I’d book the PSA when life is “normal,” avoid ejaculation/biking for 48 hours beforehand, skip testing during a UTI or prostatitis flare, and if erections/libido change for more than a few weeks or come with urinary symptoms, pain, blood, or fever, bring it up directly with your doctor rather than trying to self-interpret day to day.

I’m in the “keep it simple” camp: I just pick a regular time of year (like around my birthday), try not to do anything that might mess with the number for a couple days, and then I don’t overthink it. Erections and libido can bounce around for all kinds of boring reasons—sleep, stress, booze, work—so I try to look at the bigger picture over a few weeks instead of day to day. If something feels clearly different and it sticks around, I’d rather mention it to the doctor once than keep guessing at home. Do you already have a yearly physical you could just tie the PSA to?

I’m similar: I tie it to my annual physical so it’s on the calendar and not something I keep moving around based on how I feel that week. For erections/libido, I try to think in terms of “is this different for a month and affecting things?” rather than reacting to a couple off nights, because stress/sleep/alcohol can really muddy the waters. Do you mainly worry about the PSA number being thrown off by sex/exercise, or more about what a change in erections might mean?

I handle it by anchoring the PSA to my annual physical and keeping the “rules” simple: no ejaculation or long bike rides for a couple days beforehand, and I try not to schedule it when I’m sick or have any urinary irritation. With erections/libido I only pay attention if it’s a clear change that hangs around for a few weeks and is actually impacting sex or comes with urinary stuff, otherwise I chalk it up to sleep/stress/alcohol and move on. Is your bigger worry the PSA result getting skewed, or the meaning of the erection changes themselves?

Honestly I think the “birthday/annual physical” approach is the only way I don’t drive myself nuts. If I tried to time it around how my sex drive or erections were behaving that week, I’d be rescheduling forever.

For the PSA I’d keep it boring: pick a date, avoid sex and long bike rides for a couple days before, and don’t do it when you’re fighting a UTI-type thing or feeling irritated down there. Then whatever the number is, it’s at least comparing apples to apples year to year.

And for erections/libido, I try to treat it like sleep: a few off nights don’t mean much, but if it’s been noticeably “off” for a month or it comes with urinary symptoms, pain, blood, or fever, that’s when I’d just bring it up at the appointment instead of guessing.

When you say you’re second-guessing—are you more hung up on “did I mess up the PSA with something I did,” or more on “what does this change mean”?

Yeah, I’m with you: if you try to “optimize” the PSA around whatever your erections are doing that week, you’ll end up chasing your tail.

What helped me keep it low-stress was making the test as standardized as possible: same general time each year, same lab if possible, and then the simple pre-test stuff (no ejaculation, no long bike ride/spin class, and avoid it if you’ve got urinary burning/fever or you’re on antibiotics for something down there). Also worth remembering some meds/supplements can nudge PSA (like finasteride/dutasteride), so I’d mention those at the draw so the doc interprets the trend correctly.

On the erections side, I try to treat it like a “trend” issue: if it’s a bad week but sleep, stress, alcohol, or relationship stuff is messy, I don’t read much into it. If it’s persistently different for 4–6 weeks, or it’s paired with urinary changes, pelvic pain, blood, or systemic symptoms, then I’d bring it up plainly—because that’s actionable without you having to self-diagnose.

If your PSA ever comes back higher than expected, I’d ask about repeating it under controlled conditions before spiraling, because one weird result happens. Are you mostly worried about a one-off PSA bump, or are you noticing an erection/libido change that’s already been sticking around?