If I were you, I would request an MRI. In other countries, they use 3.0 as the “normal” limit. My PSA was 7.2, and I had prostate cancer which was subsequently successfully treated through proton radiation and ADT.
Stress may be a factor. When I retired my psa went down.
I’m thinking about asking for an MRI. There are a lot of factors: age, the BPH, stress, exercise, sexual activity…. It’s all about how much of the PSA leaks out of your prostate into your blood.
Allegedly for me at 74 a PSA of 4 is considered normal simply because the prostate gets increasingly leaky with age. So the occasional spike to 7 isn’t necessarily bad if it comes down again.
Nevertheless more data is a good thing.