You may well see people disagreeing with me here and, to be fair, I know little more about RP than what I read here plus my initial research...

All common prostate cancer treatment regimes will seriously affect your 'honeymoon' abilities.

I was your age with a similar PSA and an 'equivocal' biopsy result at the time. Over the next five years I watched my number rise all the way to 26 before having another biopsy in late 2023 and beginning treatment (ADT + IMRT) in 2024. There were reasons for this delay but I would definitely not recommend it. Luckily my cancer had not spread beyond the prostate.

If I was in your position I'm pretty sure I'd have a biopsy, do intensive 'watchful waiting', and enjoy a couple more years of your honeymoon. Once that has matured into a stable, long term relationship, then I'd discuss it deeply with her and begin to explore treatment options.

Having the biopsy sucks. All the options suck. PC sucks. Good luck!

PS: Non-PC PC joke: How do you know that a prostate biopsy is worse than childbirth? Because a year or so after a biopsy no man ever said: "Hmm, maybe I'd like another one."

PPS: I bet you $1M the urologist will shake hands with you at least once per appointment. What other doctor does that? I'm convinced this is because we know they've had their fingers in so many butts and they want to reassure us that they've washed up 🙂