Hypothalamic–pituitary–gonadal axis in which the hypothalamus and pituitary direct neuroendocrine function. The hypothalamus is located in the brain and secretes GnRH. GnRH travels down the anterior portion of the pituitary via the hypophyseal portal system and binds to receptors on the secretory cells of the adenohypophysis. In response to GnRH stimulation these cells produce LH and FSH, which travel into the blood stream. These two hormones play an important role in communicating to the gonads. In females FSH and LH act primarily to activate the ovaries to produce estrogen and inhibin and to regulate the menstrual cycle and ovarian cycle. Estrogen forms
Combined rapid anterior pituitary evaluation panel by TRH and rises in luteinizing hormone (LH) and follicle-stimulating hormone (FSH) caused by GnRH. Blood glucose levels are also monitored to ensure appropriate levels of hypoglycemia are achieved. The triple bolus test was introduced in 1973 by physicians from the London Royal Postgraduate Medical School and Queen Elizabeth Hospital, Birmingham. It followed earlier reports combining insulin and vasopressin analogues in the diagnosis of hypopituitarism. Combined rapid anterior pituitary evaluation panel A triple bolus test or a dynamic pituitary function test is a medical diagnostic procedure used to assess a patient's pituitary function. A triple bolus test is usually ordered