The presence of which hormone is primarily responsible for the symptoms associated with benign prostatic hyperplasia?

The primary hormone responsible for the symptoms associated with benign prostatic hyperplasia (BPH) is testosterone, specifically its metabolite dihydrotestosterone (DHT). In men, testosterone is converted into DHT by the enzyme 5-alpha reductase. DHT plays a crucial role in the development and enlargement of prostate tissue.

In benign prostatic hyperplasia, the proliferation of prostate cells leads to an enlarged prostate, which can cause various urinary symptoms such as difficulty starting urination, a weak urine stream, and increased frequency of urination. The accumulation of DHT in prostate tissue stimulates this cellular proliferation, contributing directly to the pathological changes seen in BPH.

While other hormones like epinephrine, insulin, and glucagon play different roles in metabolic and physiological processes, they do not have a direct impact on the growth of prostate tissue. Their involvement in urinary symptoms is minimal compared to that of testosterone and its effects on prostate health. Thus, the presence of testosterone, particularly in its DHT form, is the key factor in the symptoms and progression of benign prostatic hyperplasia.