Diuretics	Hydrochlorothiazide	High blood pressure	Unclear, possibly related to inflammation	~26% (after 5 years)	Can lower PSA significantly over long-term use
Saw Palmetto	Herbal Extract	BPH symptom relief	None proven	No significant effect vs. placebo	No need for PSA adjustment; limited clinical evidence of efficacy

Conclusion: Navigating PSA Levels with Medical Guidance

While medications like 5-ARIs are intentionally used to shrink the prostate and consequently lower PSA, other common drugs can also cause incidental reductions. The existence of medicine to lower PSA is not a solution for prostate cancer but a factor to be carefully managed in the context of screening. Men taking any medication known to affect PSA levels must maintain open communication with their physician, ensuring accurate interpretation of PSA test results. This may involve adjusting the PSA reading or taking other factors into account when assessing prostate cancer risk. Relying on an artificially low PSA can have severe consequences, making informed medical guidance the best path forward.

Medical management of benign prostatic hyperplasia at Cleveland Clinic Journal of Medicine provides further insight into therapies for BPH, including drug combinations.

Frequently Asked Questions

The most significant PSA-lowering medications are 5-alpha reductase inhibitors (5-ARIs), such as finasteride (Proscar) and dutasteride (Avodart), which can reduce PSA levels by up to 50%.

Yes, some common over-the-counter drugs, specifically nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen, have been shown to cause a mild reduction in PSA with regular use.

The main danger is that artificially low PSA levels can mask a rise in PSA caused by prostate cancer, potentially leading to a delayed or missed diagnosis. This can be particularly dangerous as cancers may be discovered at a more advanced stage.

For patients taking 5-alpha reductase inhibitors like finasteride, physicians often double the reported PSA result to compensate for the medication's suppressive effect and get a more accurate estimate of the true PSA level.

Yes, studies have shown that statins are associated with lower PSA levels. The median decline in PSA after starting a statin is around 4%, but this effect can increase with higher doses and longer use.

No. Clinical studies have consistently shown that saw palmetto does not significantly affect serum PSA levels, even at high doses.

You should inform your doctor about all medications and supplements you are taking, including over-the-counter drugs, to ensure your PSA results are interpreted correctly. Mentioning any herbal supplements and prescription drugs is crucial for accurate screening.