I often wonder if it would be much better to 'force' a bleed to keep the lining thin, than it is to just take 200mg utrogestan (or 100) continuously.
By that I mean - to stop the P for 5 days every month so that a bleed happens and the lining gets shed. Doing that seems to give it an outlet and to make more sense to me, especially once you know you are building it up. I mean, the ideal is that taking the P stops the actual build up so there is nothing there to shed. But if you know you ARE building it up then stopping P for 5 days and forcing bleeds to shed and reduce the lining would be a good thing to try.
I think most doctors know F all about HRT so don't expect them to come up with this genius idea, but it is what a lot of women are doing in various US FB groups I belong to....
The "old" UK continuous regime used to be stopping it for 3 days a month (P) to allow a bleed. Then, for some reason, it was decided this was "unnecessary". But... was it really unnecessary for many women? Perhaps it was very useful...