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During male puberty, testosterone causes body hair, muscle growth, and a deepening voice. In adult life, it controls sex drive, maintains muscle mass, and helps make sperm. In females, testosterone is important for the growth of bones and muscles, and healthy organs.
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There are different forms of testosterone in your blood that may be measured to help diagnose certain health problems. Most of your testosterone is attached to proteins. The proteins prevent your tissues from using the testosterone right away, which helps control the amount of "active" testosterone in your body. Testosterone that's not attached to proteins is called free testosterone. Free testosterone acts on your tissues.
For males who have gone through puberty, the test is mostly used for symptoms of low T levels (testosterone levels which are too low). Testosterone levels tend to decrease with age. But other health issues may also cause low T, such as thyroid problems, long-lasting illness, or problems with the testicles.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
Your test results may mean different things depending on which test was done, your age, your symptoms, the results of other tests, and other conditions you may have. So, it's best ask your provider to explain your test results.
If your results are not normal, it doesn't always mean you have a medical condition that needs treatment. It's normal for testosterone levels to decrease with age. And certain medicines can affect your results. If you have questions about your results, talk to your health care provider.
At-home test kits for checking your testosterone levels are available without a prescription. The kits provide everything you need to collect a blood or saliva (spit) sample to send to a lab for testing. Talk with your provider if you think you need to be tested. If you do a home test, share the results with your provider.
Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in the blood. For this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter (ng/mL) of blood.
The blood level of PSA is often elevated in people with prostate cancer, and the PSA test was originally approved by the FDA in 1986 to monitor the progression of prostate cancer in men who had already been diagnosed with the disease. In 1994, FDA approved the PSA test to be used in conjunction with a digital rectal exam (DRE) to aid in the detection of prostate cancer in men 50 years and older. Until about 2008, many doctors and professional organizations had encouraged yearly PSA screening for prostate cancer beginning at age 50.
Beginning around 2008, as more was learned about both the benefits and harms of prostate cancer screening, a number of professional medical organizations began to caution against routine population screening with the PSA test. Most organizations recommend that individuals who are considering PSA screening first discuss the risks and benefits with their doctors.
There is no specific normal or abnormal level of PSA in the blood. In the past, PSA levels of 4.0 ng/mL and lower were considered normal. However, some individuals with PSA levels below 4.0 ng/mL have prostate cancer and many with higher PSA levels between 4 and 10 ng/mL do not have prostate cancer (1).
If someone who has no symptoms of prostate cancer chooses to undergo prostate cancer screening and is found to have an elevated PSA level, the doctor may recommend another PSA test to confirm the original finding. If the PSA level is still high, the doctor may recommend that the person continue with PSA tests and digital rectal exams (DREs) at regular intervals to watch for any changes over time (also called observation or watchful waiting).
If the PSA level continues to rise or a suspicious lump is detected during a DRE, the doctor may recommend additional tests to determine the nature of the problem. These may include imaging tests, such as magnetic resonance imaging (MRI) or high-resolution micro-ultrasound.
In the past, men with elevated PSA levels and no other symptoms were sometimes prescribed antibiotics to see if an infection might be causing the PSA increase. However, according to the American Urological Association, there is no evidence to support the use of antibiotics to reduce PSA levels in men who are not experiencing other symptoms.
Overtreatment exposes a person unnecessarily to the potential complications associated with prostate surgery and radiation therapy. These include urinary (e.g., urinary incontinence, or leaking of urine following surgery and increased frequency and urgency of urination following radiation), gastrointestinal (e.g., loose stools or, less commonly, rectal bleeding following radiation), and sexual side effects (loss of erections or decreased erections following both surgery and radiation).
The PSA test may give false-positive results. A false-positive test result occurs when the PSA level is elevated but no cancer is actually present. A false-positive test result may create anxiety and lead to additional medical procedures, such as a prostate biopsy, that can be harmful. Possible side effects of biopsies include serious infections, pain, and bleeding.
False-positive test results are common with PSA screening; only about 25% of people who have a prostate biopsy due to an elevated PSA level are found to have prostate cancer when a biopsy is done (2).
A subsequent analysis of data from the PLCO used a statistical model to account for the fact that some men in the PLCO trial who were assigned to the control group had nevertheless undergone PSA screening. This analysis suggested that the level of benefit in the PLCO and ERSPC trials was similar and that both trials showed some reduction in prostate cancer death in association with prostate cancer screening (6).
The third and largest trial, the Cluster Randomized Trial of PSA Testing for Prostate Cancer (CAP), conducted in the United Kingdom, compared prostate cancer mortality among men whose primary care practices were randomly assigned to offer their patients a single PSA screening test or to provide usual care in which screening was not offered. After a median follow-up of 10 years, more low-risk prostate cancers were detected in the single PSA test group than in the usual (unscreened) care group (even though only about a third of men in the screening group actually had the PSA test), but there was no difference in prostate cancer mortality (7).
However, a single elevated PSA measurement in someone who has a history of prostate cancer does not always mean that the cancer has come back. Someone who has been treated for prostate cancer should discuss an elevated PSA level with their doctor. The doctor may recommend repeating the PSA test or performing other tests to check for evidence of a recurrence. The doctor may look for a trend of rising PSA level over time rather than a single elevated PSA level.
Scientists are investigating ways to improve the PSA test to give doctors the ability to better distinguish cancerous from benign conditions and slow-growing cancers from fast-growing, potentially lethal cancers. And other potential biomarkers of prostate cancer are being investigated. None of these tests has been proven to decrease the risk of death from prostate cancer. Some of the methods being studied include
What is your level of English?
This test contains grammar and vocabulary questions and your test result will help you choose a level to practise at. The real exams contain sections such as speaking and writing which are not tested here. At the end of the test your level of English will be assessed with reference to the Common European Framework of reference for languages (cef). These levels are A1(lowest),A2, B1, B2, C1, C2 (highest)
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